Thursday 11 July 2013

Long Term Mood Improvement using NAC in Autism

A more recent post on this subject is here:

NAC (N-Acetyl Cysteine) is an anti-oxidant that is part of the autism therapy I have implemented.  I have now received feedback from other parents who are also surprised by the positive effect it has on their child with autism.  So far, it has had a positive impact in 100% of cases.

In the literature, there are several schools of thought as to why NAC is effective. 
  1. As a free radical scavenger in its own right
  2. As a precursor to Glutathione (GSH)
  3. As a glutamate antagonist
  4. Reducing homocysteine
Glutamate is one of the brain's two most important neurotransmitters, the other being GABA.  Glutamate is excitatory and so too much of it would cause you a problem.  NAC can act as an antagonist to glumate.  This is all very nicely explained by Emily Deans, a psychiatrist in Massachusetts who has a very interesting blog of her own.
In my research into the autism comorbidity asthma, I also came across plenty of talk about oxidative stress and anti-oxidants.  NAC is used, but it seems like they are looking for something stronger.

The main impact is as a precursor to Glutathione (GSH)

I recently learnt that in autism (or at least the one my son is affected by) the reason is without doubt number two.  The other roles (scavenger/antagonist) are irrelevant.

The reason I know this, is that after a few months NAC effectively stopped working.  This coincided with an asthma flare-up.  Now, I initially thought that the asthma attacks had released inflammatory cytokines and that these had stimulated the ever-present neuro-inflammation in the brain.

This is highly plausible and indeed I have literature showing which cytokines are released by asthma attacks.  So I thought that by firmly dealing with the asthma, I would at the same time subdue the autism.  This did not happen.

So after a few days I came up with "plan B", which did prove to be successful.  I hypothesised that the NAC had stopped working because I was not giving enough vitamin B12, which is part of the chemical process in which GSH is synthesised from NAC.  I have no means of knowing how much is needed exactly. In related processes both vitamin B6 and B9 are also involved.

I increased the B vitamins and within hours things began to revert towards the previous behavioural equilibrium.

So it was most likely the failure of NAC to produce GSH, and thus reduce oxidative stress, that had sparked the asthma flare-up. (this is will be covered on my later post of asthma as a comorbidity in autism)

But how much B12 is needed to synthesise GSH?

In your diet you have vitamins B6, B9 and B12, but it is unclear how much is needed to synthesise GSH.  A further complication is that B vitamins are not well absorbed in the gut, and some people absorb them better than others.  Older people are known to absorb B12 poorly.  There are expensive sub lingual B vitamin supplements, but there is no evidence that they actually work better.

There are at least two NAC products targeted at older people to protect them from memory loss and Alzheimer's disease:-

 Both products combine NAC with vitamins B6, B9 and B12,

                                             Over the counter NAC        Cerefolin NAC        Betrinac

N-acetylcysteine (NAC)              600mg                            600mg                     600mg
Vitamin B9 (folate)                                                          1,000 mcg               800 mcg
Vitamin B6                                                                           25mg                       20mg
Vitamin B12                                                                    1,000mcg                1,000mcg

 Both products are for preventing memory loss, rather than just increasing GSH.

For a comprehensive look into B vitamins including their role in the brain, and how they are (or are not) absorbed, take a look at this link from the US Office of Dietary Supplements.

Reducing homocysteine

Homocysteine is linked with strokes, and particularly in the US there are doctors who use NAC for the purpose of lowering homocysteine.

Dr. Baum, medical director of the Mind/Body Medical Institute, a Harvard affiliate, recommends 1,000 micrograms (mcg) of folate, plus 25 milligrams (mg) of vitamin B6, 1,000 mcg of B12, and 1,800 mg of the amino acid N-acetyl-cysteine (NAC). "With folate, B6, B12, and NAC supplements, almost everyone will have normal homocysteine levels," says Dr. Baum.

There is even a discussion about the role of homocysteine in autism.  A very recent paper from Poland is: A focus on homocysteine in autism

I think think that high homocysteine, just like low GSH, is a marker of oxidative stress.  In some of the literature it is stated that homocysteine cause oxidative stress.

Here is another paper: Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism

And yet another one:-


If you read all the papers you will come across various graphics showing biological cycles within the body, like the one below.  This is how I know that the various B vitamins are needed.

