go get your NAC, people...

[healthabc]

check out todays study results. Best is, NAC is a healthy, wonderful antioxidant for overall health for anyone... "Natural Molecule Could Improve Parkinsons" sciencedaily.com

[whack-a-mole]

Or, for those preferring a direct link to the referred article: sciencedaily.com/releases/2...

[silvestrov]

NAC is a sulfur amino acid and is more stable than cysteine - which is used in the amino acid management protocol. Yes NAC has a therapeutic future for Parkinson's disease and has a past history of investigation to support this claim. Several articles,

N-acetyl-cysteine in the treatment of Parkinson's disease. What are we waiting for?

ncbi.nlm.nih.gov/pubmed/225...

N-Acetyl Cysteine Protects against Methamphetamine-Induced Dopaminergic Neurodegeneration via Modulation of Redox Status and Autophagy in Dopaminergic Cells

hindawi.com/journals/pd/201...

Oral N-Acetyl-Cysteine Attenuates Loss of Dopaminergic Terminals in α-Synuclein Overexpressing Mice

journals.plos.org/plosone/a...

And there are others......

There has been only 1 negative article about its use and rather than post an additional laborious, tedious and overly technical article, I am posting one from that self-promoting blowhard, Mercola. The article is simplified and easier to understand.

articles.mercola.com/sites/...

I researched NAC and the general consensus among practitioners is that it is safe unless large doses are regularly taken. I take 600 - 1,200 mg/day and most clinical trials use 1,800 mg/day.

NAC's use in medicine is to save someones life who have OD'd on acetaminophen. Excess acetaminophen destroys the liver and NAC replenishes its glutathione levels thus preventing damage. It is used in emergency wards.

[enjoysalud in reply to silvestrov]

Before Kaiser knew what was ailing my son, I paid for a SpectraCell Lab blood test. This was early 2014. That's where I first heard the word "NAC". Among the repletion suggestions they suggested 1200mg daily of NAC with each meal. He was scraping the bottom of the barrel for Glutathione. He started NAC and also Immunocal (whey protein isolate). NAC scared me, at least what I read that was available at that time. I took him off NAC for about a year. Wish I hadn't. He's back on. Silvestrov, that's why I so greatly appreciate your postings. You bring me new research to consider, but also reinforce what I have read and the action I have taken. The unsolicited support is so important. In that regard, this website is crucial for me, and your postings especially. Also, thank you, HEALTHABC, your original posting led me to read the article in ScienceDaily. I'm off to start my day!!

[silvestrov in reply to enjoysalud]

It is my pleasure to be of assistance. Of course any research I do also helps myself so sharing the information is the obvious thing to do. Here is an article about glutathione and PD:

Parkinson's disease: A disorder due to nigral glutathione deficiency?

"Amino acid analysis of autopsied human brain showed reduced glutathione (GSH) content significantly lower in the substantia nigra than in other brain regions. GSH was virtually absent in the nigra of patients with Parkinson's disease. Oxidative degradation of l-DOPA and dopamine in vivo may generate reactive oxygen species (hydrogen peroxide, superoxide, hydroxyl radical, or singlet oxygen) which can damage membranes and other cellular components. Since GSH is an important natural antioxidant, a deficiency of GSH in the substantia nigra could make this region vulnerable to oxidative injury. If confirmed, the hypothesis that loss of nigrostriatal dopaminergic neurons results from a regional GSH deficiency could have important therapeutic implications for the management and prevention of Parkinson's disease."

sciencedirect.com/science/a...

In addition to NAC I also take acetyl l carnitine and alpha lipoic acid (in the same capsule). They both pass through the blood brain barrier, raise glutathione levels, work at 100-1000 times lower concentration when combined and, like NAC, have been shown to be effective in Parkinson's disease studies:

ncbi.nlm.nih.gov/pubmed/204...

ALA is one of the only antioxidants which is both fat and water soluble so it is an universal antioxidant.

