I’ve decided to break down my supplements post, as it’s been hanging over my head feeling like too much work to get started on for way too long now. So I’m going to do a Spotlight on Supplements feature every so often and just introduce one supplement at a time. Remember that I am not a medical professional and am not qualified to give advice on supplements, I’m just sharing my research and personal experience with you. Talk with your doctor if you want to change what you’re taking, over-the-counter or not.
NAC, or N-Acetyl Cysteine, is a new addition to my mound of supplements I take to help with my CRPS. It’s a derivative
Schematic of the metabolism of acetaminophen (paracetamol) by the hepatocyte. (Photo credit: Wikipedia)
of L-Cysteine, an amino acid used by the liver to help break down toxins. NAC specifically is used to bind with the toxic by-products of acetaminophen (Tylenol) that occur as the liver breaks down the drug. This is important for pain patients because we often are taking a high amount of acetaminophen as part of our medications–common prescriptions of both hydrocodone (Vicodin) and oxycodone (Percocet) contain high levels of acetaminophen.
The acetaminophen in these drugs is present for two reasons. First, opioids are more effective at pain control when combined with a little acetaminophen. Second, the acetaminophen is present as a not-very-well-thought-out deterrent to abuse of opioid prescription medications, as acetaminophen in too-large doses causes liver damage. Because this is a punitive system, it merely serves to make people who take too many of these pills very ill, eventually. Not the best deterrent, to make a sick person (addict) sicker (liver damage) for being sick, but what can I say, our society’s treatment of drug addiction is inhumane and I find it sickening. See previous posts for more on that.
However, many people have been prescribed these kinds of combination pills for breakthrough pain with an as-needed label. For instance, I had one prescription that was labeled, “Take 1-2 every 6 hours as needed.” Sounds great, except my new doctor pointed out that the maximum of 8 pills a day, which was what I was needing at that time, was significantly over the safe maximum daily dose of acetaminophen, which is 3000mg/day. (New doctor=better than old doctor! He changed my prescription to a better ratio for me.) Even at the safe maximum, it can be hard for the liver to keep up with processing all that acetaminophen without using up the necessary amino acids.
Another factor is the typical diet of a pain patient: we’re not cooking ourselves labor-intensive home-cooked meals so much as trying to eat as best as we can with the energy we have to spend on our food. Some days, this is a well-rounded diet. On more difficult days, TV dinners and other quick fixes are more the norm. This makes supplements even more important for us, since we are not fully in control of our diets.
NAC supplements could be helpful to anyone who takes a regular amount of acetaminophen every day, and that includes many of us with CRPS or other pain conditions.
If you think my Spotlight on Supplements feature is a good idea, or a bad idea, or if you have any requests for specific supplements for me to cover, tell me what you think in the comments!