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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Emme_V2 on March 23, 2013, at 23:22:47
Hi. A few months ago, I tried N-acetylcysteine to augment Lamictal. I believe i was taking 1,200 mg, but I'd have to double check. I think the pdoc who recommended it said to get up to 2,400 mg (again - I'd have to find the notes). Anyway, around that time, I had a few weeks of overpowering fatigue and weak-feeling arms and legs. My primary care doctor found nothing to explain it, and it was chalked up to a recurrence of depression since I have sometimes had bad fatigue as a symptom. But just to be safe, I discontinued the NAC. Then the fatigue evaporated. The timing of the start and end of the fatigue suggests NAC might have been doing it, but I can't really be sure without doing a retrial. I cannot find anything on the internet indicating fatigue as a possible side effect.
My question is this: has anyone here had a similar experience with NAC?
Thanks,
emme
Posted by rovers95 on March 24, 2013, at 19:15:30
In reply to NAC and fatigue?, posted by Emme_V2 on March 23, 2013, at 23:22:47
> Hi. A few months ago, I tried N-acetylcysteine to augment Lamictal. I believe i was taking 1,200 mg, but I'd have to double check. I think the pdoc who recommended it said to get up to 2,400 mg (again - I'd have to find the notes). Anyway, around that time, I had a few weeks of overpowering fatigue and weak-feeling arms and legs. My primary care doctor found nothing to explain it, and it was chalked up to a recurrence of depression since I have sometimes had bad fatigue as a symptom. But just to be safe, I discontinued the NAC. Then the fatigue evaporated. The timing of the start and end of the fatigue suggests NAC might have been doing it, but I can't really be sure without doing a retrial. I cannot find anything on the internet indicating fatigue as a possible side effect.
>
> My question is this: has anyone here had a similar experience with NAC?
>
> Thanks,
> emmeYes, I had definite brain-fog with this and was absolutely exhausted. Funnily enough Dr Cheney (a leading CFS doctor) advocates strongly against its use.
Cheers
Rover
Posted by Emme_V2 on March 25, 2013, at 5:39:59
In reply to Re: NAC and fatigue?, posted by rovers95 on March 24, 2013, at 19:15:30
> > Hi. A few months ago, I tried N-acetylcysteine to augment Lamictal. I believe i was taking 1,200 mg, but I'd have to double check. I think the pdoc who recommended it said to get up to 2,400 mg (again - I'd have to find the notes). Anyway, around that time, I had a few weeks of overpowering fatigue and weak-feeling arms and legs. My primary care doctor found nothing to explain it, and it was chalked up to a recurrence of depression since I have sometimes had bad fatigue as a symptom. But just to be safe, I discontinued the NAC. Then the fatigue evaporated. The timing of the start and end of the fatigue suggests NAC might have been doing it, but I can't really be sure without doing a retrial. I cannot find anything on the internet indicating fatigue as a possible side effect.
> >
> > My question is this: has anyone here had a similar experience with NAC?
> >
> > Thanks,
> > emme
>
> Yes, I had definite brain-fog with this and was absolutely exhausted. Funnily enough Dr Cheney (a leading CFS doctor) advocates strongly against its use.
>
> Cheers
>
> RoverThanks, Rover. That sounds like my experience. I should discuss this further with my doctor. Based on the debilitating level of fatigue I had, I feel like it's kind of a risky proposition and odds are I won't try it again. Do you know why Cheney is opposed to its use for CFS?
emme
Posted by former poster on March 29, 2013, at 0:25:52
In reply to Re: NAC and fatigue? » rovers95, posted by Emme_V2 on March 25, 2013, at 5:39:59
Sounds like your dose is too high? NAC can decrease oxygen levels looking to similar symptoms of altitude sickness.
Posted by Emme_V2 on March 30, 2013, at 6:28:10
In reply to Re: NAC and fatigue? » Emme_V2, posted by former poster on March 29, 2013, at 0:25:52
> Sounds like your dose is too high? NAC can decrease oxygen levels looking to similar symptoms of altitude sickness.
Interesting thought. I was at half the recommended dose, and I started at a quarter of the recommended dose for at least a few days. I don't think what I experienced was particularly like altitude sickness, but yes, it might have just been too much. I seem to be a "low dose" person for most things.
Posted by Emme_V2 on March 30, 2013, at 6:31:44
In reply to Re: NAC and fatigue? » Emme_V2, posted by former poster on March 29, 2013, at 0:25:52
> Sounds like your dose is too high? NAC can decrease oxygen levels looking to similar symptoms of altitude sickness.
Just curious where you found this information.
NAC can reduce reactive oxygen species, which is a desirable effect.
Posted by former poster on March 30, 2013, at 23:45:20
In reply to Re: NAC and fatigue?, posted by Emme_V2 on March 30, 2013, at 6:31:44
I heard about the hypoxia side effect from at least 2 different sources, but all I could find right now is this little paragraph from Wikepedia:
http://en.wikipedia.org/wiki/Acetylcysteine#Adverse_effects
Researchers at the University of Virginia reported in 2007 study using very large doses in a mouse model that acetylcysteine could potentially cause damage to the heart and lungs.[31] They found that acetylcysteine was metabolized to S-nitroso-N-acetylcysteine (SNOAC), which increased blood pressure in the lungs and right ventricle of the heart (pulmonary artery hypertension) in mice treated with acetylcysteine. The effect was similar to that observed following a 3-week exposure to an oxygen-deprived environment (chronic hypoxia). The authors also found that SNOAC induced a hypoxia-like response in the expression of several important genes both in vitro and in vivo.
