Gasping For Breath

By David Blyweiss, M.D.

The other day, my office got a frantic call from Jane. The night before she had suffered a frightening bout of breathlessness. You see, Jane had been a pack-a-day smoker for much of her life. And, although she quit more than 10 years ago, she was left with a devastating case of COPD.
Long-time tobacco smokers like Jane have the highest risk of developing COPD, also called Chronic Obstructive Pulmonary Disease. It’s a major cause of disability, affecting at least 12 million people, and the fourth leading cause of death in the U.S.

Once you get the diagnosis of COPD, it’s generally assumed that your lung function will steadily decline over time. Eventually, damaged airways can become colonized with dangerous bacteria, leading to chronic infection and even more inflammation. COPD sufferers also experience a great deal of oxidative stress. Free radicals from inhaled cigarette smoke, environmental pollutants and those formed in the body as a result of inflammation can damage and burden the lungs. In the case of COPD, structural changes take place in the lung tissues and airway walls, resulting in irreversible damage.

The good news—and yes, there really is some good news—is that there is significant evidence that the amino acid N-Acetyl-Cysteine (NAC) can help alleviate oxidative stress thanks to it’s amazing antioxidant properties. This, in turn, eases the symptoms of COPD and slows its progression.
A German randomized pilot study of adults with acute chronic bronchitis showed that 600 mg. of NAC taken twice a day led to a near doubling of the rate of bacterial eradication compared with standard therapy. At the same time, NAC helped reduce other symptoms and improve the participant’s quality of life. NAC also helped patients with moderate-to-severe COPD improve their physical performance on lung function tests, especially after exercise.

A recent study done in Israel assessed the lung function of 24 COPD patients who took either 600 mg. of NAC or a placebo twice daily for six weeks. At the end of six weeks, the patients switched what they were taking, so that everyone ended up taking NAC by the end of the study. The researchers measured various indicators of lung function during rest and after exercise at the beginning and end of the study. They found that when the patients took NAC they experienced improved lung function, as well as the amount of air they were able to inhale and exhale. Their exercise endurance also improved. The researchers attributed the overall improvement in lung function to a reduction in “air trapping”—or a better exchange of air in alveoli, the parts of the lung where inhaled and exhaled air are transferred.

There’s also preliminary evidence that NAC may help protect against secondhand smoke—whether or not you suffer from COPD. Chinese researchers have found that NAC protects specific cells in the lungs called Clara cells from oxidative damage and decreases airway inflammation induced by cigarette smoke.

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Besides protecting the lungs and alleviating symptoms of COPD, NAC has been shown to:

  • raise antioxidant levels, including glutathione levels—the master antioxidant;
  • support memory and brain function;
  • improve immune function;
  • support healthy eye function; and
  • have anti-aging properties.

I believe that NAC is a critical supplement for anyone with respiratory problems, especially those suffering from COPD. But it’s also useful for helping anyone achieve optimal overall health. For general protection, I recommend taking 250 mg. daily. But if, like Jane, you suffer from COPD or other chronic respiratory problems, it’s wise to increase that amount to 600 mg. twice a day. While NAC won’t provide immediate relief, over time you might just find yourself breathing easier.


Dekhuijzen PN. The role for N-acetylcysteine in the management of COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2006;1:99-106.

Liao JP. Effects of N-acetylcysteine on Clara cells in rats with cigarette smoke exposure. Chinese Medical Journal (Engl). 2010;123:412-417.

Stav D. Effect of N-acetylcysteine on air trapping in COPD: a randomized placebo-controlled study. Chest. 2009;136:381-386.

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