Vitamin B12 Therapy

I really just need to know how much B12 is needed and how to give it.  In the end the best resource turned out to be a  bulletin from a US medical insurer, and here it is:-

Clinical Policy Bulletin:  Vitamin B-12 Therapy

The document is very thorough; here are some key parts:-


Vitamin B-12 belongs to the family of cobalamins. It is available in all animal-derived foods, and is absorbed at a rate of 5 mcg per day. After being ingested, vitamin B-12 becomes bound to intrinsic factor, a protein secreted by gastric parietal cells. The vitamin B-12/intrinsic factor complex is absorbed in the terminal ileum by cells with specific receptors for the complex. The absorbed complex is then transported via plasma and stored in the liver. Since the liver stores 2,000 to 5,000 mcg vitamin B-12 (adequate for up to 5 years), dietary deficiency of cobalamin (Cbl) is rare. In most cases, vitamin B-12 deficiency is due to an inability of the intestine to absorb the vitamin, which may result from an autoimmune disease that reduces the production or blocks the action of intrinsic factor, or from other diseases that result in intestinal malabsorption. The most frequent underlying cause of vitamin B-12 deficiency is pernicious anemia, which is associated with decreased production of intrinsic factor.

In a systematic review of randomized trials on vitamin B-6, B-12, and folic acid supplementation and cognitive function, Balk and colleagues (2007) stated that despite their important role in cognitive function, the value of B vitamin supplementation is unknown. A total of 14 trials met selection criteria; most were of low quality and limited applicability. Approximately 50 different cognitive function tests were assessed. Three trials of vitamin B-6 and 6 of vitamin B-12 found no effect overall in a variety of doses, routes of administration, and populations. One of 3 trials of folic acid found a benefit in cognitive function in people with cognitive impairment and low baseline serum folate levels. Six trials of combinations of the B vitamins all concluded that the interventions had no effect on cognitive function. Among 3 trials, those in the placebo arm had greater improvements in a small number of cognitive tests than participants receiving either folic acid or combination B-vitamin supplements. The evidence was limited by a sparsity of studies, small sample size, heterogeneity in outcomes, and a lack of studies that evaluated symptoms or clinical outcomes. The authors concluded that there is insufficient evidence of an effect of vitamin B-6, B-12, or folic acid supplementation, alone or in combination, on cognitive function testing in people with either normal or impaired cognitive function. This is in agreement with Clarke et al (2007) who stated that randomized trials are needed to ascertain the relevance of vitamin B-12 supplementation for the prevention of dementia.

Vitamin B-12 therapy can be administered orally or by injection. Vitamin B12 tablets of up to 5,000 mcg may be obtained over the counter without a prescription.

In a review on vitamin B-12 deficiency, Oh and Brown (2003) noted that, because most clinicians are generally unaware that oral vitamin B-12 therapy is effective, the traditional treatment for B-12 deficiency has been intramuscular injections. The authors cited evidence that demonstrates, however, that oral vitamin B-12 has been shown to have an efficacy equal to that of injections in the treatment of pernicious anemia and other B-12 deficiency states (Elia, 1998; Lederle, 1998; Kuzminski et al, 1998; Lederle, 1991). The authors explained that, although the majority of dietary vitamin B-12 is absorbed in the terminal ileum through a complex with intrinsic factor, there is mounting evidence that approximately 1 % of a large dose of oral vitamin B-12 is absorbed by simple diffusion which is independent of intrinsic factor or even an intact terminal ileum.
Kuzminzki et al (1998) reported on the outcome of 33 patients with vitamin B-12 deficiency who were randomized to receive oral or parenteral vitamin B-12 therapy. Patients in the parenteral therapy group received 1,000 mcg of vitamin B-12 intramuscularly on days 1, 3, 7, 10, 14, 21, 30, 60, and 90, while those in the oral treatment group received 2,000 mcg daily for 120 days. At the end of 120 days, patients who received oral therapy had significantly higher serum vitamin B-12 levels and lower methylmalonic acid levels than those in the parenteral therapy group.

 On treating B12 deficiency :-

Although the daily requirement of vitamin B-12 is approximately 2 mcg, the initial oral replacement dosage consists of a single daily dose of 1,000 to 2,000 mcg (Lederle, 1991; Oh and Brown, 2003). This high dose is required because of the variable absorption of oral vitamin B-12 in doses of 500 mcg or less. This regimen has been shown to be safe, cost-effective, and well tolerated by patients.


