Written by Christopher Kelly
May 5, 2016
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Christopher: Hello and welcome to the Nourish Balance Thrive Podcast. My name is Christopher Kelly and today I'm joined by David Aiello. Hi, David.
David: Hi, Christopher.
Christopher: I have got David on today to talk about supplement that I have found to be very useful personally in the past and has been really useful for some of the athletes that we work with. The indication has come by way of some of the testing that we do particularly the organic acids. That supplement is N-acetylcysteine. And I've got David on to talk about how the supplement can help and how it works and some other good stuff. So, David, why don't you start by telling us a little bit about yourself?
David: Well, myself, I was trained at immunology at Stanford at the Herzenberg Laboratory and we have a wonderful cooperation, the folks out there, for a long time. And one of the things that was close -- and I'm fundamentally though a businessman. In my efforts to take things from the laboratory into the field, to commercialization, I said to myself and to my professional colleagues I want to make a product that is relevant, that is made the right way, that is given at the right dose, and in which there's a context of cooperation with people in the medical community and sports community who understand and care for people's health, who have integrity and want to do it right.
And the resonance I found was acetylcysteine has so much undiscovered, unknown, misunderstood potential. It has to be clarified and has to be worked. So since 2000, we've done in our company over, I guess, 12 or 13 clinical trials now using our acetylcysteine product and a pharmaceutically made placebo. We've done clinical trials in breathing and immunity and oxidative stress and mental health. And it's been wonderful to really discover a lot about acetylcysteine that was true and that we could clarify. So, it's been great to do that.
Christopher: I mean, this is an interesting thing. How did you narrow it down to cysteine? Of all the things you could have chosen on the planet, why cysteine?
David: It makes me think of the question of why did you marry that woman? There's so many other women, how did you choose her? I mean, it's kind of a question like that. You become fascinated with something and your mind just sees forward in thinking about that, you see this is a huge big business scientific project and it can be such a broad scope of help to people. We didn't even understand what the scope could be actually way back then.
I mean, mental health was not even on our radar. Acetylcysteine was originally developed as an antidote for Tylenol toxicity and it's still used today. People usually accidentally take too much Tylenol or acetaminophen. They usually by accident means that they're taking a Percocet because they have back pain or post surgical pain or something like that but then they also have a cold so that they're taking a cough and cold product and it will also have acetaminophen. And when you double up on that for two or three days you can become very, very sick and highly at risk of liver failure and you need to be rushed to the hospital.
About 80,000 people every year in the United States do get reported Poison Control Center for such types of toxicity -- infants, old people, people in hospitals. And, of course, there's intentional overdose too. But that's actually a small, relatively small number of people. But coming out of that, the professors at Stanford said, "Well, why does that work? Why should that work?" And the answer is that cysteine is giving you what you're short of. Your body wants to deal with that immense amount of oxidative stress that is coming out of the toxic metabolite of excessive acetaminophen consumption. It's called NAPQI.
And it doesn't have enough glutathione which is it's normal conjugate. How would you say, you conjugate with that oxidant? And you turn it off, it's not dangerous anymore. But you can't make enough glutathione if you don't have all three of the amino acids that you make, that you need to make with it. So, you need glycine, your body has a ton of that, you need glutamate, which most people have a lot of, but not everybody, and you need cysteine.
And if you look at the nutritional profile of almost every protein you'll see that cysteine is less than 2% of the weight of most proteins -- chicken or fish or whatever it is. And also, the nutritional studies are not even that good about amino acid contents of proteins because we don't really know what the effects of different types of food preparation due to them. So, we're sure that when you eat a steak or a piece of chicken or fish or whatever, or a bean, that it started off with a certain amino acid profile. But you don't necessarily metabolize those amino acids as amino acids because they can be just kind of burnt into nitrogen products, if you will.
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So, we don't really know. But what happens is that some people, because of a disease state, because of genetics or because of their lifestyle -- and that could be a good lifestyle or negative things in their lifestyle -- have extra needs for glutathione. And one of the reasons for that could be exercise. One of the needs for that could be tremendous recovery needs that a person has because of the work that they're doing in their athletic activity. And also could be because they're taking acetaminophen or other glutathione reducing drugs.