This combo should be taken on an empty stomach between meals in the morning and afternoon but it can cause stomach upset (anxiety and sleeplessness) so they should not be taken at night. If stomach upset occurs take them with a protein free meal - breakfast and lunch (I do this) because proteins compete with amino acids for entry into the BBB and will reduce their effectiveness. This is the same reason why you do not take amino acids (or protein) with levodopa because they will blunt its effect.

If someone takes ALA they should take thiamine because large doses of ALA can deplete thiamine.

Best wishes...... off to work here.

Rich

[enjoysalud in reply to silvestrov]

Silvestrov, my 54 year old son is very reluctant/resistant on his supplements. He will only take them before/during/after meals. I pick my battles. That one I left for another time. After just one week on the liquid vitamin/supplement (green tea extract, CQ10, Vit C, B-12 complex) I see visible improvement. Also, I think L-theanine has helped anxiety (along with cocktail). Silvestrov, I need guidance on the NADH. I read all that you sent and all that you sited. What brand do you suggest I buy or does it matter? Thanks!! HOT in Los Angeles today.

[silvestrov in reply to enjoysalud]

I know hot from living in Georgia for 14 years and it was balmy at times. In general, the best supplements are pharmaceutical grade and naturally they cost more. Because I take so many supplements I try to buy bulk, for example when I buy theanine I purchase the following:

nutrabio.com/mm5/merchant.m...

There are 750 200 mg servings which should last quite a long time.

NADH is more expensive than theanine and if you want to purchase pharmaceutical grade, find a bunch of products and compare prices. I always read the reviews people write because they can be brutally honest in evaluating a product and it can cut through the marketing hype.

NADH is Nicotinamide adenine dinuceotide + hydrogen, it is the biological form of hydrogen and hydrogen itself is being tested as a therapy for PD. Now this is my type of therapy - drinking a glass of water:

ncbi.nlm.nih.gov/pubmed/234...

According to an online source: "Take NADH with water thirty minutes before or two hours after meals. There are no known drug or nutrient interactions associated with NADH."

Plus, "NADH has been tested for 26 weeks at 1,000mg daily - with no negative side-effects. " Sounds safe to me....

Since CoQ10 worked so well for me I never felt the need to take NADH.

Rich

PS. Here is Birkmayer's NADH:

iherb.com/product-reviews/C...

[enjoysalud in reply to silvestrov]

Thank you! That was helpful.

[p-oui in reply to silvestrov]

Rich, if I understand correctly, you take NAC 600 - 1,200 mg/day. Can you share what benefits specifically you saw near term and perhaps long term?

The study reviewed at news-medical.net/news/20160...

subjects took 600 mg a day by pill 2 x day. They were on a mix of IV and pills and took less via IV on non-pill days. Again, the details are clearly outlined in the above link but it looks like a similar dose that you have been taking but only in pill form.

RESULTS of this study seemed very positive "Compared to controls, the patients receiving NAC had improvements of 4-9 percent in dopamine transporter binding and also had improvements in their UPDRS score of about 13 percent."

Since I am new to PD I don't know how impressive this is, do you or any others know how significant this is?

Since this is not a big pharma win I think that there must be significant reason to warrant funding for additional trials which are going on now:

clinicaltrials.gov/ct2/show...

I have reached out to Thomas Jefferson University hosting the trial and will share what I learn. Meanwhile, I am curious what others are finding specifically,

Thanks

Pamela

[silvestrov in reply to p-oui]

Pamela,

I take NAC as a cocktail of antioxidants which have been shown to work together for a singular purpose: correct mitochondrial dysfunction. NAC, along with CoQ10, alpha lipoic acid, acetyl l carnitine compliment each other and have been shown to have synergy when taken together.

The results you posted about are huge because dopamine transporter binding is important:

"The dopamine transporter (DAT) controls the spatial and temporal dynamics of dopamine (DA) neurotransmission by driving reuptake of extracellular transmitter into presynaptic neurons. Many diseases such as depression, bipolar disorder, Parkinson’s disease, and attention deficit hyperactivity disorder are associated with abnormal DA levels, implicating DAT as a factor in their etiology."

ncbi.nlm.nih.gov/pmc/articl...

