Hi ,

NAC vs Glutathione
Glutathione is made from 3 amino acids: glycine, glutamine and cysteine. NAC (or N-acetylcysteine) is a source of cysteine that can be used by the body to make glutathione. Glutathione is particularly concentrated in the liver.

Often we see that the rate-limiting step to create glutathione is the amount of cysteine. The OAT has a marker (number 56 on the OAT test you have done with GPL in march) called N-acetylcysteine. If this marker is low, it means that you either 
• don’t produce NAC or 
• it is being used up because there is an increased need for NAC or
• both!

Do we need both?
The advantage of using glutathione as a supplement is that you know you are having glutathione in your body. NAC still needs to be converted to glutathione, but in a lot of cases, it raises glutathione. To form glutathione, you still need the other amino acids and cofactors. If these are somehow a problem, glutathione is a better choice.

Do blood tests and OATS show whether the liver and kidneys need detoxing?
Blood tests and OATS show often a lot of information that needs to be interpreted. The values of tests are just one part of the puzzle. Patterns seen in values are a second one. Let’s continue with the example above of Glutathione.

Take a look at the picture below:[Glutathione production.png]
Here you can see a picture of all that is needed to create glutathione. Yes, detoxification uses up a lot of glutathione. But when you lack precursors and cofactors like B vitamins, it is hard to produce good amounts of glutathione as well.

On your OAT from march 2022 for example, the results showed a low amount of vitamin B6. This can lead to a build-up of homocysteine, while homocysteine can’t be used to create glutathione.

Other markers are used to see if there is a pattern of toxic exposure, from which we then can conclude what is most likely at play.

This is why Bernadette and I always ask a lot of questions and provide you with different scenarios that could be at play.

To answer your question: we do often know that the body is trying to detoxify and it is struggling to do it based on lab values. But studying lab values, whether it is an OAT or a traditional blood panel from the doctor, is a reflection of what is happening in the body. Some lab values are more direct and some lab values need more context for an appropriate interpretation.  

 what form do you prefer? There are so many brands and options for B vitamins. I suggest you take a look in Fullscript and filter your search by choosing your favorite form (liquid, capsule, vegetarian, etc…) and then see if that brand is available in Amrita.

When my clients have been on a B complex supplement for about 2 months, but have a higher need for B6, I usually switch them over to Thorne’s B Complex #6 or add in Thorne’s Pyridoxal 5′-Phosphate (which is only the bio-active form of B6).