Ep. 207: NAC to improve PCOS, endometriosis, and more

What do you know about N-Acetyl Cysteine? This supplement is all the rage in health and wellness spheres, but does it have anything to offer women interested in reproductive health specifically? This episode explains what NAC is, how it functions and supports the body, and what it can do for reproductive concerns like PCOS, endometriosis, and more. We'll even walk you through some recent studies that speak to concerns specific to women living with chronic period pain and infertility. In this episode, we'll cover: 

⭐ What function NAC plays in the body

⭐ What NAC has to do with oxidative stress and free radicals

⭐ Who may benefit the most from NAC

⭐ Reproductive conditions best supported by NAC supplementation 

⭐ Case studies and research related to NAC and reproductive health

NOTE: This episode is appropriate for all audiences

SHOW NOTES

Ep. 3: BASICS – Reproductive Hormones

Ep. 39: Should I be taking supplements?

Ep. 108: Choosing a Natural Family Planning (NFP) Method

Ep. 112: Implantation Bleeding

Ep. 139: Preventing scarring, adhesions, and repeat endometriosis surgery, with Dr. Naomi Whittaker

Ep. 161: A restorative reproductive physician’s top Women’s Health supplements, with Dr. Amy Hogan

Ep. 164: Insulin Resistance impacts more than your fertility and its affecting younger women -- what can you do?

Transcript

Caitlin Estes (00:24)
Welcome back to the Woven Well podcast. If you're a frequent listener of the show, then you know that we explore a lot of topics around the female body, reproductive health, wellness, and natural fertility. We interview leading medical professionals in restorative reproductive medicine, talk with respected holistic medical professionals, and real women who have been impacted by things like body literacy and fertility awareness methods. We explore how our full design--mind, body, and spirit--come together to create our rich experience as human beings and particularly female human beings in the world. But we also provide some super practical education for you like what are your reproductive hormones and why do they matter? Is implantation bleeding a real thing and how can you spot it? And how to choose a method of natural family planning for yourself. Well today we're going to have one of those super practical episodes.

And this time we're focusing in on a major supplement that's often explored in the reproductive health space, NAC or N-Acetyl Cysteine. Now we have some previous episodes on women's health supplements in general, like our interview with Dr. Amy Hogan on her top recommendations and one of our early episodes asking how to know whether or not you even need supplements.

So check those out on the show notes if you'd like to start with a little bit more of a bigger picture overview first. Now, one thing you may take away from either of those episodes is the fact that not everyone needs to be on supplements and not everyone, not even every woman should take the same ones. So certainly talk with a doctor whom you trust to listen closely and consider seriously what would support you the best now and in the long term and whether or not a supplement like this could actually be right and helpful for you. Okay, let's dive in as we look a little bit more closely at the supplement NAC. What is NAC? I think that's a really great place to start. A lot of times our supplements will have a title like that or a name and we're like, I don't know what it is. I don't know what it does, but it's supposed to be good. I thought it'd be helpful to start out with a little bit of that.

NAC is a supplement form of the amino acid L-cysteine. So amino acids are these fundamental components of nature that work together to build proteins and these proteins are essential to our survival. They work together in countless ways through infinite combinations to provide us with what we need.

Well, the amino acid cysteine is especially anti-inflammatory and serves as an antioxidant. So you may have heard about antioxidants before and that they are positive. So this will come back into play. Because of this, it's often used to treat diseases caused or worsened by something called oxidative stress or inflammation.

So basically, as I understand it, there are both free radicals and antioxidants in our bodies that live in this balance. And when that balance falters and there are too many free radicals and not enough antioxidants, that leads to cell and tissue damage, which could then progress into consequences like cancer. So you may have heard of how free radicals cause cancer. That's sort of a big statement.

It really breaks down to this underlying bodily system and balance that's going on behind the scenes. Well the good news is that there are ways to reduce oxidative stress in our lives. For instance, living in an environment with cigarette smoke or pollution can contribute to free radicals. ⁓ Exposure to certain pesticides that may be sprayed in your apartment or applied to the outside of your home or food source.

Even alcohol consumption can contribute to free radicals. So reducing or eliminating these kind of exposures as much as possible can have a positive impact on rebalancing the antioxidants to free radicals. So that's really encouraging. There are things we can do right now to reduce the free radicals in our lives, even if we can't totally control it.

Now at the same time, even if you are making transitions like this, or maybe there are exposures that you can't totally control, well you can also increase your antioxidants and that could be another way to try to improve that balance once again. If your free radicals are too high and there's only so much you can do to reduce them, then increasing your antioxidants at the same time can help with that balance.

This is where the amino acid cysteine comes in. There are natural ways to increase cysteine. So I want to start there first, especially through nutrition. So foods that are high in protein like beef, chicken, yogurt, chia seeds, eggs, whole grains, these are all natural sources that go a long way in giving us this very specific type of amino acid that can really be helpful. But for those who don't feel that they eat enough of those things or maybe you want additional support in some way, this is where a supplemental form of cysteine or NAC may be a good option. So whether you are 20 years old and working on regulating your cycles or maybe you're 30 and in the midst of family planning or 40 and just starting to think about perimenopause, the health benefits from antioxidants extend beyond just these reproductive health issues, which are very important in these different stages of life, but also to things like your cardiovascular health, bone strength, which is key after menopause, and lung function. Okay, so it may also be especially helpful for women who have diagnoses like polycystic ovarian syndrome and or endometriosis. 