Long term high dose NAC will require careful supplementation with B vitamins.   If NAC is using up vitamin B12 faster than your child is absorbing it from food and supplements, B12 will be used up from the liver and other vitamin stores in the body.  These stores will eventually be depleted and vitamin B12 deficiency will result, if you continue to give NAC.  This is best avoided.

If money is of no concern, best to buy Cerefolin NAC or Betrinac.  If on a budget, then use the cheap NAC available on-line or in your pharmacy; but be careful to supplement far higher amounts of B6, B9 and B12 than the RDA (recommended daily amount).

Cerefolin NAC and  Betrinac have 400 times the RDA of B12, 4 times the RDA of B9 and 15 times of B6.  But each of these tablets only has 600mg of NAC.  In the autism trials the dose of NAC is 4 times higher.

It is evident that B12 is the key vitamin that acts as a precursor with NAC to form GSH (Glutathione), so this is the one to keep a close eye on should your child's NAC appear "to stop working".

It looks like 1,000 mcg of B12, of which 1% may be absorbed, is a fair place to start.  Such supplements are relatively inexpensive, and widely available.



  1. Hi Peter, thanks for your informative blog.
    You reference Dr. Deans blog above that nicely describes the NAC/Glutamate pathway. Another blog that describes this pathway can be found here.

  2. Thanks for the comment. Anti-oxidants like NAC seem to have very wide ranging potential benefits. In diabetes, they even reduce the amount of insulin the body needs, which I found quite remarkable.

  3. Just for informative purposes only, but we started the NAC protocol (I do get the BioAdvantex NAC) a couple of months ago. I no longer have bite marks on my arms. I haven't been hit, bit, or kicked (and his teachers at school haven't been, either) Repetitive behaviors...reduced, but not eliminated...He does handstands. It's really kind of funny, but we think he likes the pressure on his shoulders. Also, some vocalization things (kind of a c-note that he hits and holds).

    1. Great to hear your feedback.

      The effect does increase with the dosage, I expect you know that.

  4. Hello,
    I am new to your blog - thank you for the fascinating research! I have two questions: If I choose the Cerefolin route to introduce NAC, can I give 5 tablets per day to achieve the 3g dose you mention or will this result in too much of the accompanying B vitamins? My second question is, have you come across any research relating to the risk of Pulmonary Arterial Hypertension (PAH) with high dose NAC therapy?

    1. I would give pure NAC and then you will know for sure what substance works. If you give a high dose of B vitamins as well, you will not know was it the NAC or the B vitamins that worked. The high quality NAC is available as Fluimucil in Europe and PharmaNAC in the USA.

      Everything has some kind of possible side effect. Cardiologists at Harvard were recommending NAC + B vitamins to reduce homocysteine, to protect the heart. They would be familiar with PAH.

      I always use the smallest dose that is effective. It depends how much oxidative stress is present. Perhaps start with one tablet and gradually increase while observing the effects. Then you can reduce the dose until you notice that you have lost the positive effects. That way you will find the minimum effective dose. This dose should vary with the type of autism and body weight of the individual.

      There are other antioxidants and it would make sense to vary them to avoid any side effects. First you have to find which one(s) are effective.

  5. Speaking of vitamins and poly pills, what's your thought on this:

    1. If I were to pick a multi-vitamin, it would likely be this one given it is used in ASD studies and was able to restore oxidative stress and methylation markers back to normal, similar to the Jill James study on MB12 and folinic. It also already has lithium, NAC and CoQ10 in low dosages which is not usually present in other brands, so can consolidate 4 different supplements into one. For more sustained clinical effect, need much higher dosages of NAC throughout the day than what is in this multivitamin.

    2. It does have a lot of ingredients. Some people seem to benefit from certain things that have no impact on others, so it might make sense to go step by step. NAC at high doses really works wonders. Some people find MSM helpful. Carnitine helps with mitochondrial dysfunction, but you can diagnose this with lab tests. If these pills help, then you have to figure out which ingredients helped. Then you can better understand your type of autism and refine the therapy.

  6. I tried NAC for my son's tics mainly (and his Asperger's) but it didn't seem to work, not even at high doses. I want to reduce Risperdal (he's been on it for 3 years) but the tics seem to come back more intense. Any ideas? I thought of Clonotril or Clonidine.I'm not sure about the dosage though. My son weighs about 80kg(he's put on weight with Risperdal). Which would be more effective with tics and anxiety?

