N-Acetyl Cysteine (NAC)

Beneficial for COVID-19?

Time to geek out a little bit.

I wanted to share a couple of drawings that demonstrate how N-Acetyl Cysteine (NAC), is effective in quenching Reactive Oxygen Species (ROS), the most damaging free-radicals produced in the body AND with regard to SARS-CoV-2 (the virus causing COVID-19), NAC prevents the formation of Von Willebrand’s Factor the main culprit that is causing blood clotting which obstructs small vessels in COVID-19 infections leading to hypoxia and contributing to death. (See the articles below). NAC also contributes cysteine which boosts the body’s production of glutathione, the “Master Antioxidant” and powerful quencher of ROS and other free-radical oxidants. The “Cytokine Storm” we are hearing so much about with COVID-19 is partly as a result of this whole process of increasing oxidative stress. Other factors include, the immune system’s attempt to destroy the virus, whereby it releases oxidizing chemicals to attack it and the upregulation of inflammatory cytokines, hence cytokine storm. If a person is “primed” for out-of-control inflammation due to chronic systemic inflammation, they are ripe for a cytokine storm. People with hypertension, diabetes and obesity and other co-morbidities are already primed in this way. That is why it is important to be PROACTIVE and reduce systemic inflammation BEFORE they contract COVID. Once they do it is often too little too late. Changing a person’s inflammatory status through diet and supplementation can take weeks. Stress this to your loved ones and encourage them to start now! Have them email me at info@wellnessdoc.com if they need help with a game-plan.

The source of the diagrams below is a podcast I have been following from MedCram.com, an online medical education site. I have been following Roger Seheult M.D., an exceptional instructor covering the COVID-19 Pandemic. He has four board certifications in pulmonology, emergency medicine, pulmonology and sleep. He works daily in a hospital and is actively involved with treat COVID positive patients. You can watch his exceptional daily COVID-19 Updates on YouTube, or at the MedCram site. www.medcram.com

Oxidative stress causes disease and the mechanisms for reducing it

The left side of the chart represents oxidation and moving right to reduction

Starting from the left and working right… This diagram shows how oxygen (O2) can be oxidized to two forms of Reactive Oxygen Species (ROS), the dangerous Superoxide Radical O2¢ .and then further right into an equally dangerous Hydroxy Radical (OH¢). The Superoxide and Hydroxy Radicals are very unstable and represent the most damaging oxidative free radicals to our health.

  • Below on the left side, you can see how Superoxide Dismutase Enzyme (SOD: formed by zinc, copper and manganese), can convert the Superoxide radical back to oxygen (O2) or to hydrogen peroxide (H2O2).
  • Beneath the Hydroxy Radical, you can see how GSHPX can convert it into harmless water (H2O).

In the middle with the green arrows at the top, you see how the hydrogen peroxide (H2O2), can be converted by the Catalase enzyme back to oxygen (O2) and water (H20) on the right. Water is the most greatly reduced form (least harmful, since the body is approximately 70% water).

The purple area is the one that pertains to NAC and glutathione.

  • The 2 GS-H is the reduced form of glutathione, with a sulfhydryl group (S-H).
  • The GSHPX is the Glutathione Peroxidase Enzyme, which along with glutathione reduces the hydrogen peroxide (H2O2) into water (H2O). This is where the magic happens with glutathione!
  • The G-S-S-G on the right, is the oxidized form of glutathione with a di-sulfide bond (S-S). It then regenerated back into glutathione by GSH Reductase Enzyme. The GSH Reductase Enzyme also converts NADPH into NADP+.

Why are blood clots (thrombosis) developing and how can NAC help prevent it?

Now that we have a basic understanding about where NAC effects the process of the Hydroxyl Radical, this chart shows how NAC and in turn Glutathione prevent the development of the von Willebrand’s Factor (vWF) clotting element.

The reason he calls this a hypothesis, is that even though many studies (some you will see below) have demonstrated this effect, there have not been enough large-scale randomized trials to definitively prove this out.

Starting at the left…

SARS-CoV-2 binds to the ACE2 receptors on cell membranes, decreasing ACE2 activity         

  • That cause an increase in Angiotensin 2 and a decrease in Angiotensin 1 and 7
  • That increases Hydroxy Radical (OH¢)
  • That causes endothelial cell dysfunction (affecting the cells lining the blood vessels)
  • That triggers an increase in Von Willebrand’s Factor (vWF), released when there is damage to the endothelium
  • Which then causes thrombosis (clotting)

Recent autopsies of lungs from people that have died of COVID-19 have found that the small vessels are full of these clots, reducing blood flow and preventing oxygenation of the blood. These clots can form in other vessels and organs as well. This explains some of the other manifestations of COVID-19 complications.