Of course, there's many pathologies as well that reduce glutathione in the body. So, when that happens, you need to give cysteine, and the way to do that is not through L-cysteine. L-cysteine, sometimes they're even available in health food stores but it's not really very safe and it's not safe in high doses. The safe way to take it is with acetylated cysteine. It's just a little molecule that gets cleaved in the stomach but to ingest it, it's the safest way to take it. Take it in very high doses, it's not toxic. In most people, it has no side effects whatsoever.
A few people get a bit of digestive upset but it's quite rare. But the main thing is with cysteine, with acetylcysteine, it has to be prepared property and handled properly through the manufacturing process and all through the supply chain until you take it and that's really the problem. One of the problems with acetylcysteine in the past has been improper handling. So, our company set out to say it's not just research about cysteine that we have to dig into but we also have to figure out the right way to preserve its functional activity in the body.
So, we wrap it in that we make it into an effervescent pill, which is very pleasant because when you take it you have to drop it in the water. It's like an Alka-Seltzer type of effect. And you drink it. It's very nice to have. It gives people hydration, which a lot of us need, as you know. And it delivers the cysteine intact because we've put a little burst of nitrogen in the packet when we wrap every single pill. So, when you're opening the pill, there's been no oxygen, certainly no wet oxygen exposed in that chemical to the molecule from the point of manufacturing. So, that's why we have very good stability. And that's really the key.
If you don't do that, if you just take cysteine or N-acetylcysteine that comes from kind of a cheapy capsule, that capsule was made by people putting the capsule together in ambient air, which is fairly humid, 60%, 70% humidity in ambient air, and a lot of oxygen around. And so, that is just causing the molecule to degrade over time and you're taking degradation products. You're taking oxidized -- NAC has a biological activity, which is in opposition to being an antioxidant. It's actually bad for you. So, I always encourage people, if you have a real need to take a supplement, let's give you the right kind and the right quality so that's why we designed the manufacturing process for PharmaNAC in the way we did.
Christopher: What is then, the sulfur smell that you sometimes get with N-acetylcysteine in a capsule?
David: Well, it does have a natural kind of distinctive odor because the sulfur moiety on the acetylcysteine is an important part of its function as an antioxidant because it is donating sulfur to the glutathione molecule. So, it's normal for NAC to have what I would call a distinctive odor. What people are really bothered about is -- one of the degradation products of acetylcysteine is hydrogen sulfide, H2S. It's the thing that makes an egg smell rotten. It's highly repulsive. It's poison naturally. Of course, no one could -- you don't ever get enough of it to really be toxic to use as a human being.
But we are very sensitive to it in our genetics. The way we were built is that we're sensitive to it because it's a poison. So, a human being can detect H2S at six parts per billion in the atmosphere. So, when NAC starts to go bad you will detect that stink. However, if it doesn't smell, that doesn't mean that it's good because it could still be degraded in any one of seven other degradation pathways.
We don't carry HPLC lab kits around with us in our pocket when we shop so we really don't know. So, we have to really go by decent respectable understanding of is there really a reason to be worried about the stability of this molecule? In the case of, say, acetaminophen or aspirin, they're highly stable molecules. So, you don't really have to go to the ends of the earth to protect it with nitrogen envelopes in special packaging per tablet if you may be convenient.
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But it's not chemically necessary to retain the stability of it. But with acetylcysteine, our research shows that you do because we did assays on other products which were these encapsulated products and we just saw that in some cases there was no NAC in there. There were degradation products of NAC but not NAC. And on the research side, if I may digress, it gets really crazy because we found a doctor in New York State. He wanted to do a study of NAC in his -- he had some kids with bipolar disorder and wanted to see if it could help them because there's some indication of oxidative stress in that illness.
So, he said, boy -- this is before he knew us. He went down to the supplement store and picked up some NAC. He was, "Wow, that stuff really smells bad but, you know what, I don't know. So, I guess that's what it smells like." So, he had to make a placebo. So, he went to the lab and said at the pharmacy, at the hospital pharmacy and he said, "Guys, make me a placebo like this." They go, "We don't know how to make something that stinks like this."
