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Erschienen in: Sports Medicine 8/2017

19.01.2017 | Systematic Review

Performance and Side Effects of Supplementation with N-Acetylcysteine: A Systematic Review and Meta-Analysis

verfasst von: Kate Rhodes, Andrea Braakhuis

Erschienen in: Sports Medicine | Ausgabe 8/2017

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Abstract

Background

N-Acetylcysteine (NAC) is a promising antioxidant supplement with potential as an acute strategy to enhance performance in elite sport, but there are concerns about its side effects with high doses.

Objective

To review the current literature and evaluate the effects of NAC supplementation on sport performance and the risk of adverse effects.

Methods

The literature up to May 2016 was searched on MEDLINE (PubMed), EMBASE, SPORTDiscus, Google Scholar and Scopus databases to identify all studies investigating the effects of NAC supplementation on exercise performance and/or side effects experienced. Performance outcomes from each study were converted to the percent effect equivalent to mean power output in a time trial. All pooled analyses were based on random-effects models generated by Review Manager (RevMan) [Computer program], version 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014).

Results

A total of seven studies met criteria for inclusion in the sport performance meta-analysis, and 17 for inclusion in the side effects meta-analysis. The typical daily dose of NAC reported was 5.8 g·d−1; with a range between 1.2 and 20.0 g·d−1. The mean increase in performance was 0.29% (95% confidence interval −0.67 to 1.25). The difference in the odds ratio of side effects on NAC compared with placebo was 1.11 (95% confidence interval 0.88–1.39). The sub-analysis of NAC dose suggested an increase in side effects as the dosage of NAC increased; however, this observation requires further investigation.