    1. I would suggest showing that paper I suggested to your doctor:-

      The Management of Tics

      You may find that withdrawing Risperdal is the trigger for the increase in tics, so perhaps you need to very gradually reduce the dose.

      Here is a link to a step by step guide, from doctors at Harvard:-

    2. Continue to supplement with NAC 165mg - 420mg and B-Vitamins but include Octanoic Acid 80mg - 200mg.

    3. My son had nervous tics and multiple doctors couldn't figure out why. My sons babysitter mentioned magnesium working for another child so I tried it and my sons tics were almost gone the same day and completely dissipated after about 2 weeks. My son isn't autistic but in case the info can help anyone, I thought it'd be good info to share.

    4. Thanks, magnesium does indeed to have a very positive effect in some people, and that includes autism. It is easy to try it.

  7. I hace vive muy son NAC 900 mg\8 h his steriotip has lowered but not stop.He 60 kg.Can I give him more dosis?Till how much?

    1. Plenty of people are using 2,700 mg per day in people less than 40kg.

      You can give 900 mg three times, or you can even 450 mg six times.

      The half-life of NAC is short and so giving NAC more often may give a better result. You can also buy sustained release NAC,called "NAC SUSTAIN".

      Maybe best idea is give a big 900mg dose when he wakes up and then spread out the other 1800 mg through the day. There is no point giving it at bedtime.

  8. Any thoughts on how much NAC might a 2 years old take? Thanks

    1. More relevant is probably weight. I know a boy who needed 1800mg as a four year old to control stimming. Whatever dose you give needs to be split in three or so doses through the day. So you could try 300mg three times a day, for example. It does vary from person to person.

  9. Thanks peter for your blog. I just bought pharmanac and it was delivered today. My son is 110 pounds. He is autistic and among his obsessions is food and vocal stimming. I was searching for the dosage when I came across your blog. The pharmanac has 900 mg of NAc. Isn't 900 enough for the day.

    1. You will likely need three 900mg tablets a day. You can make it work even better by splitting the tablets in half and dosing more often. You could also use sustained release NAC. So its 2,700mg and after 3 or 4 hours the effect wars off. The cheap NAC capsules also work and are much cheaper.

  10. It's very likely that I haven't studied enough yet, so be patient with me... I have a 9 year old with Aspergers and I'd like to help her get control of OCD and impulses, for her safety and future. So now I'm debating two antioxidants: ala and NAC. But wouldn't ALA be safer, albeit slow acting, especially if there might be a Mercury or heavy metal issue in the body/brain? And wouldn't ALA also address the high glutamate levels? And cross the BB barrier? Either way, if Mercury is present and starts getting stirred up, one would need to be prepared to help toxins out of the body so they don't just stir around and create symptoms, right?

    I've heard NAC can be tough on the stomach... And mostly destroyed by stomach acids before very much of it even gets absorbed. Has this come up in your research?

    Still learning here, as much as I can. Any info would be appreciated, thanks!

  11. Angela, NAC and ALA are very similar, they are both "thiol" antioxidants. Both are used widely as drugs for various conditions. In many countries NAC is prescribed to very young children as a mucolytic agent; its helps dissolve mucus/phlegm. ALA is widely used to help treat problems associated with diabetes. None of these people seem to have any problems with mercury and I guess many have amalgam fillings.

    People with autism have oxidative stress and therefore cannot dispose of metals as quickly as typical people. One role of the body's own antioxidants is to dispose of unwanted substances, that get picked up from the environment. But these antioxidants have been overwhelmed by problems created by the autism.

    NAC and ALA and most other antioxidants will chelate metals. This why people who give high doses of chelating substances to treat their perceived "vaccine injury" will see an improvement in behavior. In trying to remove various metals, they have reduced oxidative stress, which is the real problem.

    NAC has not caused problems either or my sons. If it was destroyed by stomach acids, doctors would not be prescribing it to children with suborn mucus or Grandpa with COPD (severe asthma.

  12. Regarding PharmaNac I was going to order it but read the formulation changed a couple of years ago and that it is now made in India and has Sucralose (Splenda) which is something our family avoids due to the cancer risk. How do you feel about this? I was so excited about Pharmanac and I am now disheartened to hear they have formulated it with Sucralose?