So, what they ended up doing was they made a placebo but then they rolled the placebo pills in the stinky NAC to make the placebo stink as much as the NAC did. Like how crazy does that have to get? So, we just say, we're trying to get the word out, we have a NAC unmarked, drug and placebo, available for researchers who want to do high quality respectable field studies to really learn about NAC. And if they give us a protocol that we like then we'll work at arrangement to them to get them the study materials. And that policy has really helped learning. We've learned a lot over the years by doing that.
Christopher: That's wonderful. That's so great to see a supplement company investing in teaching and education and furthering the science in that way and not just trying to make money. That's really cool.
David: I mean, making money is built on a view and it's built on a way you want to live and what you're accountable for and what do people trust you for. I mean, you go to a certain kind of store and say, "I trust them to have the lowest price that's why I'm here." You go to a different kind of store, you go, "I want something that will never break. I want that machine and I want to trust that it won't break." So, I'll go there.
Everybody, when you're dealing with another commercial counterparty, you're always evaluating what are my values, what are theirs and are we in sync? I think that we sync well with people who are serious about their metabolism and their health and are looking to make a rational decision and approach to why they're spending their money on this and why they're putting their, exposing their body.
Christopher: And I wanted to talk to you about how do you decide whether or not you need it because -- I'll tell you the story and I apologize to my listeners who've probably heard this before. Back a long time ago, I did a urinary organic acids test and I found high levels of oxidative stresses, 8-hydroxy-2-deoxyguanosine, which is my favorite word for impressing people. And then also p-Hydroxyphenylacetate. So, these markers of cell turnover and of DNA damage by oxidative stress. I emailed my uncle and he sent me some interesting papers.
I guess, my main question was like: Oh, is this a problem? Should I be concerned about this? And he said, "Yes, absolutely." That oxidative stress plays a role in Alzheimer's disease and aging and all kinds of other diseases and it's a real problem. And he sent me this paper that showed that the lycopene in tomato juice was able to reduce oxidative stress as the organic acid that I measured. And since then I've realized that the situation is a bit more complicated than that.
So we see an increase in oxidative stress after physical activity and -- remember that all of my listeners are all athletes looking to increase their performance. But the oxidative stress that takes place after exercise may actually be part of the signaling mechanism that leads to an increase in fitness. And so taking a ton of antioxidants or anything that's going to increase your glutathione status right or during exercise may be a bad idea. So, beyond paracetamol toxicity, how do you decide or how would you decide whether someone needs NAC?
David: It's I think useful to understand that NAC itself is technically an antioxidant but it doesn't matter that it's an antioxidant. What I mean by that is that your acetyl group is cleaved in the stomach and then you have this cysteine that's roaming around your body and your body has exquisite control over what it does with that cysteine. So, it could park it in your liver or it could conjugate it with glycine and then you've got cysteinylglycine roaming around in your serum in your blood.
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And then if it wants to make glutathione that is going to make it a functional antioxidant it's going to shuttle that into that cell, glutathione gets made in cells, and that's where the glumates join to it. So, until then, in other words, you have a pool of cysteine available. So, you're not just kind of pouring water on the fire. We often have these analogies when we talk about oxidative stress of the fire and pouring of water on the fire and stuff like that and trying these methodologies of control.
So, our supply of cysteine through taking acetylcysteine is a method for, let's say, filling up the water tank that's available for the fireman should it be out of control. But you're not just pouring water on healthy fire, you know what I mean? Sometimes you need that signaling to happen or you need normal oxidative metabolism to happen. And you don't want to be kind of blind while you're fighting about a body process that should be happening. That's kind of working across purposes with a blindfold on.
So, that's why I don't think taking IV glutathione, for example, is a very good idea at all. Not that I think that's a widespread concept. But just to illustrate the contrast. Our model of approaching this is to say your body is going to have times when it needs to recover. During the exercise and immediately after the exercise, you're going to have a lot of -- I should probably let you fill in the blanks here -- but metabolic and anabolic activity that are going to happen that you want to happen.
