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NAC for PCOS: Does it Help?

If you’re one of the 6-12% of American women living with polycystic ovarian syndrome, or PCOS, you are likely looking for a better way to manage your symptoms.1 

Unfortunately, the most common guidance given to women with PCOS is to just “eat healthy and lose weight.”

Several options have been investigated to help with the treatment of PCOS. 

This article will walk you through what the NAC supplement is and the most up-to-date research  regarding the various claims made about using NAC for PCOS. 

This article is for informational purposes only. Always consult with your healthcare provider before starting any new supplements.

What is N-Acetyl Cysteine?

NAC, or N-acetyl Cysteine, is an antioxidant used as a possible complementary treatment. Many claim that the benefits of NAC supplements can help treat a wide range of conditions, from COVID to mood disorders to PCOS.

Antioxidants help protect our cells at a molecular level. Normal metabolic processes can result in the production of free radicals, which can alter the DNA of our cells.

When our bodies have increased amounts of free radicals, this can result in oxidative stress and inflammation. 

Antioxidants bind to free radicals, therefore helping to reduce oxidative stress and inflammation in our bodies.2 

We know that women with PCOS are at increased risk of oxidative stress and inflammation, which may contribute to symptoms and associated health risks.

Therefore, it has been theorized that NAC may help manage PCOS. 

NAC for PCOS: How could it help?

Decreased inflammation

Research shows that people with PCOS have elevated levels of blood inflammatory markers. 

Increased inflammation is associated with many of the signs and symptoms of PCOS, including weight gain and insulin resistance.

What we don’t know yet is the root issue. This is a “Which came first: the chicken or the egg?” situation with the inflammation and insulin resistance.

The inflammation may contribute to insulin resistance, or the insulin resistance may result in the inflammation.4

Regardless, the antioxidant function of NAC could help reduce inflammation, and could help improve associated insulin resistance and weight gain.

Ovulation and Fertility

It is suspected that the improved insulin sensitivity that may come from NAC may help encourage ovulation.5 

A meta-analysis showed that women with PCOS who were supplementing with NAC saw improved rates of ovulation and pregnancy when compared to a placebo.5  

Reduced androgens

Elevated testosterone levels contribute to acne, excessive hair growth on your face and body, and male pattern hair loss (hair loss around front and top of the head). 

Reducing inflammation and insulin resistance has been shown to help decrease testosterone levels, therefore improving these symptoms.5 

Can I Take NAC for PCOS Hair Loss and Acne?

Because NAC helps reduce inflammation, people with PCOS on a NAC supplement may notice the following:

  • Improved acne
  • Improvement in hair loss 
  • Reduced growth of unwanted facial or body hair

Although the research does indicate that testosterone levels may be reduced with NAC supplementation, there is limited evidence supporting the use of NAC to reduce acne, hair loss, and unwanted facial hair.

Decreased insulin resistance

Insulin resistance is a common concern for many with PCOS. Insulin is a hormone that allows glucose to enter cells.

This hormone binds to a receptor on the cell, which then allows glucose to go into the cell to be used for energy.

The problem with insulin resistance is that the insulin is not able to bind to the receptor as effectively. This results in higher levels of insulin in the bloodstream, and often higher blood sugars. 

Many doctors will prescribe metformin to help manage blood sugars and improve insulin resistance.

However, NAC has been researched as an option that may help your cells to become more sensitive to insulin. A study by Fulghesu et. al showed that women who took NAC had improvement in their peripheral insulin sensitivity.6 

To learn more about blood sugar balance with PCOS, check out our article about fruit and insulin resistance.

Is NAC like metformin? 

NAC has been proposed as an alternative to metformin. 

One study that compared NAC to metformin for the treatment of PCOS saw greater improvements in lipid panels, fasting blood sugar, and fasting insulin in the NAC group compared to the metformin group. However, review of other randomized control trials did not see this difference.7,8

More research needs to be conducted to see if NAC would be an adequate option to replace metformin.

Improvement in fatty liver disease

Several animal studies have shown that NAC supplementation may help protect against non-alcoholic fatty liver disease. However, more research needs to be conducted on humans to confirm these findings.9 

Dose of NAC for PCOS

Most studies that look at the use of NAC for PCOS used 1200-1800mg/day in divided doses.5,8

How long does it take for NAC to work?

Most studies provided treatment with NAC for 2-12 months, with the shortest duration seen at 5-6 weeks of treatment.5,6, 

Final Thoughts

Some research indicates that NAC may help reduce insulin resistance, androgen levels, and inflammation as well as encourage ovulation in people with PCOS.

However, studies on the effectiveness of NAC for PCOS have been mixed.

Oral use of NAC is generally considered safe. The most common side effects are nausea, vomiting, and diarrhea.10 Like most medications or supplements, there is a rare risk of severe allergic reaction.

Given the potential benefits, oral use of NAC for PCOS may be helpful for managing symptoms.

What else has been helpful in managing your PCOS? Let us know in the comments below!

Interested in learning more about natural ways to manage PCOS? Check out these articles on adrenal PCOS or PCOS teas.

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