N-Acetyl Cysteine (NAC)?

I am newly diagnosed (October), although I think I had symptoms for a year and half prior to that. So far, it has been manageable, but I realize it’s still early. Only a few vertigo attacks, which were mild-moderate and mostly occurred upon waking in the morning. As a lifelong music lover and hobbyist musician, it’s the hearing changes/tinnitus that have been most distressing.

I’m symptom-free now and have been since I was diagnosed and put on sodium restriction and a diuretic. An audiogram in November found no hearing loss in my affected ear and ECoG was inconclusive. When I was diagnosed, my ENT heavily pitched the idea of immediately beginning intratympanic steroid injections as an early intervention to forestall hearing loss. Scared of losing my hearing, I was all for it. But now I’m thinking I should wait a bit to see how the disease progresses.

Anyhoo… on to my question…does anyone here take N-Acetyl Cysteine (NAC), and if so, what has been your experience? There doesn’t seem to be much on the internet related to Meniere’s. However, there has been some research on NAC and prevention of hearing loss from noise exposure and ototoxic drugs (cisplatin, in particular). NAC is an antioxidant whose current main medical use is as the standard treatment for acetaminophen overdose. It’s a precursor to the powerful free-radical scavenger glutathione as well as to the neurotransmitter glutamate. The latter has caused it to be recommended by some holistic psychiatrists as a complementary, non-pharmacologic therapy for anxiety and OCD. NAC is generally safe to take and has been part of my supplement regimen for a few years (600 mg.). Now I’m thinking about increasing my dose the next time I have tinnitus related to Meniere’s. I have not discussed this yet with my ENT, but I’m wondering if NAC would have a protective effective on cochlear hair cells.

 

I've been taking 600 mg. for some time, occasionally doubling it after a hard workout or before drinking alcohol. So I'm really interested in the research of Dr. Carol Foster at the University of Colorado. She published a paper a few years ago theorizing that the progressive hearing damage in MD is the result of reperfusion ischemia -- the paradoxical injury and/or death to cells when blood supply is returned after a temporary interruption. Its a factor in heart attack and stroke, and NAC has been studied positively as a means to mitigate its impact. In Foster's theory, hydrops impedes blood perfusion in the inner ear. Then when other vascular factors (like migraine or cardiovascular disease risks) are piled on, blood perfusion reaches a critical low and people experience the characteristic symptoms of an attack. But when blood flow resumes, hair cells suffer further injury through a cascading series of chemical events resulting from the oxidative stress of reperfusion. At least that's her theory. Since NAC is allegedly safe and I tolerate it well, and because I'm starting at a baseline of no hearing loss in my affected ear, I figure there is no harm in making myself a guinea pig and tripling or quadrupling my NAC dose whenever MD flares. It may take years for me to get an answer, and I'm only an n of 1, but at least NAC is inexpensive.