    1. There are plenty of other producers of NAC, packed in gelatin capsules, which you can open. They do not taste good.

      In most countries effervescent N-Acetylcysteine is a prescription drug called Fluimucil, this is not sold in the US.

  13. Did you happen to see the study on NAC done at Indiana University? This study was a 12-week randomized, double-blind, placebo-controlled pilot trial of oral NAC in youth with ASD.
    The results of this trial indicate that NAC treatment was well tolerated, had the expected effect of boosting GSH production, but had no significant impact on social impairment in youth with ASD.
    Peter why do you think this is?

    1. In my son NAC stops stereotypy/stimming almost from the first pill. I am not sure what they mean by social impairment and I have no idea why that was the primary goal of the trial.

      In some people, but not my son, NAC stops self injury. Clearly oxidative stress causes different behaviors in different people, this should not be a surprise.

      I am beginning to think that all substances will be deemed to be failures in trials, because the people running the trials do not understand what autism is, but that would come as news to them.

  14. Hi Peter, soon after I got a mild autism diagnosis for my son at 2.8 years which I expected all along I immersed myself in literature promising recovery with simple and safe supplements ...books are devoted to such possible recoveries especially for newly diagnosed high functioning kids..advocated by some much respected medical professionals. I tried gluten free, Caesin free, supplemented with efa, vitMins , minerals and then tried digestive enzymes and probiotics. And would you believe with every new treatment I got clear improvements which stalled or reverted to baseline depending on the feature involved. Then I stopped everything and the pattern repeated itself. So ultimately reducing the quantity of milk which my kid used to drive like crazy and which he started refusing point blank and which gave him deep peaceful sleep, everything else seems to be the placebo effect. He continues to improve in areas where we have not provided any intervention and had he been on somdthing we would have attributed the natural gain as being brought about by the magical supplement. As expected, it's the highest functioning kids who seem to benefit by the treatments which makes me doubtful about the actual role the vit and minerals play viz a viz the spontaneous improvement graph of these kids. Although books like overcoming autism and those by Martha Hebert seem to energize parents into proactive roles and work to improve general health of their kids it seems to me like a huge spurious movement where agendas particularly green activism has got mixed up with autism treatment selling organic soaps to green hirings as a cure for autism.

  15. Hi Peter, soon after I got a mild autism diagnosis for my son at 2.8 years which I expected all along I immersed myself in literature promising recovery with simple and safe supplements ...books are devoted to such possible recoveries especially for newly diagnosed high functioning kids..advocated by some much respected medical professionals. I tried gluten free, Caesin free, supplemented with efa, vitMins , minerals and then tried digestive enzymes and probiotics. And would you believe with every new treatment I got clear improvements which stalled or reverted to baseline depending on the feature involved. Then I stopped everything and the pattern repeated itself. So ultimately reducing the quantity of milk which my kid used to drive like crazy and which he started refusing point blank and which gave him deep peaceful sleep, everything else seems to be the placebo effect. He continues to improve in areas where we have not provided any intervention and had he been on somdthing we would have attributed the natural gain as being brought about by the magical supplement. As expected, it's the highest functioning kids who seem to benefit by the treatments which makes me doubtful about the actual role the vit and minerals play viz a viz the spontaneous improvement graph of these kids. Although books like overcoming autism and those by Martha Hebert seem to energize parents into proactive roles and work to improve general health of their kids it seems to me like a huge spurious movement where agendas particularly green activism has got mixed up with autism treatment selling organic soaps to green hirings as a cure for autism.

  16. Patricia lemnar has brought out an excellent compilation of material regarding everything you can do to recover your child from autism and I highlight the 'everything' for she spreads it vast over a realm of science , pseudo science and voodoo science. For she has devoted huge sections to removing toxic overload from your child's life which she claims will recover him sufficiently if he has been diagnosed in the past one year.
    Leaving your slippers outside, greening your lifestyle, switching to chemical free substances for building , cleaning clothing and the list goes on. Then there is a section on the influence of ancestral traumas and pains and healings. What is the author trying to say..imagine a vulnerable parent diverting his precious resources to something like atonement of ancestral angst.

  17. Peter--How long does it typically take for the NAC to begin showing positive effects if one is a responder?

    Also, are you aware of any phenotypes that have had a paradoxical (negative) effect from it?