Conclusions

Despite initial research publications reporting positive performance effects with NAC, at this stage it cannot be recommended further. The risk of side effects from NAC supplementation also remains unclear owing to significant variations in effects. Suboptimal reporting and documentation in the literature creates difficulties when meta-analysing outcomes and generating conclusions.
Literatur
1.
Zurück zum Zitat Powers SK, Jackson MJ. Exercise-induced oxidative stress: cellular mechanisms and impact on muscle force production. Physiol Rev. 2008;88(4):1243–76.CrossRefPubMedPubMedCentral Powers SK, Jackson MJ. Exercise-induced oxidative stress: cellular mechanisms and impact on muscle force production. Physiol Rev. 2008;88(4):1243–76.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Sakellariou GK, Jackson MJ, Vasilaki A. Redefining the major contributors to superoxide production in contracting skeletal muscle: the role of NAD(P)H oxidases. Free Radic Res. 2008;48(1):12–29.CrossRef Sakellariou GK, Jackson MJ, Vasilaki A. Redefining the major contributors to superoxide production in contracting skeletal muscle: the role of NAD(P)H oxidases. Free Radic Res. 2008;48(1):12–29.CrossRef
3.
Zurück zum Zitat Powers SK, Duarte J, Kavazis AN, et al. Reactive oxygen species are signalling molecules for skeletal muscle adaptation. Exp Physiol. 2010;95(1):1–9.CrossRefPubMed Powers SK, Duarte J, Kavazis AN, et al. Reactive oxygen species are signalling molecules for skeletal muscle adaptation. Exp Physiol. 2010;95(1):1–9.CrossRefPubMed
4.
Zurück zum Zitat Reid MB. Free radicals and muscle fatigue: of ROS, canaries, and the IOC. Free Radic Biol Med. 2008;44(2):169–79.CrossRefPubMed Reid MB. Free radicals and muscle fatigue: of ROS, canaries, and the IOC. Free Radic Biol Med. 2008;44(2):169–79.CrossRefPubMed
5.
Zurück zum Zitat Cobley JN, McGlory C, Morton JP, et al. N-acetylcysteine’s attenuation of fatigue after repeated bouts of intermittent exercise: practical implications for tournament situations. Int J Sport Nutr Exerc Metab. 2011;21(6):451–61.CrossRefPubMed Cobley JN, McGlory C, Morton JP, et al. N-acetylcysteine’s attenuation of fatigue after repeated bouts of intermittent exercise: practical implications for tournament situations. Int J Sport Nutr Exerc Metab. 2011;21(6):451–61.CrossRefPubMed
6.
Zurück zum Zitat Slattery KM, Dascombe B, Wallace LK, et al. Effect of N-acetylcysteine on cycling performance after intensified training. Med Sci Sports Exerc. 2014;46(6):1114–23.CrossRefPubMed Slattery KM, Dascombe B, Wallace LK, et al. Effect of N-acetylcysteine on cycling performance after intensified training. Med Sci Sports Exerc. 2014;46(6):1114–23.CrossRefPubMed
7.
Zurück zum Zitat Sen C, Packer L, Hänninen O. Handbook of Oxidants and Antioxidants in Exercise. Amsterdam, The Netherlands: Elsevier Science; 2000. Sen C, Packer L, Hänninen O. Handbook of Oxidants and Antioxidants in Exercise. Amsterdam, The Netherlands: Elsevier Science; 2000.
8.
Zurück zum Zitat Leelarungrayub D, Khansuwan R, Pothongsunun P, et al. N-Acetylcysteine supplementation controls total antioxidant capacity, creatine kinase, lactate, and tumor necrotic factor-alpha against oxidative stress induced by graded exercise in sedentary men. Oxid Med Cell Longev. 2011;2011:329643. Leelarungrayub D, Khansuwan R, Pothongsunun P, et al. N-Acetylcysteine supplementation controls total antioxidant capacity, creatine kinase, lactate, and tumor necrotic factor-alpha against oxidative stress induced by graded exercise in sedentary men. Oxid Med Cell Longev. 2011;2011:329643.
9.
Zurück zum Zitat Maughan RJ. The Encyclopaedia of Sports Medicine: an IOC Medical Commission publication. The Olympic Textbook of Science in Sport. West Sussex, UK: Wiley; 2009. Maughan RJ. The Encyclopaedia of Sports Medicine: an IOC Medical Commission publication. The Olympic Textbook of Science in Sport. West Sussex, UK: Wiley; 2009.
10.
Zurück zum Zitat Holdiness MR. Clinical pharmacokinetics of N-acetylcysteine. Clin Pharmacokinet. 1991;20(2):123–34.CrossRefPubMed Holdiness MR. Clinical pharmacokinetics of N-acetylcysteine. Clin Pharmacokinet. 1991;20(2):123–34.CrossRefPubMed
11.
