Synopsis

Source of validity: Scientific
Rating (out of 5): 3

N-Acetyl Cysteine (NAC) has some scientific validation for use in systemic lupus erythematosus (SLE), primarily based on its biological effects as a precursor to glutathione, a key antioxidant. Research indicates that patients with lupus often have increased oxidative stress and depleted glutathione levels, which may contribute to immune dysregulation and tissue damage. Clinical studies, such as a 2012 randomized, double-blind, placebo-controlled trial published in Arthritis & Rheumatism, found that NAC supplementation (up to 2.4g/day) significantly improved disease activity scores and reduced fatigue in SLE patients. These effects are thought to be due to NAC’s ability to replenish glutathione, suppress T-cell activation, and inhibit mTOR (mechanistic target of rapamycin), a pathway implicated in lupus pathogenesis. However, the overall evidence base is still modest, with relatively few well-powered clinical trials. Some studies note gastrointestinal side effects at high doses, and not all outcomes have been consistently positive. NAC is not part of standard lupus therapy guidelines, but its favorable safety profile and mechanistic rationale have led to off-label use as an adjunct in certain cases. In summary, while not a first-line treatment, NAC has a moderate degree of scientific support for its adjunctive use in lupus, primarily due to its antioxidant properties and effects on immune pathways.

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