Evidence supporting the use of: N-Acetyl Cysteine
For the health condition: Multiple Sclerosis

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Synopsis

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

N-Acetyl Cysteine (NAC) has some scientific rationale for being explored as a supportive therapy in Multiple Sclerosis (MS), but the evidence base is still limited and largely preliminary. NAC is a precursor to glutathione, a key intracellular antioxidant, and it is hypothesized that boosting antioxidant defenses may help counteract the oxidative stress implicated in the pathogenesis of MS. Several preclinical studies in animal models of MS (such as experimental autoimmune encephalomyelitis, EAE) have shown that NAC supplementation can reduce demyelination and neuroinflammation, likely via its antioxidative and anti-inflammatory effects.

In humans, evidence is sparse. A small pilot clinical trial published in 2020 (Berk et al., Frontiers in Neurology) investigated the effects of NAC (administered both orally and intravenously) in MS patients over two months. The study found some improvements in cerebral glucose metabolism (as measured by PET scan) and reported subjective improvements in cognition and attention, but the sample size was small and the study was not blinded or placebo-controlled. There are no large, high-quality randomized controlled trials establishing NAC as an effective treatment for MS symptoms or disease progression.

In summary, while there is a plausible scientific mechanism and some initial animal and pilot human data suggesting potential benefit, the current evidence remains weak (rated 2/5), and NAC should not be considered a proven or primary therapy for MS at this time.

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