Zurück zum Zitat Medved I, Brown MJ, Bjorksten AR, et al. N-Acetylcysteine enhances muscle cysteine and glutathione availability and attenuates fatigue during prolonged exercise in endurance-trained individuals. J Appl Physiol (1985). 2004;97(4):1477–85. Medved I, Brown MJ, Bjorksten AR, et al. N-Acetylcysteine enhances muscle cysteine and glutathione availability and attenuates fatigue during prolonged exercise in endurance-trained individuals. J Appl Physiol (1985). 2004;97(4):1477–85.
12.
Zurück zum Zitat Sen CK, Rankinen T, Vaisanen S, et al. Oxidative stress after human exercise: effect of N-acetylcysteine supplementation. J Appl Physiol (1985). 1994;76(6):2570–7. Sen CK, Rankinen T, Vaisanen S, et al. Oxidative stress after human exercise: effect of N-acetylcysteine supplementation. J Appl Physiol (1985). 1994;76(6):2570–7.
13.
Zurück zum Zitat Aruoma OI, Halliwell B, Hoey BM, et al. The antioxidant action of N-acetylcysteine: its reaction with hydrogen peroxide, hydroxyl radical, superoxide, and hypochlorous acid. Free Radic Biol Med. 1989;6(6):593–7.CrossRefPubMed Aruoma OI, Halliwell B, Hoey BM, et al. The antioxidant action of N-acetylcysteine: its reaction with hydrogen peroxide, hydroxyl radical, superoxide, and hypochlorous acid. Free Radic Biol Med. 1989;6(6):593–7.CrossRefPubMed
14.
Zurück zum Zitat Bangsbo J, Iaia FM, Krustrup P. The Yo-Yo intermittent recovery test. Sports Med. 2008;38(1):37–51.CrossRefPubMed Bangsbo J, Iaia FM, Krustrup P. The Yo-Yo intermittent recovery test. Sports Med. 2008;38(1):37–51.CrossRefPubMed
15.
Zurück zum Zitat Bailey SJ, Winyard PG, Blackwell JR, et al. Influence of N-acetylcysteine administration on pulmonary O2 uptake kinetics and exercise tolerance in humans. Respir Physiol Neurobiol. 2011;175(1):121–9.CrossRefPubMed Bailey SJ, Winyard PG, Blackwell JR, et al. Influence of N-acetylcysteine administration on pulmonary O2 uptake kinetics and exercise tolerance in humans. Respir Physiol Neurobiol. 2011;175(1):121–9.CrossRefPubMed
16.
Zurück zum Zitat Zembron-Lacny A, Slowinska-Lisowska M, Szygula Z, et al. Modulatory effect of N-acetylcysteine on pro-antioxidant status and haematological response in healthy men. J Physiol Biochem. 2010;66(1):15–21.CrossRefPubMed Zembron-Lacny A, Slowinska-Lisowska M, Szygula Z, et al. Modulatory effect of N-acetylcysteine on pro-antioxidant status and haematological response in healthy men. J Physiol Biochem. 2010;66(1):15–21.CrossRefPubMed
17.
Zurück zum Zitat Corn SD, Barstow TJ. Effects of oral N-acetylcysteine on fatigue, critical power, and W′ in exercising humans. Respir Physiol Neurobiol. 2011;178(2):261–8.CrossRefPubMed Corn SD, Barstow TJ. Effects of oral N-acetylcysteine on fatigue, critical power, and W′ in exercising humans. Respir Physiol Neurobiol. 2011;178(2):261–8.CrossRefPubMed
18.
Zurück zum Zitat McKenna MJ, Medved I, Goodman CA, et al. N-Acetylcysteine attenuates the decline in muscle Na+, K+-pump activity and delays fatigue during prolonged exercise in humans. J Physiol. 2006;576(1):279–88.CrossRefPubMedPubMedCentral McKenna MJ, Medved I, Goodman CA, et al. N-Acetylcysteine attenuates the decline in muscle Na+, K+-pump activity and delays fatigue during prolonged exercise in humans. J Physiol. 2006;576(1):279–88.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Matuszczak Y, Farid M, Jones J, et al. Effects of N-acetylcysteine on glutathione oxidation and fatigue during handgrip exercise. Muscle Nerve. 2005;32(5):633–8.CrossRefPubMed Matuszczak Y, Farid M, Jones J, et al. Effects of N-acetylcysteine on glutathione oxidation and fatigue during handgrip exercise. Muscle Nerve. 2005;32(5):633–8.CrossRefPubMed
20.
Zurück zum Zitat Currell K, Jeukendrup AE. Validity, reliability and sensitivity of measures of sporting performance. Sports Med. 2008;38(4):297–316.CrossRefPubMed Currell K, Jeukendrup AE. Validity, reliability and sensitivity of measures of sporting performance. Sports Med. 2008;38(4):297–316.CrossRefPubMed
21.
Zurück zum Zitat Ferreira LF, Reid MB. Muscle-derived ROS and thiol regulation in muscle fatigue. J Appl Physiol (1985). 2008;104(3):853–60. Ferreira LF, Reid MB. Muscle-derived ROS and thiol regulation in muscle fatigue. J Appl Physiol (1985). 2008;104(3):853–60.
