Dietary Nitrates, Nitric Oxide, and Health
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If you are purchasing supplements from the company that supplies our patients, or have been seen in the office this year, you may have already received a bottle of test strips that allow you to see if your body is
replete in the precursors to nitric oxide. Nitric oxide is best known for being the mechanism of action of nitroglycerin, which was used to treat coronary artery disease for more than a century before scientists determined how it worked. Nitric oxide also has a role in hypertension, prostate health, and resolution of inflammation.
The body makes nitric oxide by metabolizing nitrates, found in dark leafy greens and in root vegetables such as beets. Nitrates are absorbed and then collected and concentrated in the salivary glands. Nitrates in saliva are metabolized by oral bacteria into nitrites, which are swallowed. The absorbed nitrite can then be
changed into nitric oxide in the tissues; this pathway may be especially important to help resolve inflammation in areas of low oxygen in the body, as found in tumors or in wound healing.
Eating a wide variety of vegetables can provide sufficient nitrates for health, but most Americans do not do this. The nitrate content of vegetables can vary widely, depending on growing conditions and choice of fertilizer. Commercially available beet powders can have nitrate levels ranging from high to almost zero.
Even if sufficient nitrates are ingested, if saliva production is poor, or the bacteria in the mouth are abnormal, the conversion from nitrate to nitrite may not occur. It has been known for some time that poor oral health and cardiovascular disease are correlated; the role of the oral flora in nitric oxide metabolism may
explain why.
The test strips for nitrites in saliva can help determine whether you need more of the precursors for nitric oxide. If you are a patient and did not get them, with
your next order ask the supplement company for test strips and instructions for use. For all others, you can purchase a bottle from the company HumanN - click here for the listing on Amazon.
If you need more nitrates, first, eat more vegetables! For nutritional supplementation, there are two products that can be of value: Neo40 by HumanN, and Sonne’s #18. Sonne’s #18 is a dehydrated organic beet product from beets grown with compost and seaweed, good sources of nitrates. Neo40 has beet powder that has been tested for appropriate nitrate content; it also includes nitrites and an herb that helps the enzymatic conversion processes run more smoothly. In tests in conditions such as pre-hypertension, Neo40 has been found to
be helpful. (We do not recommend the HumanN product Neo40 Professional, which has extra ingredients that can be excessive for patients on a comprehensive nutritional program.)
Purchasing supplements from third party sellers on Amazon or from other discounted online sellers can be problematic because of counterfeiting. However, HumanN itself is selling Neo40 on Amazon, as well as on their own
site.
In the past, some nutritionally oriented practitioners recommended the amino acid arginine to stimulate nitric oxide production. While there is an enzymatic pathway
to convert arginine to nitric oxide, it is complex and prone to dysfunction as we age. Supplementation with large amounts of arginine has not been shown to increase nitric oxide or to provide the benefits that would be expected if it did.
The HumanN website is a good source of information if you would like to learn more about this topic.
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