However, after that, you are in a period of recovery. If muscles are just in a state of suffering then if you can accelerate recovery then you can work harder sooner than you otherwise would have. So, if you take a look at it, if we look at it longitudinally over time then people will have adequate antioxidant loads of cysteine tend to do better because their cumulative amount of work that they're able to accomplish is higher. You see, the area under the curve, if you will, is greater.
And we're not working at something where we're trying to extinguish a valuable metabolic process. So, understanding cysteine as a background supply, like a pool of cysteine that's available to make, to balance glutamine placement in cells, which is very important to mental health, for example, or to make more glutathione in case you do have oxidative stress, that's important. If you don't have the cysteine, your body is just not going to make the glutathione count and you're going to have potential damage to variety of cell types.
Glutathione is the ubiquitous antioxidant. It's the most important antioxidant in every mammalian cell. You have to have a ton of it. Your lungs need a ton of it. I mean, when you're breathing hard, you're obviously breathing in immense amounts of oxygen, the interface in your lung to your lung air has about 100 times as much glutathione as intracellular glutathione in the rest of your body. So, an athlete definitely is exposing himself to a lot of opportunity for oxidative stress. Exercise is amazing. You just got to give yourself the cysteine that you'll need when you need it.
And you really don't know when you're going to need it. Cysteine has -- this is interesting actually. Cysteine has -- there's about a three-hour gap between when you take cysteine, when you eat it, and when it shows up in your blood -- when it peaks, I'm sorry, in your blood. And then there's about another three-hour gap until your glutathione.
Christopher: Oh, interesting.
David: Yeah. Sometimes people think of it as like caffeine or something. I'll take an espresso shot and I'll feel it right away and I've got the effect right now. Cysteine isn't like that. So, it's very helpful to think of it as you're the Scottish piper who's blowing air into the bag but that's actually in a very indirect relationship to the sound that's coming out. See, it's two different processes. One is putting the cysteine in the body and the body's processes making a whole antioxidant reaction through glutathione is, A, deferred and, B, only done with exquisite control where it's needed.
Christopher: And where is the cysteine? You talked about a pool of cysteine. It was my understanding that we can't really store protein so where exactly is it? Is it what's just been taken in through the diet recently and then is floating around and available and, therefore, very transitory? Or is there actually some cysteine stored in some tissue somewhere that can be broken down? How does it work?
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David: Well, a variety of organ store cysteine in the tissue. There liver is the biggest place for storing cysteine. Then there are large amounts of cysteinylglycine that are in your serum, in your blood that are available roaming around in case a cell signals, "Hey, I'm under oxidative stress. Come and help me out." And then it will pull the cysteinylglycine into the cell, make glutathione, and then the cell will defend itself from the oxidant.
Christopher: And so this is different then. Maybe a better analogy for the N-acetylcysteine is you're just bringing the lumber to the yard and it's kind of up to the yard whether or not they build a house out of it versus some of the plant extract, so like it's a natural antioxidant in itself. Do you think that's the difference? Say, the lycopene was the example I thought of earlier. It's just a compound found in plants that acts as an antioxidant. So, that will be like pouring water onto the fire rather than just bringing the lumber to the yard.
David: Yeah. I mean, I think that's true. That is difference, structural part of the therapy or of the nutrition plan. So, I mean, you say how do we know who needs it. So, part of my answer is your body knows if it needs it and it will do a really good job in figuring it out. The other is what do we think and what do we and what do we buy and things like that? I always tell people go to your health advisor, go to you and work it out. Because every case is different.
The average of us is not a real person. Everybody is a little bit different and our genetics, our background, our diet, our behavior, our stress load, all these things, medical background is sometimes complicated. So, the advisor has to kind of put it together. I mean, if you have a person, for example, who has a family history of hormonal cancers like breast cancer or prostate cancer, definitely very smart to think about adding lycopene into that diet, if it's through tomato, juice, tomato sauce or if it's with a lycopene supplement.
We make a lycopene supplement to be available for people as well. But I think that is a highly specific question that could make lycopene really relevant to people. That's not the only reason that lycopene is relevant but that's just an example of when it can be.
Christopher: Lycopene is cheap, right? I think that's the reason that this study used tomato paste to it because it's so cheap compared to some of the supplements which are very expensive.