22.
Zurück zum Zitat Braakhuis AJ, Hopkins WG. Impact of dietary antioxidants on sport performance: a review. Sports Med. 2015;45(7):939–55.CrossRefPubMed Braakhuis AJ, Hopkins WG. Impact of dietary antioxidants on sport performance: a review. Sports Med. 2015;45(7):939–55.CrossRefPubMed
25.
Zurück zum Zitat McGaw B, Glass GV. Choice of the metric for effect size in meta-analysis. Am Educ Res J. 1980;17(3):325–37.CrossRef McGaw B, Glass GV. Choice of the metric for effect size in meta-analysis. Am Educ Res J. 1980;17(3):325–37.CrossRef
26.
Zurück zum Zitat Trewin AJ, Petersen AC, Billaut F, et al. N-Acetylcysteine alters substrate metabolism during high-intensity cycle exercise in well-trained humans. Appl Physiol Nutr Metab. 2013;38(12):1217–27.CrossRef Trewin AJ, Petersen AC, Billaut F, et al. N-Acetylcysteine alters substrate metabolism during high-intensity cycle exercise in well-trained humans. Appl Physiol Nutr Metab. 2013;38(12):1217–27.CrossRef
27.
Zurück zum Zitat Miltenberger MR, Zipp G, Parasher R, et al. The acute effect of n-acetylcysteine supplementation on repeat sprint performance in recreationally active males. Int J Exerc Sci Conf Proc. 2015;9(3):Article 65. Miltenberger MR, Zipp G, Parasher R, et al. The acute effect of n-acetylcysteine supplementation on repeat sprint performance in recreationally active males. Int J Exerc Sci Conf Proc. 2015;9(3):Article 65.
28.
Zurück zum Zitat Nielsen HB, Kharazmi A, Bolbjerg ML, et al. N-Acetylcysteine attenuates oxidative burst by neutrophils in response to ergometer rowing with no effect on pulmonary gas exchange. Int J Sports Med. 2001;22(4):256–60.CrossRefPubMed Nielsen HB, Kharazmi A, Bolbjerg ML, et al. N-Acetylcysteine attenuates oxidative burst by neutrophils in response to ergometer rowing with no effect on pulmonary gas exchange. Int J Sports Med. 2001;22(4):256–60.CrossRefPubMed
29.
Zurück zum Zitat da Silva ND, Jr Roseguini BT, Chehuen M, et al. Effects of oral N-acetylcysteine on walking capacity, leg reactive hyperemia, and inflammatory and angiogenic mediators in patients with intermittent claudication. Am J Physiol Heart Circ Physiol. 2015;309(5):H897–905.PubMed da Silva ND, Jr Roseguini BT, Chehuen M, et al. Effects of oral N-acetylcysteine on walking capacity, leg reactive hyperemia, and inflammatory and angiogenic mediators in patients with intermittent claudication. Am J Physiol Heart Circ Physiol. 2015;309(5):H897–905.PubMed
30.
Zurück zum Zitat Hopkins WG, Schabort EJ, Hawley JA. Reliability of power in physical performance tests. Sports Med. 2001;31(3):211–34.CrossRefPubMed Hopkins WG, Schabort EJ, Hawley JA. Reliability of power in physical performance tests. Sports Med. 2001;31(3):211–34.CrossRefPubMed
31.
Zurück zum Zitat Hopkins WG. Sample sizes for magnitude-based inferences about clinical, practical or mechanistic significance. Med Sci Sports Exerc. 2006;38(5):S528. Hopkins WG. Sample sizes for magnitude-based inferences about clinical, practical or mechanistic significance. Med Sci Sports Exerc. 2006;38(5):S528.
32.
Zurück zum Zitat Childs A, Jacobs C, Kaminski T, et al. Supplementation with vitamin C and N-acetyl-cysteine increases oxidative stress in humans after an acute muscle injury induced by eccentric exercise. Free Radic Biol Med. 2001;31(6):745–53.CrossRefPubMed Childs A, Jacobs C, Kaminski T, et al. Supplementation with vitamin C and N-acetyl-cysteine increases oxidative stress in humans after an acute muscle injury induced by eccentric exercise. Free Radic Biol Med. 2001;31(6):745–53.CrossRefPubMed
33.
Zurück zum Zitat Ferreira LF, Campbell KS, Reid MB. N-Acetylcysteine in handgrip exercise: plasma thiols and adverse reactions. Int J Sport Nutr Exerc Metab. 2011;21(2):146–54.CrossRefPubMedPubMedCentral Ferreira LF, Campbell KS, Reid MB. N-Acetylcysteine in handgrip exercise: plasma thiols and adverse reactions. Int J Sport Nutr Exerc Metab. 2011;21(2):146–54.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Silva LA, Silveira PC, Pinho CA, et al. N-Acetylcysteine supplementation and oxidative damage and inflammatory response after eccentric exercise. Int J Sport Nutr. 2008;18(4):379. Silva LA, Silveira PC, Pinho CA, et al. N-Acetylcysteine supplementation and oxidative damage and inflammatory response after eccentric exercise. Int J Sport Nutr. 2008;18(4):379.
