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[1] Precursor Conversion Path: NAC is absorbed and converted to cysteine, which then combines with glycine and glutamate to form glutathione

Annals of Surgical Oncology 2011;18:37117

It was concluded that small changes in the GSH/GSSG ratio is amplified to large effects on redox potential through the oxidation/reduction of cysteine residues within proteins, rather than changes in the GSH/GSSG ratio directly affecting the cellular redox potential [11]

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ROS stimulates the activity of many physiological components, including mitogen-activated protein kinases (MAPK), tyrosine kinases, Rho kinases, and transcription factors (NF-kB, AP-1, and HIF-1) and increased concentration of intracellular free Ca 2+ also inactivates the protein tyrosine phosphatases (PTP)

This distinction matters because improvement reflects actual healing rather than masked symptoms