David: Well, yeah. And it was easy to study because in some diets, well-known Mediterranean diets, for example, you can kind of count on it epidemiologically that people are going to be eating cooked tomatoes at least three times a week. And then compared that to populations which don't eat that way and normalize out for everything else and take a look at that, those epidemiological studies were very helpful in the early days of identifying lycopene and other carotinoids as a relevant to human health. I mean, we've learned a lot though since then. I mean, the studies that you're referring to are very helpful in really showing how it's important to eye health, skin health.
Christopher: I think it's important to mention that when I run a test in someone and we found this elevation of oxidative stress, we probably also found some other problems like, for example, a yeast overgrowth or some other kind of infection. And the infection is maybe causing a bunch of inflammation and inflammation is almost synonymous with oxidative stress. So, there's kind of -- if it was like a reserved, a swimming pool say, then you're just kind of -- your capacity to cope with that oxidative stress is being overwhelmed by the fact there's so much going on in terms of the yeast and the exercise and maybe whatever else you've got going on in your life.
David: Do you also counsel people about the macro aspects of their diet as well?
Christopher: Yeah, we do. So, we've had tremendous results recommending a Paleo type diet. I would describe it as a high fat diet. Each person is individual but everybody is an athlete, typically the under eating actually, if I'm honest. That's one of the biggest problems that we see. And so part of the battle is getting people to eat enough food. That's what I spend the bulk of my time doing, is diet and lifestyle coaching. So, we do these tests and we find some problems and I have some supplements like PharmaNAC that can help solve their problems.
But I can't help feeling that most of the benefit actually come from the diet and lifestyle coaching. So, getting adequate sleep, managing stress, having a training plan that works for you at this time. All those things I think are really important for finding, for meeting goals rather than just supplements alone.
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David: Yeah. I wish personally that -- I mean, maybe we're going to work on it together but some way in which we could evaluate how much PharmaNAC helps or who does it help more than other people or so on, I don't know. Just kind of collect a lot of information and tease it out and just know more and be more aware of what matters, right?
Christopher: Yeah, exactly. And, of course, it's something I constantly wrestle with. You run a bunch of tests and then you make a bunch of recommendations. At that time my goal is just to help that person. Say you come to me and you got brain fog and you can't sleep and your performance sucks. You've not really made any progress with your training for a few months. I just want to fix that problem. To some respect, I don't really care which of the things I recommend is helping the most. I just want to do everything that I know that's relatively easy and non-invasive to do.
And, of course, I never know either. So, it's something I think a lot about. Is there something? Or is it just this one? Is it just the sleep? If I could just get everybody to sleep perfectly, would I not need any of the supplements? That's kind of an interesting question. And we've got to the point now where we've run tests on over 600 people and one of the doctors involved, Tommy Wood -- he's been on the podcast lots of times -- he does peer review science for a living and writes academic papers. So, he'll be really good person to help us get something published. Yeah, absolutely. We're interested in that.
Christopher: I'm working with a computer science group in working how to push data collection kind of out to the edge so that people can track and report how they feel and how they ate and how compliant are they to the protocol. Some people have simple protocols, others difficult, other difficult for me, hard for you, that type of stuff. I mean, the questions become, well, if they -- If Chris said take this twice a day but twice a week they only did it once a day, does it matter? That kind of question.
And if you have a big enough population and real time reporting like kind of pushed out to the field on people's phones, reported into secure databases anonymously to protect confidentiality, that's what we're working on how. And I would hope that I'd be able -- my ambition is I want to be able to provide that tool, no charge, clinics and advisers such as yourself, so that you can know whether your protocols are -- like who gets the most benefit out of your protocol? And then say to people, "Look, I have evidence. It really works. This is what happened with my folks."
Christopher: I would love to do that as well. I think there's some accountability there too. I've done it recently. I guess, a great example is the food logging. But sometimes the application is so catastrophically awful I couldn't possibly inflict it on someone. It's just so terrible to use. What I really want right now is an app where you just take a picture of the food and someone maybe a computer algorithm, maybe some mechanical turks or human that's identifying this thing and then they tell you exactly what it is, what micronutrients are present, what macronutrients are present, what other compounds like lycopene we talked about there, and then just create a report at the end of the week and all you have to do is take a picture of your food.