So I want to talk those for just a second because I do think that sometimes when women are told those diagnoses, told they have PCOS, told they have endometriosis, it can feel very defeating. Okay now what? You know there's nothing I can do about this or I'm gonna have to be on these really strong medications or I'm going to have to get a surgery and I want to make sure that you know those options because if you do have endometriosis then you do deserve to know about the treatment of excision surgery and how well that can take care of endometriosis for you, but it may not be the right fit for everyone. And so our goal is to provide a wide variety of resources and things that can support you on your journey, no matter where you are and what treatment you feel comfortable with or uncomfortable with. You deserve to know options that are out there. 

So let's start with PCOS for just a second because PCOS is a condition that's often associated with insulin resistance. Okay, and we have multiple episodes worth listening to if you are at all interested in learning about the possibility of insulin resistance. But for now, I'll simply say that high insulin levels can have a negative impact on ovarian cells, causing things like reproductive hormones like testosterone to increase and making a healthy ovulation process a little bit more challenging, maybe even less likely for you to successfully and consistently ovulate. So this is pretty intimidating and it can feel very overwhelming to know that you have PCOS, yet there are lots of things that can be done to help improve that. One of those things may be to take NAC.

So there was a study published in the early 2000s that looked at the role of NAC in providing metabolic support to women diagnosed with PCOS. So basically for four to five weeks, actually for five to six weeks, the women were given either 1.8 gram of NAC if their BMI was under 30 or three grams if it was over 30.

And then lab work was done measuring their insulin resistance levels before and then after the NAC treatment over the five to six weeks. What they found was that NAC improved the insulin levels in all participants and even improved cholesterol in those who had elevated insulin levels. There was also a significant decrease in testosterone and free androgens and a significant increase in SHBG, which is sex hormone binding globulin, suggesting that NAC also improved hormonal health that could have been negatively impacted by insulin otherwise. This is critical. Just something as simple as taking NAC at those dosages for five to six weeks such a dramatic and that significant change in these hormonal levels, insulin levels, even cholesterol, which I was surprised that they looked at that. So it's really encouraging that this could have such an impact. Obviously this study is old and it's not enough, but it is an encouragement. At least I think it is all the same. 

NAC can be effective, inexpensive, wildly available, and at least for the participants in this particular study, totally free of side effects. So it's absolutely something worth considering. Now there's also another study and this one is more on endometriosis and looking at that in particular. So all the patients who had previously been diagnosed with endometriosis were treated with 600 milligrams of oral NAC three days a week for three months and improved in their study, it improved both the pain caused by endometriosis and the size of that were found on the participants ovaries. So often when endometriosis is very advanced and those cells that should be in the lining of the uterus are outside of the lining of the uterus, the more advanced it is, you are more likely to see endometriomas. So these like growths or type of cysts that can be found on the ovaries. And so this study was looking at those as well. And actually the showed an improvement in both those endometriosis symptoms, like painful periods, and some even saw those endometriomas shrink in size after just that three month study. So again, very significant. Now, another point to note is that in this particular study of those ladies who are being studied who are also trying to conceive, because it wasn't all of them, but those who were trying to conceive, 75 % conceived within six months of using the NAC treatment even without any fertility treatments. So I think this is pretty important to know. The fact that NAC can have such an impact and over a short window of time. The first study was five to six weeks. The second study was three months. So very reasonable amount of time. It's not like you have to be on this supplement for years to potentially see these results.

At the same time, think that it's important to clarify that I don't think that supplements are the end all be all of women's reproductive health care. Okay. ⁓ Just like I'm not a big fan of just throwing a medication at a symptom. I think that we can also be too quick to do that for supplements as well. ⁓ Medications and supplements are different though. So we have to be reasonable in what we expect for them to do and in how we want to balance their use within our lives. So supplements often come with fewer side effects and risks, although you should always check with your doctor before beginning one. They also may be cheaper and easier over the counter than a lot of medications. And they may be a great option as you look for ways to participate in your own health and well-being.

So there is a wealth of information out there that you can make use of. And in partnership with your doctor, you can talk about things that you are interested in. You you've read and they can make sure that it's safe for you to take. And then you can be good to participate in that way in, you know, using supplements that they may or may not have thought to recommend in the beginning. Now, if you'd like to learn more about supplements that may be right for you, is important to find a doctor who you can partner with to identify those underlying causes of whatever reproductive health issues or other issues you may be having to help you get a personalized plan to address them. 

Okay, so, whether that's going to be through nutrition and lifestyle changes like reducing toxic exposure, taking supplements or trying out medications, whatever it may be you want to find what's right for you.

We often recommend working with someone trained in restorative reproductive medicine because they value that. They do not treat you like a number. It is very individualized and they want to make sure that you know that your concern is worth their care. Well, of course we at woven natural fertility care refer clients to medical professionals like that all the time. So if we can support you in that journey and help you find that right physician or medical professional, we would be more than happy to help you do that.

You can feel free to reach out to us at Woven Fertility

to get started and find someone in your area or someone that you could work with to really get to these underlying issues. It's so important that you have someone that you can trust as you go through the process. Finding the right physician for that is critical. Now, am I a physician? No. So this is not medical advice. And that's why I keep reminding you to make sure to find someone. But I just want to encourage you that there really are good medical professionals out there who can partner with you on this journey and who value the approach that you want to take. Is it surgery? Is it medications? Is it supplement? Is it lifestyle changes? There are ways to find the right plan for you. If you have other topics that you'd like us to explore.

Feel free to email us. You can email at hello@wovenfertility.com and we love to hear your ideas. As always, thanks for listening as we continue to explore together what it means to be woven well.