The implications of these findings for long-term treatment with acetylcysteine have not yet been investigated. The dose used by Palmer and colleagues was dramatically higher than that used in humans;[31] nonetheless, positive effects on age-diminished control of respiration (the hypoxic ventilatory response) have been observed previously in human subjects at more moderate doses.[32]
Posted by Emme_V2 on March 31, 2013, at 6:59:56
In reply to Re: NAC and fatigue? » Emme_V2, posted by former poster on March 30, 2013, at 23:45:20
> I heard about the hypoxia side effect from at least 2 different sources, but all I could find right now is this little paragraph from Wikepedia:
>
> http://en.wikipedia.org/wiki/Acetylcysteine#Adverse_effects
>
> Researchers at the University of Virginia reported in 2007 study using very large doses in a mouse model that acetylcysteine could potentially cause damage to the heart and lungs.[31] They found that acetylcysteine was metabolized to S-nitroso-N-acetylcysteine (SNOAC), which increased blood pressure in the lungs and right ventricle of the heart (pulmonary artery hypertension) in mice treated with acetylcysteine. The effect was similar to that observed following a 3-week exposure to an oxygen-deprived environment (chronic hypoxia). The authors also found that SNOAC induced a hypoxia-like response in the expression of several important genes both in vitro and in vivo.
> The implications of these findings for long-term treatment with acetylcysteine have not yet been investigated. The dose used by Palmer and colleagues was dramatically higher than that used in humans;[31] nonetheless, positive effects on age-diminished control of respiration (the hypoxic ventilatory response) have been observed previously in human subjects at more moderate doses.[32]Thanks. From the Wikipedia article, then, they've observed effects that mimic hypoxia-like responses in mice (doesn't say that it actually *causes* hypoxia) at very high doses and that some gene expression effects have been observed in vitro. I wouldn't take those statements to indicate that NAC is going to cause something akin to altitude sickness in humans at moderate doses. From the last sentence, it sounds like at least one study indicates a positive effect on control of respiration if I'm reading it correctly and "positive" means what I think it does - it is tricky to look at studies cited out of context in Wikipedia in areas that are not my specialty and I've have to hunt down the original article to dope it out.
That said, you may very well be right that for whatever reason, I just can't handle the recommended dose. Anyway, I'm holding NAC in reserve for now while I see how a downward titration of Lamictal goes. The minocycline still seems to be helping enough that I may be able to lower or perhaps even stop Lamictal.
Posted by rovers95 on April 3, 2013, at 18:24:32
In reply to Re: NAC and fatigue? » rovers95, posted by Emme_V2 on March 25, 2013, at 5:39:59
> > > Hi. A few months ago, I tried N-acetylcysteine to augment Lamictal. I believe i was taking 1,200 mg, but I'd have to double check. I think the pdoc who recommended it said to get up to 2,400 mg (again - I'd have to find the notes). Anyway, around that time, I had a few weeks of overpowering fatigue and weak-feeling arms and legs. My primary care doctor found nothing to explain it, and it was chalked up to a recurrence of depression since I have sometimes had bad fatigue as a symptom. But just to be safe, I discontinued the NAC. Then the fatigue evaporated. The timing of the start and end of the fatigue suggests NAC might have been doing it, but I can't really be sure without doing a retrial. I cannot find anything on the internet indicating fatigue as a possible side effect.
> > >
> > > My question is this: has anyone here had a similar experience with NAC?
> > >
> > > Thanks,
> > > emme
> >
> > Yes, I had definite brain-fog with this and was absolutely exhausted. Funnily enough Dr Cheney (a leading CFS doctor) advocates strongly against its use.
> >
> > Cheers
> >
> > Rover
>
> Thanks, Rover. That sounds like my experience. I should discuss this further with my doctor. Based on the debilitating level of fatigue I had, I feel like it's kind of a risky proposition and odds are I won't try it again. Do you know why Cheney is opposed to its use for CFS?
>
> emme
>The experiences of specialists in CFS such as Cheney seems to be surrounded by secrecy. However, the anecdotal reports on the phoenix rising foruma relate to two suicides when individuals were supplementing high doses of NAC and also the more common observation of 'NAC-flu'.
Cheers
Rover
Posted by former poster on April 9, 2013, at 13:31:18
In reply to Re: NAC and fatigue? » Emme_V2, posted by rovers95 on April 3, 2013, at 18:24:32
I recenty switched from Bluebonnet 500mg NAC to Natural Factors 500mg NAC because Bluebonnet was sold out.
I don't feel any positive effect from the Natural Factors and possibly may be making me feel ill. It doesn't have the sulfur smell either.Is there a difference? Could the difference in quality be the factor for these posters mixed results?
This is the end of the thread.
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