Nitric oxide can increase blood flow and reduce blood pressure. Supplements which increase nitric oxide production may also be beneficial for managing certain health conditions.
Nitric oxide is produced naturally by the human body and is one of the most important molecules for blood vessel health.
It’s a vasodilator, meaning it relaxes the inner muscles of your blood vessels, causing the vessels to widen. In this way, nitric oxide increases blood flow and lowers blood pressure.
Supplements may improve your natural levels of nitric oxide. They don’t contain nitric oxide itself. However, they contain compounds that your body can use to make nitric oxide and have been shown to provide many benefits for health and performance.
What is the role of NO or Nitric Oxide?
Nitric oxide is a crucial signaling molecule in the human body with a wide range of physiological functions. It is produced and released by various cells and tissues, and its effects are diverse and essential.
Here are some of the primary roles of nitric oxide in the body:
- Cardiovascular health
- Increases blood flow
- Restores sexual function of smooth tissue (in the clitoris for women and penis for men)
- NO increases oxytocin, which is dubbed the “cuddle” or “love” hormone
- NO/oxytocin are important modulators for sexual behavior
- Oxytocin increases bonding and orgasms
- Plays a role in the healing of wounds
NO is also critical for:
- Circulatory function
- Glucose metabolism
- Cognitive function
- Digestive function
- Respiratory system
- Immune system
Common Diseases and Nitric Oxide
Erectile Dysfunction (ED) is a common health concern among men that indicates issue with blood flow. There is a huge link between cardiovascular function and erectile dysfunction ED is a very strong indicator of cardiovascular risk (60-70% by age 65).
Blood flow restoration and maintenance is important in correcting ED and improving overall vascular health—boosting nitric oxide can help improve overall circulation.
Our lifestyle is very influential on our Nitric Oxide levels. Our diet, level, regular physical activity Alcohol and tobacco consumption factor into the equation.
Diet: Eating foods rich in nitrates, such as leafy green vegetables (e.g., spinach, arugula), beets, and certain fruits (e.g., strawberries), can boost NO production. These foods provide the building blocks (nitrate and nitrite) needed for NO synthesis.
Antioxidant-rich food can help preserve NO levels by reducing oxidative stress, which can otherwise degrade NO.
Regular Exercise: Exercise stimulates the production of NO, which plays a crucial role in regulating blood flow during physical activity. Regular physical activity can improve endothelial function and NO bioavailability.
Smoking and Tobacco Use: Smoking and exposure to tobacco smoke can reduce NO levels by damaging the endothelium and interfering with NO production. Quitting smoking can help improve NO function and overall cardiovascular health.
Alcohol Consumption: Moderate alcohol consumption may have a modest positive effect on NO production and cardiovascular health. However, excessive alcohol intake can have detrimental effects on NO and overall health.
Stress Management: Chronic stress can negatively impact NO levels by promoting inflammation and oxidative stress. Engaging in stress-reduction techniques such as meditation, yoga, and relaxation exercises can help maintain NO balance.
Balanced Blood Sugar: High blood sugar levels can impair NO production and promote oxidative stress. Managing blood sugar through a balanced diet and regular physical activity can support NO function.
Weight Management: Obesity and excess body fat can lead to insulin resistance and inflammation, which can negatively affect NO levels. Weight loss and maintaining a healthy weight can improve NO production and endothelial function.
Adequate Sleep: Poor sleep quality or insufficient sleep may disrupt NO production and contribute to endothelial dysfunction. Prioritizing good sleep hygiene can support NO balance.
Blood Pressure Management:
High blood pressure can reduce NO availability. Lifestyle modifications like reducing sodium intake, maintaining a healthy weight, and exercising regularly can help manage blood pressure and support NO function.
As we age our Nitric Oxide levels naturally decline. A 50% drop in endogenous nitric oxide production by age 40 is typical. By age 60, nitric oxide levels often drop to by 85%.
