NAC

Hi everyone... Hoping someone can share their experience.... I am taking hydroxyurea & low dose daily aspirin....... can I take the NAC supplement while on those meds ??????

[Mazcd Partner MPNVoice]

hi Keiks, you can ask at your local pharmacy for their advice. Best wishes, Maz

[Hidden in reply to Mazcd]

Thanks Mazcd .... I absolutely will try asking the pharmacist.

[hunter5582]

Please be sure to check with a knowledgeable physician regarding HU-NAC interactions. Many hematologists are not familiar with various supplements and may understandably advise against the use a something they are not sure about. I consult with an Integrative/Functional Medicine doc for these questions for that reason.

I am aware that Dr. Angela Fleischman has done research looking at the use of NAC as a component of treating inflammation in MPNs. Presumably this would include people on HU. I would caution you that when considering anti-inflammatory agents, the greater concern may be interaction with aspirin. Many anti-inflammatory agents potentiate the blood-thinning effect of aspirin. While I do not think that NAC is one of those, I would certainly not assume that to be true.

I hope you can readily rind a doc with the requisite expertise to answer your question.

[Hidden in reply to hunter5582]

Hi Hunter ... Thank you so much for your response .... I did think about how it may intensify the risks of daily aspirin... I'm going to check with the pharmacist and see what he has to say... I don't think my doctor will know much about it but I may just bring it up with him.Thanks again !!

[Hidden in reply to hunter5582]

Hello Hunter again ... so I haven't asked the pharmacy yet on NAC while on daily dose aspirin BUT ... I did a little more research and it states that "if you your possibly prone to bleeding problems then it should be discussed with your doctor" .... so this has left me thinking that bleeding in itself is a risk with PV especially someone like myself with and enlarged spleen and portal hypertension and aultrasounds SOMETIMES showing fatty liver and SOMETIMES not ... (very confusing and results are from the same imaging clinic) and there is always the risk of internal bleeding regardless of the aspirin and anything else with PV .... so I don't understand why it seems that doctors are suggesting it as NAC is an amazing supplement especially for PV inflammation BUT the warnings tell us not to use it if you have a risk of bleeding.... and there are so many with an MPN on this forum who take NAC...

so its all so confusing ..... I would love to use it if its not going to add to my risk of bleeding... but so many take it and as I mentioned some doctors suggest for PV (I've read ). Crazy confusing.

🤷‍♀️

[hunter5582]

My take on it is that it is all about risk/benefit analysis. Everything we take has its own risk/benefit analysis. Not taking anything has a risk/benefit profile. Many people, including some docs, ignore the risk/benefit profile of aspirin. While it clearly can have benefits for many, it is not a benign substance. Increased hemorrhage risk is only one potential problem with aspirin.

My take on the NAC is that the potential benefits outweigh the risks. Decreasing systemic inflammation can reduce symptom burden and may also help prevent MPN progression. There is research that supports its use (see. Dr. Fleischman et al). My docs support its use in my case; however, my Integrative Medicine doc recommended that i use L-Glutathione instead. L-Glut is the downstream anti-inflammatory agent that NAC produces in the body. My doc suggested just taking out the "middle man" NAC.

Ultimately, you will just have to use your own best judgement. If you can find one where you are, I do recommend consulting with a Integrative or Functional Medicine doc. They tend to be much more knowledgeable about these issues. there seems to be a growing movement of Integrative Oncology care that will be a real benefit to us all. Perhaps you can find someone near you.

[Hidden in reply to hunter5582]

Thanks once again hunter .... not much is "open" around here in Ontario, Canada and as a "new patient" i wouldn't want my first appt to be by phone but I'll definitely do some research on Integrative Oncology.... I really like my new hematologist/oncologist and his "team" that I have access to at an oncology clinic associated with one of best trauma hospitals in Ontario .... and PV is very serious so I wouldn't want to rely solely on integrative medicine but its definitely something to maybe co-exist with my health team. I want to look into L-Glutathione for sure.Thanks again hunter !!!!!

[hunter5582]

Just in case you have not seen this, two presentations of interest are Dr. Gowin - Complimentary Treatments for MPNs and Dr. Fleischman - Nutrition and MPNs.mpninfo.org/conferences/202...

Many other good presentations too.

A few other items

oncolink.org/support/practi...

healthydebate.ca/2014/05/to...

All the best my friend.