N-Acetylcysteine (NAC)

[Jarvik]

Since NAC is a precursor to glutathione, would there be any benefit to taking glutathione instead? It's possible that some of the complications with NAC are as a result of poor conversion to glutathione. This would be similar to folic acid building up to harmful levels in people who have the MTHFR gene mutation. Such people do not convert folic acid to l-methyl folate (the bioavailable form) very well and are therefore advised to take l-methyl folate instead of folic acid.

Glutathione is available OTC in the U.S. and is rather benign. Noted neurologist Dr. David Perlmutter in Florida prescribes glutathione IV therapy to his patients for a variety of maladies, including Parkinson's and peripheral neuropathy.

I wonder if a aggressive regimen of glutathione IV therapy, like that which is administered for neuropathy, would benefit tinnitus sufferers?

Maybe it's time to see if I can find a physician who will prescribe a glutathione IV...

 

[Jarvik]

Following up on my previous post...

My physician agreed to begin a glutathione IV regimen today. I'll give it a few sessions and report further details.

Anecdotally, there are two disparate opinions on glutathione versus NAC. The neurologist I mentioned in the previous post uses glutathione IV therapy in his patients, typically in the range of 15 ml of 200 mg/ml delivered intravenously over about 10 minutes. Obviously, he thinks IV glutathione is well absorbed and well tolerated. In contrast to this, the Austin psychiatrist, Dr. Emily Deans, seems to be more of a fan of NAC, stating that there's a rate limiting conversion mechanism when supplementing with NAC, versus glutathione, that better ensures optimal levels of both NAC and glutathione than supplementing with glutathione does.

Perlmutter's application is focused on neurological degradation whereas Dean's focus is on behavior, largely aimed at autism spectrum disorders. Maybe their different applications of NAC/glutathione is what gives rise to the preference of one over the other.

 

[DutchGuy]

I see this can help people with H.
Does this also help H. from acoustic trauma? I hear every sound amplified. from soft to loud sound.

 

[OddV]

@Jarvik any relief from your first IV session?

 

[Street Spirit]

Thanks @jazz you're a goldmine, as usual.
You didnt have to go through all that trouble though. I've would've been happy with just a yes/no answer too
I think I'm gonna try it if I can find it and hope for the best.

Hey lapidus, did you try it? and did it help? how are you doing?

 

[lapidus]

Hey lapidus, did you try it? and did it help? how are you doing?

I'm on 600 mg per day, the recommended dose on my stuff is 600 mg X 2 per day but I havent started taking that dose yet. No effect at all so far and I don't really expect it to work.

 

[Street Spirit]

I'm on 600 mg per day, the recommended dose on my stuff is 600 mg X 2 per day but I havent started taking that dose yet. No effect at all so far and I don't really expect it to work.

Sorry it isn't working for you lapidus :/..perhaps taking the reccommended dose might? I am going to give it a try and will post my findings here.

 

[jazz]

I'm on 600 mg per day, the recommended dose on my stuff is 600 mg X 2 per day but I havent started taking that dose yet. No effect at all so far and I don't really expect it to work.

After 30 days, I would discontinue it. These supplements either help or not. And there's no reason to take supplements that are not doing anything for you.

That said, it's a shame you can't purchase the oral version of NAC. Everyone should take this supplement when they are going to experience noise exposure (weddings, concerts, etc.) or if they have to take a drug that could be ototoxic.

 

[lapidus]

After 30 days, I would discontinue it. These supplements either help or not. And there's no reason to take supplements that are not doing anything for you.

That said, it's a shame you can't purchase the oral version of NAC. Everyone should take this supplement when they are going to experience noise exposure (weddings, concerts, etc.) or if they have to take a drug that could be ototoxic.

No, I'm not taking the effervescent tablets, I bought this one instead:
http://www.iherb.com/Now-Foods-NAC-600-mg-250-Veggie-Caps/694

 

[jazz]

Just an update.

I am still on NAC, same dosage (600 mg, 2x a day), but have not experienced additional improvement from my last report. (To summarize, my tinnitus is lower--quite a bit--but I still have loud days and still occasionally spike. I have no known side effects from the medication.)

My conclusion is that NAC may help lower your tinnitus, but whatever tinnitus patterns you had prior to taking the drug will remain. The noise will be reduced, but may still cycle and be quite loud at times. (Which is true for me.)

I am debating how much longer I'll be on the drug, but at least through Christmas. Then I'll reevaluate.

 

[OddV]

What are the downsides to taking it long term?

 

[jazz]

I've only read of one serious side effect, but it's a big one--pulmonary arterial hypertension (PAH). Of course, the side effect was in mice. And mice studies don't necessarily translate to people.

