N-Acetyl-Cysteine (or NAC) is a particular activated form of the amino acid cysteine. It can cut the risk of H1N1 flu by 2/3. In a double-blind study in Italy, 262 people either received NAC or a placebo daily for the entire flu season. Blood tests showed that both groups were equally exposed to the flu virus. Only 25% of the people taking NAC (600 mg, twice per day) who developed antibodies to the virus showed disease symptoms, while 79% of the control group exposed to the virus went on to develop the fever, lung problems and body aches typical of influenza. The NAC supplement was 'well tolerated' and considered to be an effective risk reduction strategy.

In a study on mice given an extremely large dose of influenza virus, NAC alone did not lead to a significant increase in survival. But when combined with ribavirin (an antiviral drug), it improved survival rates from 58% to 92%. PMID:15000873 (cache) The synergism noted between NAC and ribavirin suggest that it would be beneficial to combine NAC with most antiviral drugs - NAC appears to work by reducing free-radicals that cause tissue damage, while antivirals work on a different level to reduce the spread of the virus.

NAC prevents the induction of MAPK p38 in cells. PMID:16086031 Stimulating MAPK p38 is a good way to increase the production of TNF, and seems to be particularly true in H5N1 avian flu.

Another study under different conditions found that NAC does not appear to directly inhibit TNF or MAPK, but it did lead to a modest reduction in the cytokine RANTES (18%), probably by reducing reactive oxygen species that were generated by the inflammatory cascade. PMID:10706714 NAC also reduced macrophage death due to influenza infection. PMID:9260892 (cache)

NAC is a hygroscopic material - it soaks up water from the air. Like aspirin, it can break down and release acetic acid, resulting in a vinegary smell. It should be stored in a cool, dry area in a well sealed container.

Cost

I have seen comments on the web that reflect the belief that NAC is expensive. This is not true if you shop around - for the doses used in the Italian study, Swanson Premium Brand N-Acetyl Cysteine costs about 12 cents a day, while NSI N-Acetyl Cysteine Caps costs around 22 cents a day, and Twinlab Nac (N-Acetyl Cysteine) is around 30 cents a day.

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