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J Manage Care Spec Pharm
The first and major contributor is impaired synthesis due to diminished availability of the amino acid precursors cysteine and glycine (compared with values reported in healthy controls) (20, 21), and the second is increased entrapment of GSH in its oxidized form
NAC takes the sulfur from glutathione and connects it to toxic molecules, which then become water-soluble to be excreted from the body
Both groups received standard DMARD therapy consisting of methotrexate, leflunomide, and hydroxychloroquine, while the intervention group received an additional dose of L-carnitine at 500 mg twice daily over a 12-week period
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