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An animal study showed that NAC increased histamine release in conjunction with fluoride.[ref] In people given IV n-acetylcysteine in a hospital setting for acetaminophen poisoning, about 8% of the patients had an “anaphylactoid reaction, defined as cutaneous (urticaria, pruritus, angioedema) or systemic (hypotension, respiratory symptoms)” within five hours of receiving the IV

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[9] A related cause is reduced stomach acid production with age or from long-term use of proton-pump inhibitors, [10] H 2 blockers, or other antacids, [11] and interaction with metformin