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7) N-acetyl-cysteine (NAC). NAC is a form of cysteine, an amino acid that is the rate-limiting factor
in the production of glutathione. NAC is more resistant to water absorption during storage, so it
is often used instead of cysteine. One randomized, double-blind, placebo-controlled study
investigated treatment of children with autism with NAC. Dosage was 900 mg every day for the
first 4 weeks, then 900 mg twice daily for 4 weeks and 900 mg three times daily for 4 weeks.
The treatment group had significantly more improvement in irritability than the placebo-group.
There were no measurements of glutathione, but it is a critical component of glutathione and
probably raised levels of glutathione.
Hardan A Y, et al., A Randomized Controlled Pilot Trial ofOral N-Acetylcysteine in Children with
Autism Biol Psychiatry. 2012 Jun 1;71(11):956-61. £pub 2012 Feb 18.
Figure 1 shows a schematic of the methionine cycle, which leads to the production of SAM.
Methionine is available from most dietary sources of protein (beef, chicken, nuts, etc). It is also
made in the body by recycling homocysteine, which requires vitamin B12 and folinic acid.
Methionine is converted to SAM to SAH to Homocysteine. Homocysteine is then either recycled to
methionine or converted into cystathionine, some of which eventually becomes glutathione.
Figure 2 Reduction of GSSG to GSH (net result of a more complex process which involves FADH).
NADH is the enzymatic co-factor needed to recycle glutathione.
Agape is proud to have been involved in this study and mentioned on page 16.>