But at the moment it seems like it's just a really, really clumsy logging. I guess, it would be the same for everything else, sleep and how often you take a supplement or a medicine. And I would hate to inflict that on somebody that's already stressed out and is struggling to find time to get everything done and then you give them this extra thing that's not really for them.
David: I mean, if the app says arugula, does it say Belgian Endive, and then what does the person do if it doesn't -- I mean, that's the kind of things I've said to my folks just try to just work with the clinical people to ask the important questions. And we're working on it. It'd be a couple of months until we have a prototype I think.
Christopher: Oh, interesting. And then tell me what you know -- Before we got on to this, we talked about glutamate a little bit. I think that's a really interesting story and I know that there's some genetic susceptibility. I was talking to Dr. Grace Liu who's been on my podcast recently about the GAD1 mutation that makes some people susceptible to glutamate toxicity and migraines and there may be a problem with some of these -- I don't know if you've looked at these gut supplements that contain a ton of glutamine.
And the idea is this is really good food for the cells that line the GI tract. But in actuality, in some people, it just causes a bunch of glutamate toxicity and gives them terrible migraines. So, there is a connection, isn't it, between glutamate and cysteine. I just wonder whether you could talk about that.
David: Sure. We were approached kind of out of the blue in, I think it was 2006, by a group at the University of Minneapolis and they said, "We think because of the cystine glutamate pump--" It's called the xCT system biochemically. What happens is that there are certain cell types that they have two train tracks on them and one brings the cystine in and the other pumps the glutamate out.
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And so your body, because cystine is fairly rare among amino acids, it uses cysteine as a regulator. So, and that's a useful thing to think about it in terms of glutamate as well. So, when you have neurons that have too much glutamate in the synapse, that's toxic to the neurons and what you get out of that is aberrant behavior. So, that could be an autistic child who acts out, who has self-injurious behavior, who may be hitting himself, for example.
I had a boy who was -- I mean, not my own boy but a customer of ours. She said, "My son has been hitting himself in the head since he was three." And now he was 21. And she said, "I've had him in restraints his whole life." Bottom line of the story is he had a glutamate problem and that manifested itself in self-injurious behavior. With other people it's addiction, addictive behaviors, or excessive self grooming, pulling the hair out, picking the skin, picking nails and such like that, real compulsions.
Depression. Let me talk about PTSD a little later, if you like. There's another aspect of ruminations in depression which are part of another type of compulsive thinking. Let me get back to the story because I love the story. She said to me, "David, I never thought and my whole family thought that we would never take my son out of restraints." She said, "We started him on PharmaNAC because we did a study on autism at Stanford and they showed that there was a very significant improvement in irritability in kids with autism that happened about a month, within a month of them. So, we started him on it.
So, after a few weeks, I decided to take the restraints off for 20 minutes and he didn't hit himself but I was just too nervous so I put them back on because I thought something is going to happen. So, I did that every day for a couple of days. And I said, you know what, I'm going to keep them off for 45 minutes. And so I did that. And he still hadn't hit himself."
Then she increases the protocol as one pill for a day for the month and then the next month go up to two pills to 1800 milligrams of NAC. So, she said, "I went an hour, I went two hours, I went three hours. Then I ended up after a couple of months," she said, "I had the courage to really sit all day with my son and he didn't hit himself at all." And it's so amazing to me that people can have these drastic changes in their lives that unless you're fixing that glutamate toxicity problem in the brain -- which, of course, we have no access to, we can't play with brain chemistry. I mean, it's really hard.
So, what people do is they sort of resort to turning the mind off with anti-psychotic drugs. And, of course, these have side effects as well with obesity and disintegration -- not disintegration but a kind of hiding of the personality if you will. So, glutamate is very important to mental health and all these aspects of compulsion and addictive behaviors and so on. And also to happiness. Because what we found in the PTSD study -- and this is actually relevant to everybody, to business people, to athletes, to everyone -- is how do you stay on your goal?