35.
Zurück zum Zitat Michailidis Y, Karagounis LG, Terzis G, et al. Thiol-based antioxidant supplementation alters human skeletal muscle signaling and attenuates its inflammatory response and recovery after intense eccentric exercise. Am J Clin Nutr. 2013;98(1):233–45.CrossRefPubMed Michailidis Y, Karagounis LG, Terzis G, et al. Thiol-based antioxidant supplementation alters human skeletal muscle signaling and attenuates its inflammatory response and recovery after intense eccentric exercise. Am J Clin Nutr. 2013;98(1):233–45.CrossRefPubMed
37.
Zurück zum Zitat Medved I, Brown MJ, Bjorksten AR, et al. Effects of intravenous N-acetylcysteine infusion on time to fatigue and potassium regulation during prolonged cycling exercise. J Appl Physiol (1985). 2004;96(1):211–7. Medved I, Brown MJ, Bjorksten AR, et al. Effects of intravenous N-acetylcysteine infusion on time to fatigue and potassium regulation during prolonged cycling exercise. J Appl Physiol (1985). 2004;96(1):211–7.
38.
Zurück zum Zitat Medved I, Brown MJ, Bjorksten AR, et al. N-Acetylcysteine infusion alters blood redox status but not time to fatigue during intense exercise in humans. J Appl Physiol (1985). 2003;94(4):1572–82. Medved I, Brown MJ, Bjorksten AR, et al. N-Acetylcysteine infusion alters blood redox status but not time to fatigue during intense exercise in humans. J Appl Physiol (1985). 2003;94(4):1572–82.
39.
Zurück zum Zitat Petersen DJ, Alexander GR. Needs assessment in public health: a practical guide for students and professionals. New York, US: Springer Science & Business Media; 2001. Petersen DJ, Alexander GR. Needs assessment in public health: a practical guide for students and professionals. New York, US: Springer Science & Business Media; 2001.
40.
Zurück zum Zitat Estensen RD, Levy M, Klopp SJ, et al. N-Acetylcysteine suppression of the proliferative index in the colon of patients with previous adenomatous colonic polyps. Cancer Lett. 1999;147(1):109–14.CrossRefPubMed Estensen RD, Levy M, Klopp SJ, et al. N-Acetylcysteine suppression of the proliferative index in the colon of patients with previous adenomatous colonic polyps. Cancer Lett. 1999;147(1):109–14.CrossRefPubMed
41.
Zurück zum Zitat Tynell E, Bratt G, Bielenstein M, et al. N-Acetylcysteine treatment and the risk of toxic reactions to trimethoprim-sulphamethoxazole in primary Pneumocystis carinii prophylaxis in HIV-infected patients. J Infect. 1997;35(2):143–7.CrossRefPubMed Tynell E, Bratt G, Bielenstein M, et al. N-Acetylcysteine treatment and the risk of toxic reactions to trimethoprim-sulphamethoxazole in primary Pneumocystis carinii prophylaxis in HIV-infected patients. J Infect. 1997;35(2):143–7.CrossRefPubMed
42.
Zurück zum Zitat Behr J, Maier K, Degenkolb B, et al. Antioxidative and clinical effects of high-dose N-acetylcysteine in fibrosing alveolitis: adjunctive therapy to maintenance immunosuppression. Am J Respir Crit Care Med. 1997;156(6):1897–901.CrossRefPubMed Behr J, Maier K, Degenkolb B, et al. Antioxidative and clinical effects of high-dose N-acetylcysteine in fibrosing alveolitis: adjunctive therapy to maintenance immunosuppression. Am J Respir Crit Care Med. 1997;156(6):1897–901.CrossRefPubMed
43.
Zurück zum Zitat Jackson IM, Barnes J, Cooksey P. Efficacy and tolerability of oral acetylcysteine (Fabrol) in chronic bronchitis: a double-blind placebo controlled study. J Int Med Res. 1984;12(3):198–206.CrossRefPubMed Jackson IM, Barnes J, Cooksey P. Efficacy and tolerability of oral acetylcysteine (Fabrol) in chronic bronchitis: a double-blind placebo controlled study. J Int Med Res. 1984;12(3):198–206.CrossRefPubMed
44.
Zurück zum Zitat Kelly MK, Wicker RJ, Barstow TJ, et al. Effects of N-acetylcysteine on respiratory muscle fatigue during heavy exercise. Respir Physiol Neurobiol. 2009;165(1):67–72.CrossRefPubMed Kelly MK, Wicker RJ, Barstow TJ, et al. Effects of N-acetylcysteine on respiratory muscle fatigue during heavy exercise. Respir Physiol Neurobiol. 2009;165(1):67–72.CrossRefPubMed