If you can improve dopamine transporter binding & reuptake, "the absorption by a presynaptic nerve ending of a neurotransmitter that it has secreted", you can maintain and increase dopamine levels in the brain.

NAC is here to stay and will, I predict, become standard Parkinson's therapy.

___________________________________________________________

It is difficult for me to note specific improvements from taking NAC because it was taken in the wake of large doses of CoQ10. CoQ10 has an inconsistent clinical history in PD testing. One study said it slowed progression PD by 44% and the followup did not confirm these results. When I first took the supplement it was like a thunder clap going over my head. I had chest fasciculations, major muscle twitches visible to the naked eye, and after taken 1,200 mg on the first day, they went away. So prior to taking NAC, CoQ10 did the heavy lifting to minimize/place into remission my symptoms. After Coq10 I started to the the combo of acetyl l carnitine and alpha lipoic acid (ALA) which is a combo as powerful or even more so than NAC. The beauty of this combo is when combined they work at 100 to 1,000 times lower concentration (than taken separately). ALA is both fat and water soluable and easily passes the blood brain barrier, as does acetyl l carnitine.

Some of the scientific studies:

Lipoic acid and N-acetyl cysteine decrease mitochondrial-related oxidative stress in Alzheimer disease patient fibroblasts

" Furthermore, we observed that the protective effect of LA and NAC was more pronounced when both agents were present simultaneously."

researchgate.net/publicatio...

Combined R-alpha-lipoic acid and acetyl-L-carnitine exerts efficient preventative effects in a cellular model of Parkinson's disease.

"Most notably, we found that when combined, LA and ALC worked at 100-1000-fold lower concentrations than they did individually."

ncbi.nlm.nih.gov/pubmed/204...

Alpha lipoic acid, CoQ10, melatonin & acetyl-l-carnitine :

Management of the aging risk factor for Parkinson's disease.

"The combination of alpha lipoic acid, acetyl-l-carnitine, coenzyme Q10, and melatonin supports energy metabolism via carbohydrate and fatty acid utilization, assists electron transport and adenosine triphosphate synthesis, counters oxidative and nitrosative stress, and raises defenses against protein misfolding, inflammatory stimuli, iron, and other endogenous or xenobiotic toxins."

ncbi.nlm.nih.gov/pubmed/242...

Alpha lipoic acid & CoQ10:

"A combination of lipoic acid plus coenzyme Q10 induces PGC1α, a master switch of energy metabolism, improves stress response, and increases cellular glutathione levels in cultured C2C12 skeletal muscle cells."

ncbi.nlm.nih.gov/pubmed/226...

__________________________________________________________

I have posted this information before but it is better to get it out there several times so it can be seen by as many people as possible.

Rich

[p-oui in reply to silvestrov]

Hi Rich, thank you for your thoughtful response. This is a lot of new info to me and your taking the time to share this is greatly appreciated. To me, given all that I have read and all of it being new info, it seemed so significant these studies with NAC and I have been wondering why they don't get more press. Your comment, "The results you posted about are huge because dopamine transporter binding is important" and explanation was helpful, more than you know. I thought I was misunderstanding this.

I am very curious also about understanding CoQ10. It seems these, CoQ10 and NAC are OTC medications. No doctor has shared any info about this with me - another frustration I have so far about PD is that it is difficult to figure out what needs to be done at the very onset in terms of RX. My first doctor just prescribed C/L which I decided not to take - at least for now. I am not familiar with R-alpha-lipoic acid and acetyl-L-carnitine and will look up the studies you were kind enough to share.

I am on Azilect. It seems time to take additional steps. Thank you again. BTW, your podcast was very interesting and your art is beautiful.

Glad our paths have crossed,

Pamela

[silvestrov in reply to p-oui]

Pamela,

The scientific community is a skeptical bunch and until some piece of information has passed all the proper tests (to become fact), the information is handled in a cool and categorizing manner. Plus if a doctor prescribes something as inconsistent as CoQ10, which has not passed the rigor to become a known scientific fact, the doctor is acting unethically and legally liable too. That does not mean you cannot take 1,800 mg of NAC divided into 3 doses or try either 1,200 mg of ubiquinone, oxidized coq10, or ubiquinol, the reduced form of coq10 at 100 mg three times a day.