    1. Andrew, you see the effects of NAC during the first day. A small percentage of people do indeed see a negative effect.

      Either they have an allergy to NAC or they do not have oxidative stress and might have the opposite.

    2. Maybe your readers could "Methylation". Vitamin B6, B12 and Folate make Methyl groups. They are responsible for turning genes "on" and "off" and repair DNA. Implicated in numerous diseases and disorders, including Autism, Schizophrenia, Bipolar depression among others.

  18. Roger, just curious - which mthfr snp do you have? and do you use any additional b6 for homocystinuria? Or does the betaine and NAC take care of it for you?

  19. Hello Peter grandson is 2.6 months and i want to know when can i start NAC for him

    1. If you google "fluimucil 200mg children" you will see that in some countries NAC is given to children younger than your grandson, but for other reasons.

  20. Hello, my son has been taking NAC for the past ten days, he takes 2 caps of 375mg each. I was thinking of increasing the dose, but I know he cannot take any vit B12 supps, because when I tried in the past the only result was that he turned absolutely crazy, violent, hyperactive, even in the smallest doses. He is also taking Cytoflora pre-biotics, which are great for him. I had him tested and found that his liver doesn't detox properly, he's full of pesticides and other stuff, which is why he was prescribed NAC in the first place.

  21. Update on last comment: I think I overdosed my son with NAC: he developed a rash on his shoulder, quite itchy, dark rings around his eyes, nose blocked and sore throat. Oh, and hyperactivity and irritability in the morning. He's been taking 1200mg of NAC a day, so I'll stop now and see if the allergic symptoms go away. I read hat NAC can raise histamine levels, is that true? That would explain my son's reaction.

  22. Hi like the previous guest my son cannot tolerate b vitamins whatsoever. I have tried all different ways of doing this, in multis, singular, supported by magnesium, two different types of b6, transdermal, oral, b12 shots, he doesn't tolerate them at all they send him crazy, very hyperactive and irritated. When we last tested from treating the gut his vitamin deficiency in b vitamins had restored. But we are thinking of using NAC? Would we experience problems if we cannot support with b vits? Also I have read some are giving 900mg 3x a day? Is this level normal for a child?

    1. My son has taken NAC for nearly five years without B vitamins for 95% of the time. Not all NAC seems to be equal in potency, if swallowing tablets is possible, NAC Sustain is a good choice. 2 to 3 grams a day seems to work for many people.

  23. I tried 300mg NAc on my dauther (3 years old) and her feces turned in a verry light colour. That, scared me a little. Should this be consider or everybody is getting the same simptoms?

    1. There are reports on the internet of this happening, so it is not just your daughter. Perhaps try a different brand of NAC? Supplements are not as reliable as prescription drugs.

  24. Hello! I'm wondering what dose NAC can I give to my daughter (mg/kg)? Our doctors prescription is 2 g for 10 kg.

    1. The problem you have is that NAC is not stable and so if you buy a capsule of 600mg of NAC it no longer contains that amount. This has been shown repeatedly. The worse the quality, the less the effect and the more you will need.

      The clinical trial at Stanford a few years ago used 2,700 mg split over the day.

      This is data from the recent trial in Indiana.

      N-acetylcysteine capsules available in 300 mg or 600mg strength. Target dose of n-acetylcysteine will be 60mg/kg/day TID. Dosage will be increased to this target dose from week 1 to week 3 barring side effects. Dose reduction will be allowed at any time for adverse side effects. Maximum dose of n-acetylcysteine will be 4200mg/day.

      I use 2,400mg a day in my 60 kg son, he has had same dose for 6 years.

    2. Hi Peter,
      After 6 years did you stop the medication? And are the improvements in ASD behaviors are still continued?

    3. Special Mom, NAC is one element of my son's Polypill.

      The combined effect has been that he has gone from being unable to learn anything at school, to being able to keep up with his neurotypical classmates at school for the last 6 years. In maths, science, art and music he is well above average. In English he is below average.

      We of course continue to use his therapy since we want him to move forward at school and pass his exams.

      He does regress if the therapy is stopped, but I hope not back to a 9 year old with severe autism. I do not intend to find out.

    4. Thank you Peter for the response, I heard some people saying they stopped the therapy and kids not regressing, just curious to know.
      And every kid is different and I just heard people saying that(Not sure if I can believe 100%), and very grateful you accepted the fact. Thank you again and appreciate your efforts on your son.

