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Additionally, mDNA mutations and dysfunction in mitochondrial biogenesis have been implicated in increased sensitivity to ototoxic agents (Zhang et al

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NAC may be supportive in APD by: Helping replenish glutathione, which plays a role in regulating immune responses Reducing oxidative stress that can worsen mast cell activation and inflammation Supporting overall inflammatory balance, particularly during hormonally driven immune flares Some research also suggests NAC may influence mast cellmediated pathways indirectly 13 , which may be relevant in conditions where histamine release contributes to symptoms

Aug 2020;53(4):637-650

Standing Committee on the Scientific Evaluation of Dietary Reference Intakes - Panel on Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids and the Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine (IOM)