A few CoQ10 studies:

Study Suggests Coenzyme Q10 Slows Functional Decline in Parkinson's Disease

ninds.nih.gov/news_and_even...

High-Dose Coenzyme Q10 Does Not Slow Parkinson’s Progression

pdf.org/en/science_news/rel...

I am fading here and have a good day.

Rich

[p-oui in reply to silvestrov]

Thanks so much, greatly appreciated and I will keep you posted as I learn more about the NAC clinical trial. Enjoy your day.

[mymomhaspd in reply to silvestrov]

Your posts are very informative, thank you for that.

Im trying to start off my mom on NAC - are you saying that it wont be effective without acetyl l acrnitine and alpha lipoic acid? All hers drugs are administered by my dad, who is also in his 70's - she takes mucana with or alternating with her sinemet - what would be the best way to add this into her schedule without putting too much stress on my dad .

Can we combine all three and give it twice a day - between meals . Are there any side effects ? What is the effect of adding NAC only - one lady said her dyskinesia went away ? Any feedback on that . She has loads of stiffness, balance issues and she can get very dyskinesic - but thank god no major tremors .

Also MJF states that there is no proof that Coq10 works at all, so they stopped trials on that .

For DHEA: which according to them gets destroyed by stomach acid ?" While certain confirmatory studies remain in progress, our data to date suggest a potential role for HE3286 in the treatment of PD and parkinsonism-related disorders and provide incentive for further investigation.

[silvestrov in reply to mymomhaspd]

N acetyl l cysteine does not need either alpha lipoic acid or acetyl l carnitine to be effective. What I am suggesting is by combining synergistic supplements you get a better response than by taking one of them as monotherapy. To add fuel to my fire in regards to alpha lipoic acid - LA (with acetyl l canitine) I discovered the following article last evening, and it is a good one:

Behavioral and Neurochemical Effects of Alpha-Lipoic Acid in the Model of Parkinson’s Disease Induced by Unilateral Stereotaxic Injection of 6-Ohda in Rat

"LA is an antioxidant naturally synthesized in human body. In its structural formula, there are two thiol groups that can be oxidized or reduced thus, it is a redox couple. Both the oxidized form LA and the reduced form dihydrolipoic acid (DHLA) act as antioxidant."

"Furthermore, DHLA is able to regenerate other antioxidants with low molecular weight, such as glutathione (GSH), coenzyme Q10 and vitamins A and C."

"Therefore, α-lipoic acid prevented the damage induced by 6-OHDA or by chronic use of L-DOPA in dopaminergic neurons, suggesting that α-lipoic could be a new therapeutic target for Parkinson's disease prevention and treatment."

hindawi.com/journals/ecam/2...

NAC can be taken with or without food and ALC and ALA are best taken on an empty stomach. If ALC and ALA need to be taken with food it should be at breakfast and lunch with no protein to compete with their entry into the brain and central nervous system.

The Issue

with NAC

"Pulmonary arterial hypertension (PAH) is an elevation in blood pressure in the arteries leading from the heart to the lungs."

"Scientists at the University of Virginia School of Medicine were studying the molecular signaling involved in hypoxia-related development of PAH when they observed what seemed to be a concerning finding: mice treated with NAC over periods of 3 weeks were developing PAH that mimicked the effects of chronic hypoxia. The scientists were not studying the effects of NAC itself; they were simply using it to measure other nitrogen-related transfer reactions in blood. And the doses they used correspond to a human dose of about 20 grams (20,000 mg) per day—far above any known supplement recommendation."

lifeextension.com/magazine/...

20 grams per day? A little heavy handed anyone? The recommended dose of NAC is between 600 - 1,800 mg a day. I have taken 1,800 mg/day and currently take 1,200 mg/day.

___________________

I took them, NAC, ALA, ALC, today between breakfast and lunch and lunch and dinner on an empty stomach.