On the other hand, new research suggests NAC might help with PAH. And numerous studies suggest it is helpful to the lungs. Overall, there's one negative study and dozens of positive ones so I don't believe there's a real risk to humans. But you never know.

Of course, anyone considering any drug or supplement should look up its uses, side effects, and potential drug interactions. The internet makes this information very accessible and offers multiple, high quality sources like this one: http://www.rxlist.com/n-acetyl_cysteine/supplements.htm

References:

http://www.ncbi.nlm.nih.gov/pubmed/17786245

http://www.ncbi.nlm.nih.gov/pubmed/?term=acetylcysteine improves established monocrotaline-induced pulmonary hypertension in rats

http://www.ncbi.nlm.nih.gov/pubmed/25308344​

 

[1MW]

First 600mg i feel burning/bad taste when smoking a cig.
Tinnitus became worse with very hf spikes only manageable with benzos.
Some resolution to tensor tympanic syndrome associated with hyperacusis .
Other side effects was a mild dizziness and a strange sense to my stomach.
I has some effect on hearing but it's difficult to me to continue it because it can make the things worse.
But i think i found a simple solution for 1-2-3khz tonal component of my T.
A lot of time before i had observed that i can change this tonal component (1-2-3khz)
if i put my finder in the ear canal and push at different directions for example if i push
up tinnitus become less and i push down becomes louder or by altering the pressures in eustachian tube.
For these reason i made systematically negative middle ear pressure (with valsalva/toynbe manuveur) to reduce the tonal component this has result after some time hf tinnitus in noise form to arrive.

I make more experiments and if i find some interesting i will reply.
Because this can be a spontaneous improvement and needs more testing to approve it.

 

[valeri]

@jazz
I'm desperate, have this horrible high pitch hiss and I can't help but think it's from NAC?
It happened around the time I was stopping it! I was on 600mg.
What is the chance of that?

 

[1MW]

NAC definitely works very low but works.
Try it. It lowers 0.5-2 to 10 scale and do hearing stabilization for reactive to noise T.
The results last little time from time you taken it but it is cheap with low side effects so try it.

 

[SethL]

I have been taking the time-release 600mg NAC 3X daily for the last 2.5 weeks. It is no cure, but I do notice a decent reduction in the volume and annoyance. The time release capsules say that they last 8 hours, so I've been taking one 600mg at 7am, another at 3pm, and a last one when I go to bed at night usually around 10 or 11pm.

This brings my daily total intake to 1800mg.

Is anyone else here on TT taking a similar dose?

The paper about the woman who had success said that she was taking 2g daily. I haven't experienced any bad side effect thus far. I will say that I'm considering trying out Potiga/Trobalt as well. I got my ENT to give me a prescription for it, but haven't filled it just yet. If I do fill it here in the US, it will cost me about $800 for a 2 month supply, enough for a decent trial.

I prefer to try these types of less harmful supplements before experimenting with prescriptions drugs with their potential side effects.

 

[jazz]

@jazz
I'm desperate, have this horrible high pitch hiss and I can't help but think it's from NAC?
It happened around the time I was stopping it! I was on 600mg.
What is the chance of that?

I don't believe that could happen. It's just coincidental. NAC may not help you, but I don't believe it makes your noise louder. The only exception would be when you come off the drug. If you come off rapidly, your tinnitus might spike temporarily. But it should revert back to baseline.

I've recently decreased from 1200 mg to 600 mg and so far I've had no ill effects. And I've been on the supplement for several months.

Be strong. And try not to focus on the new noise. I get random noises all the time. Some times they will stick for a while but will later go away.

 

[1MW]

@jazz
I'm desperate, have this horrible high pitch hiss and I can't help but think it's from NAC?
It happened around the time I was stopping it! I was on 600mg.
What is the chance of that?

same here stopped and got HF T

 

[valeri]

same here stopped and got HF T

High frequency tinnitus?

 

[1MW]

very high frequency T and i measure lower hearing in high frequencies
but i can modulate the HF hearing threshold with valsalva manuveur.
http://onlinetonegenerator.com/hearingtest.html

 

[jazz]

same here stopped and got HF T

Tinnitus is variable and unpredictable. I don't see how NAC increases someone's noise, and I've read over a dozen research articles. It doesn't seem possible to me. NAC is used for otoprotection for a variety of conditions, including noise exposure and antibiotic ototoxicity. NAC works be increasing glutathione in one's body; glutathione is an antioxidant that protects cells from free radical damage. And glutathione also helps to reduce glutamate, which is increased tinnitus.

http://www.huffingtonpost.com/dr-mark-hyman/glutathione-the-mother-of_b_530494.html

http://evolutionarypsychiatry.blogspot.com/2012/06/glutathione-we-loves-it-nac-and-autism.html​

That said, if anyone feels like they are getting harmed--with any type of supplement or drug--they should stop the therapy. After all, the point is to get better--not worse.

