Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Cysteine is an amino acid with a thiol (-SH) group that can bind to heavy metals such as mercury. The scientific rationale for its use in mercury poisoning centers on its role as a precursor to glutathione, a tripeptide with significant antioxidant and detoxifying properties. Glutathione can bind mercury and aid in its excretion. Some animal studies and in vitro experiments have shown that cysteine, or cysteine-derived compounds, may enhance mercury excretion. Additionally, cysteine is structurally related to the chelating drug D-penicillamine and the pharmaceutical chelator N-acetylcysteine (NAC), both of which are sometimes used in heavy metal toxicity. However, direct evidence supporting the clinical use of cysteine itself (as opposed to pharmaceutical chelators or glutathione) for treating mercury poisoning in humans is limited. Some studies suggest that cysteine may inadvertently increase mercury uptake in the brain by facilitating the transport of methylmercury across the blood-brain barrier, potentially posing a risk. Because of these mixed findings and the lack of strong clinical trials in humans, cysteine is not a first-line therapy for mercury poisoning, with established chelators like DMPS, DMSA, and BAL being preferred. In summary, while there is a biochemical basis for cysteine’s potential utility, the clinical evidence is limited and somewhat conflicting, justifying a moderate evidence rating.

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