_________________________________

"People taking carnitine have reported a number of side effects, including:

Diarrhea, nausea, stomach pain, and vomiting.

Headaches. Trouble sleeping. Higher blood pressure. Lower blood sugar and higher triglycerides (in people with diabetes). Psychosis (in people with bipolar disorder).

webmd.com/vitamins-and-supp...

Alpha lipoic acid side effects:

"Although not all side effects are known, alpha-lipoic acid is thought to be possibly safe when taken as directed. Stop taking alpha-lipoic acid and call your doctor at once if you have: low blood sugar--headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or.Jun 16, 2016."

everydayhealth.com/drugs/al...

NAC side effects:

"N-ACETYL CYSTEINE Side Effects & Safety. N-acetyl cysteine is LIKELY SAFE for most adults, when used as a prescription medication. It can cause nausea, vomiting, and diarrhea or constipation. Rarely, it can cause rashes, fever, headache, drowsiness, low blood pressure, and liver problems."

webmd.com/vitamins-suppleme...

_______________________________________________________

Yes MJF Foundation gave the big thumbs down to coq10 but everyone reacts differently to supplements and it is one I could not live without. Once I accidentally forgot to take my supplements with me to work and hit up several drug stores and health food stores and purchased essential supplements to get me through the day: Coq10, fish oil, a dopamine producing supplement (tyrosine in this case), B12 in the form of methylcobalamin. It did the job and I returned home and resumed my standard therapy. Coq10 is safe, cheap and readily available. I am fortunate to have such a strong response to it.

_______________________________________________________

I took DHEA for my adrenal therapy and though I am sure it helped me but it was taken for only 4 months. I do not think it should be taken for an extended period of time. There was a study showing that spraying liquid magnesium chloride on the skin raised DHEA levels:

Magnesium-containing compositions and methods for enhancing dehydroepiandrosterone levels

"The effects of a magnesium-containing composition on DHEA levels in humans in accordance with the present invention were studied. Twenty subjects (18 female, 2 male) applied a lotion having the formulation shown in Table 1, below, twice daily for one month. Application quantities were approximately two teaspoons of lotion. DHEA-S serum levels and magnesium levels were measured before and after the study for all subjects. DHEA-S serum levels measured from blood samples were performed by the Core Endocrine Lab at Pennsylvania State University, Hershey, Pa. The DHEA-S serum measurements are accurate to within +2%. The results are shown in Table 2 below. As shown in Table 2, seventeen of the twenty subjects had an increased DHEA-S level after the study and eight of the twenty subjects for whom magnesium levels were measured showed an increase in magnesium levels. DHEA-S is present in quantities over ten times that of free DHEA. The results of this study suggest that reserves of DHEA, stored as sulfates, are increased by the methods disclosed herein. These methods offer great ease and safety for raising magnesium and DHEA levels in treated individuals. This is in marked contrast to oral administration of magnesium (e.g. magnesium taurate) which is difficult to absorb and does not increase DHEA levels."

google.com/patents/US7364753

[skpv1990 in reply to silvestrov]

I have suffered with PD since 2012 I have been lots of different meds couldn't take alot of them I would be so sick from them or had bad side effects I am taking 5 Carbidopa levodopa a day and if not careful I will get sick on them I feel that they help some but the trimmers near stop completely is it safe to take the vitamins with the Carbidopa levodopa i am 56 yrs old from ky

[silvestrov in reply to skpv1990]

It seems that Parkinson's disease patients have varying responses to whatever therapy they may be receiving whether it be drugs, vitamin supplements, exercise, etc... and caution/safety should always be the first and foremost concern.

Generally speaking, in theory anyway, specific vitamins will actually help levodopa/carbidopa to work better because the drug Sinemet/Madopar can cause certain deficiencies. For example, any form of Sinemet causes a sub-clinical niacin deficiency. If someone had a clinical niacin deficiency they would eventually develop pellagra - a skin condition with neuro-psychiatric implications. Historically pellagra = dermatitis, diarrhea, dementia and eventually, death.