How do you make a plan and stick to the plan? And some of the things that keep people from their plans have negative rehearsals of ideas. They think I don't like her, she doesn't like me, this is no good, everything always goes bad for me, this is not going to go right, I'm not going to do that, blah, blah. And they rehearse the negativity over and over again. So clinically, that's called ruminating. And ruminating keeps a person from constructive planning and from constructive execution of a plan.
If somebody gives you the plan, you're just not interested in putting your 110% into it if you're ruminating about negative stuff. So, in our PTSD study -- this is not published. This is only a manuscript. But I have permission from the author, a professor at the University of South Carolina. He said, "David, you could tell the story." So, what happened in the NAC group that [0:34:32] [Indiscernible] with PTSD who had a comorbid addiction, they went into a halfway house and why in the halfway house? Because we believe that abstinence is important in starting off the reprogramming of the brand.
So, they start off the NAC and they abstain. And what they found was there's this drastic reduction of cravings. All of the people who had PTSD fell out of the PTSD diagnosis during the course of that trial. None of the people in the place group did. All the people in the NAC group did.
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Now, why? This is insight. If you take a look at it, say, all right, there's a questionnaire. You answer both the questions and they're in various categories. If you answer above 50, you have PTSD. If you score below 50, you don't have PTSD. So, we look at the anxiety, they were still anxious. If you look at jumpiness -- you drop a glass on the floor and somebody thinks [0:35:24] [Indiscernible]. They were still jumpy. What changed was ruminations.
So, ruminations fell off the cliff. Now, why was that helpful to an addict who was depressed with PTSD? Now they can participate in planning. Now, they can attach to goals. Because they're not ruminating about all this negative stuff. And so that helped them to lose their addictive behaviors because they were really doing the work. It's not that the NAC is doing the work. NAC is not changing your life. What the NAC is doing is freeing the mind from this ruminating habit.
And then you can participate now with your counselors, your advisers, whoever is giving you cognitive behavioral therapy, or your coach, whoever it is, to say, "Look, this is what we got to do. Here's our plan. Let's go for it." And now you can participate in that because you're not ruminating.
Christopher: Interesting.
David: I thought that's a beautiful thing. This is a very, very fresh insight. And I think it's relevant too for me as a businessman or any kind of athlete, I think that's a -- what do you think?
Christopher: Yeah, I know it is amazing. And I love the idea that at some point biology drives behavior. There's nothing wrong with you really. At some point, we can boil this down to biology and if you can test and manipulate that then that's a really interesting thing. Well, this has been fantastic. I'm really excited. So, where do people go? Where should I go to find out more about your studies?
David: Really we don't. Because of FDA rules, we don't publish a lot of leading consumers by the nose with medical information. We don't want to be thought of as exploiting consumers or stuff like that. We give medical information to practitioners. So, we would supply you. If you want, I can give you lots of information on a variety of topics. And it can be kind of summary information that you can read in five minutes and kind of get the topic, the way I talk, like that kind of stuff. Or we could give you the science papers and do it that way. So, in other words, we provide the information to professionals and then it's up to the professionals to decide that their clients, if you will, should take our product.
Christopher: Okay. That makes a lot of sense. Yeah, absolutely. I want to read everything. I know that Tommy will want to read everything too.
David: That's great. I love the way you have an appetite to hear about it all.
Christopher: Oh, yeah, absolutely. That's kind of how I got into this was I had a bunch of problems and I fixed them and I was like, how did that just work? I need to know how that worked. And that got me to where I am today. But, yeah, we originally discovered PharmaNAC, I should say, to Jamie Kendall-Weed who is a medical doctor. And she said, "Well, you know that you can give people N-acetylcysteine and that will help them with their glutathione stasis and reduce the oxidative stress that you just found on that organic acids test."
And I'm like, "Okay." So, we recommended it as a supplement and then you redo the organic acids test and, sure enough, the organic acid has gone down and the person is showing improvement. And so that's how we got into it. I've not actually done a lot of reading around the product or read any of your studies. So, yeah, absolutely. I look forward to doing that.
David: Okay. I will send you some.
Christopher: Cool. That was great. Thank you very much, David.
David: Okay.
[0:38:44] End of Audio
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