  25. Fantastic insights Peter !!

    I am from Karachi, Pakistan

    Just got Oxiva brand in my country, its expensive though around 47c/tablet it has

    6mg methylfolate
    2mg methylcobolamin
    600mg NAC

    I can see the pharma co is marketing this for cognition and memory and reducing homocysteine

    All drugs/medicine in my country are available OTC :) It is mentioned on this one that it has to be used with a physicians supervision, so this makes me sure about the quality as well.

    we also have fluimucil available..I didnt know that or I would have given that a try first.

    I got 10tabs of Oxiva for a trial, hoping for the best.

    As i told you earlier my son has this staph dermatitis problem and he had early eczema problem (surprisingly its no more now) after he got vaccinated for chicken pox. he was also treated with HepB IGG at birth as the mother was carrying. But he has regressive autism.

    i did some searching on staph, HB and NAC and homocysteine, look what I found

    Homocysteine exaggerates microglia activation and neuroinflammation through microglia localized STAT3 overactivation following ischemic stroke

    Nasal colonization with methicillin-resistant Staphylococcus aureus associated with elevated homocysteine levels in the general US adults.

    The effect of N-acetylcysteine on growth and biofi lm formation in Staphylococcus epidermidis strains

    NAC for Persistent Infections | FX Medicine

  26. Hi Peter.

    I am very happy to find this blog. My language is Spanish, I use a translator.

    I've been reading for days and thanks for doing this blog.

    My 4 year old daughter has CBS / C699T ++. Another protocol suggests so many supplements.

    I want to add NAC to my daughter. Homocysteine ​​in blood was within range.

    I have to consider something else before using NAC.
    Thanks María

    1. Maria, NAC is helpful to many with autism, but certainly not all. It is simple to try.

  27. I have been giving my son (3.6 years 15.5 kg) NAC for 1.5 months, he has already eliminated 2 of his 3 stereotypes and 1 reduced but still present his current dose is 900mg/day divided into 3 times. I recently gave him 1200 mg for 2 days (600 morning, 300 afternoon and 300 night) and he almost eliminated his last stim, but I am concerned about the dose for his age and weight since I read in the trials that the target dose is 60mg/kg/day.

    Now, if I were to do the GSH / GSSG tests and he got normal values, should he stop taking NAC? Or if he had done it before starting, should he still have supplemented it?; Or is there something that is not seen in that analysis?

    Regarding the NAC sustain, I guess it can't be shredded as it would affect its release mechanism.

    I started 6 days ago with posntan, I will report my impressions in 2 weeks

    Greetings from Peru!

    1. Nicolas, in autism the brain is usually in a state of oxidative stress. This causes the imbalance between GSH and GSSG. It is like a fire burning in the background which you damp down with NAC.
      NAC does not treat the cause of the oxidative stress.
      If you stop NAC now, very likely the oxidative stress comes straight back along with all the stereotypy
      If you successfully treat the cause of the oxidative stress then you may no longer need NAC , or perhaps only a lower dose will be needed.
      I have found that Ponstan greatly reduced the need for NAC.
      Another parent had to give a lot of steroids and found that NAC was no longer needed.
      I think the GSH:GSSG test would be a good guide, if it was readily available.

    2. Thanks for your time Peter,

      Today we had a painful episode with our son Jacobo, it seems that his TEA is going well, but today his ADHD surfaced to the maximum, his impulsiveness and hyperactivity, he could not contain himself by going to the elevators and escalators of the shopping center, nor did he want to leave the toys from the supermarket, so much so that he did not let us do the shopping and ended up crying

      Some of the polypill he has been taking should help with his
      ADHD, or what am I missing?

      - Clonazepam
      - Piracetam
      - Ponstan
      - Risperidone (0.6mg/day)

      Nicholas from Peru

    3. Risperidone is used by some people with ADHD, but you should be aware that this drug has side effects and really is a drug of last resort in cases with aggression or self injury etc. Your son is very young to take an anti psychotic drug.

      Some hyperactive behavior is quite normal in very young kids with autism. You need to redirect it into something like jumping on a trampoline. I would focus more on cognition , speech and skill acquisition.

    4. It is conceivable that piracetam might cause hyperactivity in some people.

  28. If giving b-vitamins for nac, should i take b6, b9, b12, or just b12?


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