@1MW and @valeri If the NAC somehow increased your tinnitus, your noise will revert back to baseline upon discontinuation. If your noise doesn't revert back, then I'd suspect something else is going on. Earlier this week, I had two horrible days (not from the NAC), and I reverted back to normal. I don't see how the supplement could've damaged your hair cells since NAC is used to protect hearing.

take care and hugs!!

 

[Markku]

Please let me take this moment:

I have to say that I never stop being impressed by @jazz's posts. She always puts a significant amount of effort in researching vital information about any subject she writes about.

Thanks jazz!

Also, I'm still taking NAC. Now 1200 mg per day.

No positive change. Overall, my tinnitus has gotten worse, but not due to NAC (noticed the worsening before NAC).

 

[LadyDi]

Agreed, @Markku. @jazz is the best. She is able to translate the medicalize of research. Her posts always are balanced (no grandstanding here), informed, timely -- and caring. While I deeply appreciate Jazz's intelligence, what I value most is I feel she cares about us all. Plus she has the cutest avatar ever.

Here is to Jazz... and all TT managers. All of you have helped me make it to today. Blessings and my gratitude.

 

[jazz]

Please let me take this moment:

I have to say that I never stop being impressed by @jazz's posts. She always puts a significant amount of effort in researching vital information about any subject she writes about.

Thanks jazz!

@Markku Thank you for the faith you've placed in me. You've created a forum that is truly a gift to the tinnitus community. Indeed, Tinnitus Talk is the tinnitus community. This is our only place for knowledge and support. And this goodness stems from your vision to create this forum. We are all in your debt.

I'm grateful to contribute and proud to be part of the forum.

@LadyDi Thank you for the very kind words. And I always enjoy reading your posts. Your knowledge, kindness, and common sense are second to none! And thank you for your contributions. I've learned much from them and continue to learn. (And I love your Literary Cat!)

Well, it's time for more research, for learning never ends!

 

[1MW]

Initially NAC improved me (i was very bad with spikes etc) and for 2 days had for some time 0db.
|One day sleep with totally 0db with my ear covered by pillow in a super sillent room.
Then after almost a pack NAC i got HF T and then stopped NAC.
After stopped i got freaking bad headache (migraine type) and massive profound multitonal T with severe hyperacusis.
After and because i was in panic from this situation i got big dose of oral streroids (methyprednisole) benzos and paracetamol.
Today iam better with 1db 5db T and not so much H maybe is from steroids or the good sleep.
The T was so severe that lorazepam hasn't any effect to it* has only some effect to headache.
* my baseline T stops almost with 3mg lorazepam if iam off from all benzos for 1-2 months.

My conclution is that NAC do something to hearing but is can not say if it is good o bad.
Some got T from NAC taking it for other reason.

A nice article http://evolutionarypsychiatry.blogspot.gr/2012/06/glutathione-we-loves-it-nac-and-autism.html

But remember all these medications are temporary the true solution is to find the cause of T and cure the cause.

 

[Marcini]

"But remember all these medications are temporary the true solution is to find the cause of T and cure the cause."

Now if anyone figured that one out they would become a trillionaire.

I was going to try NAC but the recent comments haven't been the most positive. Now I'm not so sure. Its always hard to tell whether or not a supplement made something better, worse or indifferent. When I started taking Mg I appeared to have a spike. I stopped taking it then restarted later and no spike the second time. Was the Mg the cause first time? Who knows. I suspect NAC will be much the same. Sadly these supplements often provide very little benefit at best.

 

[SoulStation]

"But remember all these medications are temporary the true solution is to find the cause of T and cure the cause."

Now if anyone figured that one out they would become a trillionaire.

I was going to try NAC but the recent comments haven't been the most positive. Now I'm not so sure. Its always hard to tell whether or not a supplement made something better, worse or indifferent. When I started taking Mg I appeared to have a spike. I stopped taking it then restarted later and no spike the second time. Was the Mg the cause first time? Who knows. I suspect NAC will be much the same. Sadly these supplements often provide very little benefit at best.

I love NAC. It is good for you regardless and is protective of hearing.

 

[Marcini]

@SoulStation Did you notice any positives on the tinnitus front?

 

[SoulStation]

@SoulStation Did you notice any positives on the tinnitus front?

I did a few times after I started use. Now I try not to look at my tinnitus too hard at all so maybe it helps sometimes. I take it more for protective purposes.

 

[valeri]

Can I take high dose 1200mg all at once after noise exposure and for how long?