The following article chronicles a man who took 250 mg/day of niacin and it improved his parkinsonian symptoms:

Low-dose niacin supplementation modulates GPR109A, niacin index and ameliorates Parkinson's disease symptoms without side effects

"The aromatic amino acid decarboxylase inhibitor carbidopa (typically prescribed as a part of carbidopa/levodopa) was shown to deplete niacin levels in the body in PD patients."

After taking niacin for 45 days: "Improvements in motor, cognitive, and sleep measures were observed following the intervention."

onlinelibrary.wiley.com/doi...

Carbidopa has been shown to also cause a deficiency of pyridoxine/vitamin B6:

Effect of pyridoxine on the depletion of tissue pyridoxal phosphate by carbidopa

"These findings suggest that large doses of carbidopa can, by depleting tissues of PLP. cause potentially undesirable nonspecific changes in pyridoxine-dependent enzymes. However, the coadministration of pyridoxine with carbidopa can maintain tissue PLP levels and protect against such enzyme changes."

researchgate.net/publicatio...

If you are taking natural levodopa as derived from mucuna pruriens plant you do not need to take pyridoxine because it decreases (carbidopa-free) levodopa's effeciency.

There are a couple of cases of levodopa/carbidopa causing epileptic siezures and one case was cured by pyridoxine administration:

tandfonline.com/doi/abs/10....

Use of any form of levodopa can raise homocysteine levels, a non-protein amino acid associated with vascular disease and dementia, and cobalamin/vitamin B12 is a cofactor in lowering homocysteine levels. If you have low B12 levels you will probably get cognitive impairment or neuropathy.

Neuropathy in Parkinson’s Disease May Be Related to L-Dopa Exposure

"Exposure to L-dopa is inevitable in most IPD patients at some point during their course, but perhaps we should be measuring MMA levels in these patients and treating with cobalamin supplementation to reduce MMA levels and prevent neuropathy."

medscape.com/viewarticle/72...

In the following study PD patients were deficient of B12 and Folate:

Folate and vitamin B12 levels in levodopa-treated Parkinson's disease patients: Their relationship to clinical manifestations, mood and cognition

"Levodopa-treated PD patients showed significantly lower serum levels of folate and vitamin B12 than neurological controls..."

"Cognitively impaired PD patients exhibited significantly lower serum vitamin B12 levels as compared to cognitively non-impaired."

sciencedirect.com/science/a...

Normally doctors give PD patients 1 mg/day of B12 in the form of cyanocobalamin. I have tried cyanocobalamin and find to be a poor imitation for the most potent form of B12 - methylcobalamin. As the following article notes:

"Treatment with high dose vitamin B12 been shown to be safe for more than 50 years."

In this article the authors chronicle daily doses of B12 given up to 50 mg and in the case of people suffering from cyanide poisoning, they receive 10 grams, that is 10,000 mg of hydroxocobalamin in a 2 hour period. That is 10 thousand times the recommended daily dose. I have taken 5 mg/day sublingual methylcobalamin for 5+ years with no negative side effects. Studies have shown that oral B12 is just as effective as raising B12 levels as is injections. Sublingual B12 is best because in some elderly patients stomach nutrient absorption is compromised with time. Plus the stomach requires adequate amounts of intrinsic factor, a protein which helps the body use B12.

Vitamin B12 (cobalamin) deficiency in elderly patients

cmaj.ca/content/171/3/251.full

Methylcobalamin/B12, methyltetrahydrofolic acid/Folic acid B9, pyridoxyl 5 phosphate/B6 are the best forms of each vitamin and being water soluble you would need to take exceedingly large doses to have negative side effects.

Have a good day (off to faking I am working).

[AmyLindy in reply to silvestrov]

Great list of references!

[horsplay]

So, is it the sulfer? If so, then that could be why MSM seems to help.

[p-oui]

A clinical trial I found on MFJJ for NAC: foxtrialfinder.michaeljfox....

They have not responded to me yet. Also, a Glutathione trial just finished and I haven't seen the results of it yet:

foxtrialfinder.michaeljfox....