Is Nitric Oxide the key to wellbeing?

What is nitric oxide?

Nitric oxide (NO) is a gas normally associated with pollution and toxicity, but which occurs naturally in small amounts in the body. It is a free radical, reacting very readily and lasting for less than a second once created in the body, but is an electron donor, meaning that it has antioxidant and anti-inflammatory effects.

What does it do?

The main action of NO is to cause smooth muscle to relax, resulting in dilation of airways and blood vessels. This dilation is essential for oxygen delivery from our lungs into our bloodstream, and from the bloodstream into our cells and tissues. Dilation of blood vessels also contributes to lower blood pressure as vessels widen, allowing easier flow. Nitric oxide is also a strong anticoagulant and inhibits clotting of blood, helping to protect against arterial plaques.

In the intestines NO maintains blood flow to the gastric mucosa, protecting the lining of the gastro-intestinal tract, and it supports gastric emptying and overall motility.

NO supports our immune system, protecting against airborne infectious organisms that we might inhale, and also regulating immune and inflammatory cells.

It supports energy production in our cells, and plays a role in glucose uptake into cells, supporting the action of the hormone insulin.

How is it produced?

Nitric oxide is produced in the body, converted from nitrates in our food and through the oxidation of the amino acid arginine, via the action of special NO-producing enzymes called NOS enzymes.

Another major source is from helpful bacteria living in small deep crevices near the base of our tongue. These are part of our oral microbiome.

The tissues lining nasal sinuses constantly produce nitric oxide, and nasal breathing draws it into the lungs. Humming agitates the airflow, washing even more available NO into our lungs, which is why it can help to clear our airways.

Sunlight exposure releases NO stored in our tissues.

Movement support nitric oxide production through vascular expansion

Low levels

A number of factors may contribute to lower levels

• Production of the NOS enzymes tends to decline with age as an effect of lifestyle choices such as smoking, sedentary lifestyle, alcohol consumption, unbalanced diet and stress

• PPI medications (such as Omeprazole) and antacids lower acid levels, shutting down digestive NOS enzyme function.

• Mouthwashes and fluoride toothpaste are antibacterial and damage or destroy the oral microbiome

• Breathing through our mouth bypasses the beneficial effects of nasal breathing, meaning that NO is not drawn into the lungs. In addition it creates a more acidic environment in the mouth that damages the oral microbiome.

• The may be a link between high cholesterol and NOS enzyme production.

We might not notice low levels at first, but an early sign – in both men and women – may be erectile dysfunction as blood vessels to our sexual organs do not dilate sufficiently. There may also be a rise in blood pressure, and breathing patterns become less efficient, or maybe we develop sleep apnoea.

If symptoms progress chronic metabolic diseases may occur, such as insulin resistance, ageing, autoimmune conditions and dementia.

Recommendations for supporting good levels in the body

1. Eat foods that promote nitric oxide synthesis

   • Leafy greens, beets, garlic, citrus fruits, nuts and seeds are all rich in nitrates.

   • Processed meats such as bacon, ham and sausage are often preserved with nitrites. (This might be a surprising recommendation, after all it is known that there is a potential link between these foods and rectal cancer. However sufficient levels of vitamins C and E protect agains the risk of the process that creates carcinogens from nitrites. Vegetables, fruits, nuts, seeds, egg, and oily fish are all good sources of these vitamins.)

   • Meat, fish, nuts, seeds, legumes, whole grains and dairy products are all good sources of arginine to support the creation of NOS enzymes.

2. Breathe through your nose to benefit from the first line of defence against airborne pathogens, and to draw more nitric oxide into the lungs for more efficient oxygen delivery.

3. Aim to do some physical exercise such as swimming, brisk walking or gardening, several times a week

   • Physical exercise turns on the nitric oxide-producing NOS enzymes

   • Aerobic exercise in particular can help to restore age-related reductions in NO production

4. Stop using mouthwash, and move away from using fluoride toothpaste. These both damage the oral microbiome

5. Try to keep within the government recommended limit of 14 units of alcohol per week.

Conclusion

Nitric oxide is clearly not the be all and end all of good health – there are many other factors such as balancing levels of nutrients in the body, some of which may be linked to NO levels. However continued low levels of NO may be an important component of the deterioration of health that many of us see with advancing years.

And the three best ways to support levels? In short

Eat well

Breathe well

Move more

:-)