NAC can work at two spots in this process:

  • Directly on the Hydroxy Radical (OH¢)
  • By decreasing Von Willebrand’s Factor (vWF)

Ways to increase the body’s production of glutathione:

In addition to NAC as a contributor of cysteine, vitamin C and selenium also contribute, as do sulfur containing foods like onions, scallions, garlic, shallots, beef, fish and poultry and others. Undenatured whey protein is another good source of cysteine and glutamine, assisting in the production of glutathione. Glutathione supplements are not very effective because orally, it is poorly absorbed. Another non-invasive way to boost glutathione is sub-lingual glutathione (available at the link after the articles below. Intravenous glutathione is another effective way and is used in many studies on glutathione.

Featured NAC Article: von Willebrand’s Factor & NAC

N-acetylcysteine reduces the size and activity of von Willebrand’s Factor in human plasma and mice

From the article Discussion:

Our experiments demonstrate that NAC has many effects that could be of benefit in TTP and other thrombotic disorders involving hyperreactive forms of vWF. These effects included reduction of vWF multimer size, removal of ULVWF strings from the endothelial surface, and marked shortening of the time to reestablish normal blood flow in the microvasculature of ADAMTS13-deficient mice challenged to secrete vWF. Even at concentrations of NAC with no discernible effect on vWF multimer composition, NAC reduced the disulfide bond encompassing the vWF A1 domain, which is important for vWF’s ability to bind platelet GPIb. The effect of NAC on vWF’s hemostatic potency was demonstrated by its inhibition of platelet agglutination to ristocetin and prolongation of the aperture closure time measured by PFA.


And a graphic representation of the effects of NAC from the same article


Other articles showing benefit with NAC and respiratory/viral infections including Acute Respiratory Distress Syndrome (ASRDS) and the blood clotting and oxidative stress complications of COVID-19

N-Acetylcysteine as an antioxidant and disulphide breaking agent: the reasons why


N-acetylcysteine attenuates systemic platelet activation and cerebral vessel thrombosis in diabetes


High dose N-acetyl cysteine improves inflammatory response and outcome in patients with COPD exacerbations


The effect of N-acetylcysteine on biofilms: Implications for the

treatment of respiratory tract infections


Effects of N‑acetylcysteine treatment in acute respiratory distress syndrome: A meta‑analysis


N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia


In Vitro Study of N-acetylcysteine on Coagulation Factors in Plasma Samples from Healthy Subjects


Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment


The effect of N-acetylcysteine on blood coagulation and platelet function in patients undergoing open repair of abdominal aortic aneurysm


Potent Thrombolytic Effect of N-Acetylcysteine on Arterial Thrombi


N-acetylcysteine inhibits thrombosis in a murine model of myeloproliferative neoplasm


N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19

A Study of N-acetylcysteine in Patients With COVID-19 Infection


Disulfide Bond Reduction of Von Willebrand’s Factor byADAMTS-13†


Visit my page at https://www.wellnessdoc.com/nutritional-viral-prevention-and-treatment-products/ to learn more about NAC and several other natural antiviral prevention and treatment nutrients, including product recommendations. You also have access to purchase products there that I have hand selected as the finest available.

Alan Palmer

I have been a practicing chiropractor for 30 years. Originally from Minnesota, I graduated from Northwestern College of Chiropractic in 1985. Since 1996 and 1998 respectively, I have provided chiropractic care for the players, coaches and employees of the Arizona Coyotes National Hockey League Hockey Club and the Arizona Diamondbacks Major League Baseball Team. In addition, I provided care for the San Francisco Giants in spring training for 7 years. Since 1985 I have been studying functional medicine applications, Complementary Alternative Medicine (CAM) concepts and advanced clinical nutrition strategies. I welcome stubborn and complicated cases and those that traditional allopathic medicine has failed. One of my goals is to help people to reduce their dependency on medications. I do this by addressing the underlying causes of their illness or disease rather than treating their symptoms. This is accomplished by focusing on the restoration of normal healthy biochemistry and function through diet, exercise, supplementation and lifestyle modification.