45.
Zurück zum Zitat Hopkins W, Marshall S, Batterham A, et al. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc. 2009;41(1):3.CrossRefPubMed Hopkins W, Marshall S, Batterham A, et al. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc. 2009;41(1):3.CrossRefPubMed
46.
Zurück zum Zitat Patton KT, Thibodeau GA. Anatomy & Physiology. Missouri, US: Elsevier Health Sciences; 2014. Patton KT, Thibodeau GA. Anatomy & Physiology. Missouri, US: Elsevier Health Sciences; 2014.
47.
Zurück zum Zitat Powers SK, Smuder AJ, Kavazis AN, et al. Experimental guidelines for studies designed to investigate the impact of antioxidant supplementation on exercise performance. Int J Sport Nutr Exerc Metab. 2010;20(1):2–14.CrossRefPubMedPubMedCentral Powers SK, Smuder AJ, Kavazis AN, et al. Experimental guidelines for studies designed to investigate the impact of antioxidant supplementation on exercise performance. Int J Sport Nutr Exerc Metab. 2010;20(1):2–14.CrossRefPubMedPubMedCentral
48.
Zurück zum Zitat Reid MB. Invited review: redox modulation of skeletal muscle contraction: what we know and what we don’t. J Appl Physiol (1985). 2001;90(2):724–31. Reid MB. Invited review: redox modulation of skeletal muscle contraction: what we know and what we don’t. J Appl Physiol (1985). 2001;90(2):724–31.
49.
Zurück zum Zitat Kanter M. Free radicals, exercise and antioxidant supplementation. Proc Nutr Soc. 1998;57(1):9–13.CrossRefPubMed Kanter M. Free radicals, exercise and antioxidant supplementation. Proc Nutr Soc. 1998;57(1):9–13.CrossRefPubMed
50.
Zurück zum Zitat Brown M, Bjorksten A, Medved I, et al. Pharmacokinetics of intravenous N-acetylcysteine in men at rest and during exercise. Eur J Clin Pharmacol. 2004;60(10):717–23.CrossRefPubMed Brown M, Bjorksten A, Medved I, et al. Pharmacokinetics of intravenous N-acetylcysteine in men at rest and during exercise. Eur J Clin Pharmacol. 2004;60(10):717–23.CrossRefPubMed
51.
Zurück zum Zitat McArdle WD, Katch FI, Katch VL. Essentials of Exercise Physiology. Philadelphia, US: Lippincott Williams & Wilkins; 2006. McArdle WD, Katch FI, Katch VL. Essentials of Exercise Physiology. Philadelphia, US: Lippincott Williams & Wilkins; 2006.
52.
Zurück zum Zitat Tse HN, Raiteri L, Wong KY, et al. High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest. 2013;144(1):106–18.CrossRefPubMed Tse HN, Raiteri L, Wong KY, et al. High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest. 2013;144(1):106–18.CrossRefPubMed
53.
Zurück zum Zitat Kerksick CM, Roberts MD, Dalbo VJ, et al. Changes in skeletal muscle proteolytic gene expression after prophylactic supplementation of EGCG and NAC and eccentric damage. Food Chem Toxicol. 2013;61:47–52. Kerksick CM, Roberts MD, Dalbo VJ, et al. Changes in skeletal muscle proteolytic gene expression after prophylactic supplementation of EGCG and NAC and eccentric damage. Food Chem Toxicol. 2013;61:47–52.
54.
Zurück zum Zitat Arstall MA, Yang J, Stafford I, et al. N-Acetylcysteine in combination with nitroglycerin and streptokinase for the treatment of evolving acute myocardial infarction: safety and biochemical effects. Circulation. 1995;92(10):2855–62.CrossRefPubMed Arstall MA, Yang J, Stafford I, et al. N-Acetylcysteine in combination with nitroglycerin and streptokinase for the treatment of evolving acute myocardial infarction: safety and biochemical effects. Circulation. 1995;92(10):2855–62.CrossRefPubMed
55.
Zurück zum Zitat Travaline JM, Sudarshan S, Roy BG, et al. Effect of N-acetylcysteine on human diaphragm strength and fatigability. Am J Respir Crit Care Med. 1997;156(5):1567–71.CrossRef Travaline JM, Sudarshan S, Roy BG, et al. Effect of N-acetylcysteine on human diaphragm strength and fatigability. Am J Respir Crit Care Med. 1997;156(5):1567–71.CrossRef
Metadaten
Titel
Performance and Side Effects of Supplementation with N-Acetylcysteine: A Systematic Review and Meta-Analysis
verfasst von
Kate Rhodes
Andrea Braakhuis
Publikationsdatum
19.01.2017
Verlag
Springer International Publishing
Erschienen in
Sports Medicine / Ausgabe 8/2017
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-017-0677-3

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