Medications Can Affect Nitric Oxide Levels
Certain medications dramatically affect NO levels production, especially PPI’s (protein pump inhibitors) which shut down the nitric oxide production altogether.
PPI’s (like Protonix, Prevacid and Prilosec) and SSRI’s (like Celexa, Lexapro, Zoloft, Paxil and Prozac) inhibit nitric oxide conversion pathways and inhibit sexual function, which is a widespread issue.
Anti-infectives, blood pressure medications, and many stomach medications can all also negatively affect levels of nitric oxide.
Other Causes of Low Nitric Oxide Levels
Oddly enough, antiseptic Mouthwash is another potential cause of lowered nitric oxide levels. Studies indicate that antiseptic mouthwash disrupts certain oral bacteria flora in our mouths that generate nitric oxide in our bodies.
Stress can have a significant impact on nitric oxide (NO) levels in the body. Nitric oxide is a molecule that plays a crucial role in various physiological processes, particularly in regulating blood vessel dilation and relaxation, immune function, and neurotransmission. Stress can influence NO levels through several mechanisms:
Sympathetic Nervous System Activation
When a person experiences stress, their sympathetic nervous system, often referred to as the “fight or flight” response, becomes activated. This leads to the release of stress hormones like adrenaline and norepinephrine. These hormones can reduce NO production by inhibiting the activity of the enzyme endothelial nitric oxide synthase (eNOS), which is responsible for synthesizing NO in blood vessel walls.
Increased Oxidative Stress:
Chronic stress can lead to an increase in oxidative stress in the body. Oxidative stress occurs when there is an imbalance between the production of harmful reactive oxygen species (ROS) and the body’s ability to neutralize them with antioxidants. High levels of ROS can scavenge and break down NO, reducing its availability for vasodilation and other physiological functions.
Stress can also trigger an inflammatory response in the body. Chronic inflammation is associated with reduced NO bioavailability because inflammatory molecules can interfere with the activity of eNOS and decrease the production of NO.
Prolonged stress can lead to endothelial dysfunction, a condition where the inner lining of blood vessels (endothelium) does not function optimally. Healthy endothelium produces NO to help maintain blood vessel tone and regulate blood flow. Stress-induced endothelial dysfunction can reduce the release of NO, contributing to cardiovascular problems.
Chronic stress is a risk factor for the development of high blood pressure (hypertension). Reduced NO availability can impair blood vessel relaxation, leading to increased vascular resistance and elevated blood pressure.
Stress can also affect mental health conditions such as anxiety and depression, which have been associated with altered NO metabolism. Changes in NO levels may contribute to the development or progression of these conditions.
Supplementation for Nitric Oxide Deficiency
A large majority of patients I see are have severely depleted nitric oxide levels. If Nitric Oxide has been depleted, there a few potential ways to restore it with supplements.
Quality supplements will change your levels very effectively (90 min after taking energy levels soar, brain fog lifts, etc. and levels can be retested to see change)
NO enhances the effects of some medications (including PDE5 inhibitors like Viagra, Bimix/Trimix. There are no contraindications, however, patients on Coumadin, blood thinners, anti-clotting meds, transplant medications, or who have blood flow issues must take that into consideration and be mindful. If a patient can eat spinach, arugula, or beets then generally speaking they are able to take NO supplements.
Taking NO supplementation increases circulatory functioning, which helps many body systems; ie anywhere you have small vessels, like brain, heart and reproductive organs.
What to Look For and What to Avoid in a Nitric Oxide Supplements
Choosing a NO supplement can take some research, given the wide variety of options on the market. I recommend opting for NO supplements that do not contain oxalates.
Dietary supplementation is great, as well. Oxalates are compounds found in many foods, and they bind to other minerals like calcium, creating kidney stones in some cases. For this reason, Nitric oxide from arugula is best because of its lower oxalate levels.
What are the Possible Negative Effects of NO supplements?
