NAC does not cause rash or flushing as Niacin. Men on high doses of testosterone have low HDL.
Pharmacol Res. 1993 Oct-Nov;28(3):213-8.
Dose-related increase of HDL-cholesterol levels after N-acetylcysteine in man.
Franceschini G, Werba JP, Safa O, Gikalov I, Sirtori CR.
Source
Centre E. Grossi Paoletti, University of Milano, Italy.
Abstract
Changes in plasma lipid-lipoprotein levels were evaluated in 10 hyperlipidemic patients during treatment with progressive doses (from 1200 mg day-1 to 3600 mg day-1) of N-acetylcysteine (NAC). Plasma total cholesterol and triglyceride levels, as well as those of lipoprotein (a) did not change to an appreciable extent, even with the highest dosage. However, the HDL-cholesterol levels showed a significant, dose-related rise, the mean absolute increase, with the highest NAC dose, being of approximately 10 mg dl-1 (16.2%). The rise of HDL-cholesterol was independent of changes in other lipid-lipoprotein parameters, suggesting a possible direct effect of NAC on the HDL system.
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Based on the study published in Parkinsonism & Related Disorders (2026), titled "N-Acetylcysteine is associated with changes in functional connectivity in patients with Parkinson's disease," here is a summary focusing on the specific improvements observed after treatment.
Overview of the Study
The research evaluated 44 patients with Parkinson's Disease (PD) randomized into two groups:
NAC Group: Received weekly intravenous infusions (50 mg/kg) plus daily oral doses (500 mg x2) for six months, alongside standard care.
Control Group: Received standard care only.
Key Functional Connectivity (FC) Improvements
The most significant findings involved the "wiring" or communication between the basal ganglia (the brain's motor control center) and other cortical regions. After six months of NAC treatment, the following changes were observed:
Restoration of Motor Network Connectivity: NAC patients showed significantly different functional connectivity between the basal ganglia and key motor-related areas, specifically the:
Rolandic Operculum: A region vital for sensory-motor integration.
Precentral and Postcentral Gyri: Areas responsible for executing motor commands and processing touch/position.
Precuneus Integration: There was a notable change in connectivity with the precuneus, a hub of the Default Mode Network (DMN). This is significant because the precuneus is involved in self-awareness and visuospatial processing, which are often impaired in PD.
Clinical & Symptomatic Improvements
The imaging changes were not just "on paper"; they correlated directly with how patients felt and moved:
Improved UPDRS Scores: Patients in the NAC group showed a significant improvement (reduction) in their Unified Parkinson’s Disease Rating Scale (UPDRS) scores compared to the control group.
Brain-Behavior Correlation: Specifically, the changes in connectivity within the precuneus were directly correlated with the improvements in clinical symptoms. This suggests that the NAC treatment helped "re-sync" brain regions that had become disconnected due to the disease.
Dopaminergic Support: Building on previous work by the same team, these connectivity changes likely reflect NAC’s ability to increase Glutathione (GSH) levels and support Dopamine Transporter (DAT) binding, essentially protecting the surviving dopamine neurons from oxidative stress.
Conclusion
The study concludes that NAC is a promising disease-modifying intervention. Unlike treatments that only mask symptoms (like Levodopa), NAC appears to alter the underlying functional architecture of the brain, leading to measurable improvements in motor and potentially cognitive stability through its antioxidant properties.
