How NAC and Glutathione Can Help to Heal Hashimoto's

Disease

Glutathione (Full name: N-L-gamma-glutamyl-cysteinyl glycine, shortened form: GSH) is a tripeptide

consisting of three amino acids: cysteine, glycine and glutamic acid. It is the body's primary
antioxidant, and is essential in keeping the right balance between the oxidant production and
antioxidant defence within cells. A loss of this balance is a common feature in many human diseases,
and oxidative stress within cells is mainly due to deficiency of glutathione or its precursors (1).
Glutathionine should exist in high concentrations in all cells of the body.

What Does Glutathione (GSH) Do?

This hugely important tripeptide plays an important role in maintaining the correct oxidation-
reduction potential inside cells, thereby affecting their biochemical reactions. It scavenges oxidising
free radicals, detoxifies heavy metals, pesticides, acetaminophen (paracetamol) and leukotrienes
(fatty molecules that contribute to inflammation in certain conditions, such as asthma and allergic
rhinitis). It stores and transports amino acids, regulates the cell cycle, protein synthesis and gene
expression, and protects thyroid cells from self-generated hydrogen peroxide.

Why is Glutathione (GSH) important for Someone with Hashimoto's Disease?

Glutathione thyroid hormones protects the body in an extraordinary number of ways, but the fact
that it protects the thyroid against hydrogen peroxide is particularly significant.

In untreated Hashimoto's, the body's levels of T4 (thyroxine) begin to fall, and TSH (thyroid
stimulating hormone) levels generally start to climb. In order to stimulate the thyroid to make more
T4, the TSH activates the thyroid cells to make hydrogen peroxide. If the TSH levels remain high,
the thyroid cells continue to produce more and more hydrogen peroxide, and this can lead to
increased inflammation, scarring, and ultimately the destruction of thyroid cells. If the hydrogen
peroxide manages to gain entry to the cell, the damage becomes far worse.

Hydrogen Peroxide and Hashimoto's Disease

Hydrogen peroxide is thought to play a significant role in the development and progression of
Hashimoto's disease, despite the fact that the thyroid gland actually requires hydrogen peroxide for
thyroid hormone formation. Hydrogen peroxide is normally produced during the oxidation of the
iodine ions - it is an essential part of the thyroid function. But the critical factor is the protection of
the thyroid cells (the levels of glutathione), and the place in which the iodine ions are oxidized. If
oxidation occurs inside the cells, the hydrogen peroxide is produced inside the cells, and the cells
sustain damage.

A 2001 study (2) found that if hydrogen peroxide is allowed to enter thyroid cells, it attacks and
cleaves thyroglobulin (a protein within the thyroid gland), producing fragments that are able to
diffuse into other cells - and these fragments were recognized by autoantibodies taken from people
with Hashimoto's disease. This suggests that hydrogen peroxide entry into thyroid cells may actually
be the cause of Hashimoto's disease.
In addition, the predominant infiltrating cells in autoimmune diseases such as Hashimoto's
thyroiditis are phagocytic macrophages, neutrophils and various T-cells; the macrophages and
neutrophils damage the tissues by releasing highly cytotoxic proteins, including hydrogen peroxide
(3) - adding further to the problem.

How Glutathione Becomes Depleted

The body's stores of glutathione can become depleted through alcoholism, HIV infection, cirrhosis,
diabetes, surgical trauma, fasting, toxins (such as organophosphates or solvents), overuse of
acetaminophen (paracetamol), chronic stress, inadequate diet, elevated adrenaline release,
extensive strenuous exercise, or infection. It is also associated with cigarette smoking, as smoking
increases the rate at which the body uses glutathione.

There is an extremely rare condition known as glutathione synthetase deficiency (found only in
around 70 people worldwide), which is caused by gene mutation and causes severe problems from
birth.

How to Restore Glutathione Levels

Glutathione is not easily absorbed through oral supplementation, but is synthesized in the body from
amino acids, and body levels can be increased through oral administration of glutathione precursors
(4) such as N-acetylcysteine (NAC), S-adenosyl-L-methionine (SAMe) and gluatmine. Oral
administration of NAC of doses up to 8,000 mg/day was not found to cause clinically significant
adverse reactions (1), although doses of 600mg/day were enough to significantly improve symptoms
of chronic lung disease (1).

There is no recommended dietary allowance (RDA) for glutathione or N-acetylcysteine (NAC). Intake
of NAC does increase zinc loss through urine, so zinc supplementation would be advisable for
anyone supplementing NAC over an extended period. Read more about dosage and safety levels
here.

Glutathione can also be "upregulated" (i.e. the amount in the cell increased) by vitamins C and E,
and lipoic acid (an organosulfur compound found in spinach, offal - such as hearts, livers, and
kidneys - yeast extract, and broccoli). N-acetylcysteine (NAC) is considered to be the most effective,
fastest route to raising levels of glutathione. It also increases levels of glutathione (through
synthesis) only when there is an actual need, and it seems to concentrate only in tissues where
glutathione is required. (Burgunder JM et al 1989)

N-acetylcysteine (NAC) and Hashimoto's Disease

The fact that NAC is able to restore glutathione levels and thereby protect the thyroid (as well as
protecting the body in numerous other ways) is particularly interesting given its ability to "crack
open" bacteria such as chlamydia pneumonia, which "hide" inside the body's own cells during one
part of their life cycle, using the host cell's machinery to replicate. Chlamydia pneumoniae has been
implicated in autoimmune diseases such as multiple sclerosis, and N-acetylcysteine (NAC) is
considered an important part of treatment. Read more about NAC here.
If you suspect bacterial infection with a bacteria susceptible to NAC, take the NAC deficiency test

References:

"N-Acetylcysteine - a safe antidote for cysteine/glutathione deficiency"; Atkur, Mantovani,

Herzenberg and thyroid problems Herzenberg; Current Opinion in Pharmacology; 2007; 7.

"Hydrogen peroxide-induced production of a 40 kDa immunoreactive thyroglobulin fragment in

human thyroid cells: the onset of thyroid autoimmunity?, Duthoit, C., Estienne, V., Giraud, A.,
Durand-Gorde, J.M., Rasmussen, A.K., Feldt-Rasmussen, U., Carayon, P., Ruf, J., ; Biochem. J. (2001)
360(Pt 3):557-562.

"Autoimmune disease: Mechanisms"; Encyclopedia of Life Sciences; DeLisa Fairweather

"Competition for glutathione precursors between the immune system and the skeletal muscle:
pathogenesis of chronic fatigue syndrome, Medical Hypotheses"; Bounous, G., and Molson, J.,;
53(4):347-349.