Blood Pressure Changes
One of the primary actions of NO in the body is to relax blood vessels, leading to vasodilation and a drop in blood pressure. While this can be beneficial for individuals with hypertension (high blood pressure), it may cause excessively low blood pressure (hypotension) in some people, leading to dizziness, lightheadedness, and fainting.
Interactions with Medications
NO supplements can interact with medications, especially those used to treat hypertension or erectile dysfunction. Combining NO supplements with drugs like nitrates (e.g., nitroglycerin) or PDE5 inhibitors (e.g., sildenafil, tadalafil) can lead to a dangerous drop in blood pressure.
Some individuals may experience gastrointestinal discomfort, including nausea, diarrhea, and stomach cramps, when taking NO supplements. These side effects are generally mild but can be bothersome.
NO supplements may cause headaches in some people, possibly due to the dilation of blood vessels in the brain. These headaches are typically mild and go away quickly.
In rare cases, individuals may be allergic to ingredients in NO supplements, leading to allergic reactions such as itching, rash, swelling, or difficulty breathing.
Some NO supplements contain nitrites or nitrates, which can be converted to nitric oxide in the body. Excessive consumption of nitrites/nitrates can lead to a condition called methemoglobinemia, where there is an abnormal amount of methemoglobin in the blood, reducing its oxygen-carrying capacity. Symptoms may include shortness of breath, fatigue, and bluish skin or lips. Nitrites and nitrates should be used cautiously and in moderation.
Tolerance and Dependency
There is a concern that regular use of NO supplements could lead to tolerance, meaning the body becomes less responsive to their effects over time. People who use NO for a pre-workout supplement may also develop a psychological dependency on these supplements for exercise performance.
Quality and Safety Issues
The dietary supplement industry is not as strictly regulated as pharmaceuticals. Therefore, the quality and safety of NO supplements can vary. Choose your supplements wisely!
Point of Contact Testing
Test strips work by measuring the amount of nitrate in the body. They are cheap, fast, and show generalized results, and can give great insight into if you need to start taking steps to improve your nitric oxide levels. You can find a wide selection of quick nitric oxide level tests online.
Nitric Oxide Helps With Overall Health
Maintaining Nitric Oxide levels helps maintain overall health. The health benefits of nitric oxide are often overlooked by the average person. Lifestyle factors such as weight management, diet, and exercise habits all play a part in maintaining nitric oxide health in the body. Getting a good understanding of your current levels and adjusting your lifestyle and supplement intake may even shave a few points off blood pressure!
As hormone and medical weight loss experts, we can help you develop strategies to manage your weight as well as create strategies to maximize your Nitric Oxide levels. Contact us today to learn more about how we can help.
Dr. David LaMond, MD
Founder, Medical Director, Blue Sky MD
Dr. LaMond is a nutrition and prevention expert; who is a successful medical entrepreneur. Dave developed and operates numerous successful medical practices, along with a consulting company which helps physicians and medical practitioners operate successful independent practices. Drawing from his foundation and board certification in Family Medicine, he developed the innovative medical principles behind the Blue Sky MD concept of total patient care. Blue Sky MD has appeared on the INC 5000 list three times; as one of the 5000 fastest growing privately held companies in the US.
Dave has been a featured speaker for numerous medical conferences and has been a business and health consultant and has made several appearances on health television broadcasts. His written work has been featured in medical journals and other print media; with a focus on sports medicine, nutrition, wellness and non-invasive cosmetic procedures.
Additionally, Dr. LaMond has been a luminary, speaker and consultant for Crescent Health Solutions, Eleme Medical, Osyris, Suneva Medical and Candela Corporations, served as a clinical professor for Wake Forest University and is an expert in non-invasive and minimally invasive body contouring and cosmetic laser surgery.
Dr LaMond is passionate about the outdoors and has a love for mountain biking. He works as a nutritional coach and physician for professional cyclists, and enjoys training and riding along-side them. Dave has competed in high level mountain bike events regionally and nationally in masters level competition and has been on the podium at USA cycling National Championships.