Hey Powermad. That's the first time I've seen somebody mention N-acetyl cysteine here. Very good thought and post. Not to mention that N-AC is probably the most substantiated in medical literature, in comparison to the supplements like Liv and Milk Thistle which have few studies on them and the ones that do show up on a medline search usually involve very small series of patients / volunteers, thus making the results questionable.
The standard dosing protocol for N-AC in acetominophen (tylenol) overdose is to start it within 8 hrs of ingestion at an initial oral dose of 140mg/kg, then give 70mg/kg every 4 hrs for 17 doses (72 hrs). In Europe it is given IV and maintained for 48 hrs. Anyways, so even a "maintenance dose" of 70/kg for someone of average 70 kg size (likely not many people on this board) is 4900mg (4.9 gm) every 4 hrs. Thus, a daily dose of 1000mg per day to try to avoid some of the cholestatic effects of oral AAS likely would not cause any problems.
Having said that, acetominophen overdose is specifically a hepatocellular toxicity (damages the liver cells themselves) without significant bile duct injury (cholestasis), whereas liver damage from oral AAS is more a cholestatic injury due to damage to the bile ducts, causing obstruction of bile outflow from within the tiny bile ducts within the liver. In fact, AAS liver injury is called "pure cholestasis", in that it is usually not associated with damage / necrosis to the liver cells themselves. This is seen with oral contraceptives, oral AAS, and even tamoxifen (nolva). Thus, I'm not sure how much N-AC will specifically inhibit AAS-specific liver / small bile duct injury. As an aside, some drugs that cause a mixed picture of cholestasis and liver cell necrosis would include septra (antibiotic), captopril (for high BP), etc.
