Nitric oxide - Dr. Axe

It was only a few decades ago that people started paying attention to nitric oxide. Named molecule of the year in 1992, it previously had been a pretty undervalued aspect of human health.

Several years later, in 1998, three scientists were given a Nobel Prize for their discovery that nitric oxide is a key molecule in the cardiovascular system that helps keep blood vessels healthy and regulates blood pressure.

We now know that nitric oxide can boost health in even more ways.

Does nitric oxide help sexually? Some studies show that boosting levels of nitric oxide in the body (such as with the herbal supplement yohimbe) may help with erectile dysfunction (ED) and possibly increase sexual arousal in general.

Today, supplements that raise nitric oxide levels are very popular. The interesting thing — you can’t take nitric oxide pills, but you can take supplements that contain ingredients that your body uses to produce nitric oxide.

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Supplements aren’t the only option, though. You can also boost your nitric oxide levels naturally by eating foods rich in nitrates. Vegetables like beets and leafy greens are are especially high in nitrates. Exercise is another natural way to increase levels in the bod, naturally. Could you use a nitric oxide boost in your life?

What Is Nitric Oxide?

The nitric oxide formula is NO, which means that this colorless gas is made up of one molecule of nitrogen and one molecule of oxygen. Nitric oxide, also called nitrogen oxide or nitrogen monoxide, is produced by almost every cell of the human body. Two amino acids, L-arginine and L-citrulline, boost nitric oxide production in the body. More specifically, the kidneys turn L-citrulline into L-arginine, which is a precursor to nitric oxide.

It is considered a mediator of cell-to-cell communication and plays an important role in a large variety of processes in the body, including inflammation, vasodilation and neurotransmission. It’s considered to be one of the most crucial molecules when it comes to the health of our blood vessels. Nitric oxide plays a very key role in vasodilation.

What is vasodilation? It is an opening or widening of blood vessels that results from relaxation of the muscular walls of the vessels.

Health Benefits

1. Lowers Blood Pressure

What does nitric oxide do to your body?It does many things, including acting as a vasodilator. That means it is able to encourage easier blood movement through the vessels so the heart doesn’t have to pump as hard. This helps decrease blood pressure. Studies to date demonstrates how dietary nitrate intake and the resulting increase in nitric oxide production acutely lower blood pressure in healthy humans.

In addition to positive effects on blood pressure, nitric oxide also can improve endothelial function. This is significant since endothelial dysfunction is known to contribute to the development of artherosclerosis, which can lead to a heart attack or stroke. A study published in 2014 in the Journal of Clinical Hypertension found that a single administration of an oral active nitric oxide supplement decreased blood pressure, improved vascular compliance and restored endothelial function in patients with hypertension.

2. Decreases Blood Clot Likelihood

In addition to decreasing blood pressure, another impressive nitric oxide function is its ability to boost heart health by making blood platelets less sticky. Why is this a good thing? When the platelets are less sticky, they are less likely to clump together and form a blood clot. Blood clots can be potentially deadly because they can cause strokes and heart attacks. Research shows that nitric oxide can help reduce the rate of clot formation as well as clot strength.

Researches from Johns Hopkins have also demonstrated using animal subjects how nitric oxide can decrease blood vessel inflammation and prevent clotting.

3. Helps Erectile Dysfunction and Boosts Sexual Arousal (for Men and Women)

Nitric oxide is the principal mediator of penile erection. It activates relaxation of the smooth muscle in the penis. Studies indicate that it increases blood flow, which is needed to initiate and maintain an erection.

As men age, there tends to be a decrease in nitric oxide synthase or NOS, which are the enzymes that cause the production of nitric oxide from L-arginine. With this decrease in NOS and hence NO, there tends to be a lowered erectile response. This can be a reason why a man struggles with erectile dysfunction.

The positive nitric oxide blood pressure effects are another reason why nitric oxide seems to help ED since high blood pressure and ED have been linked. The discovery of the nitric oxide erection relationship actually has led to the development of some of the most well-known impotence drugs in existence today. Nitric oxide also appears to play an important role in female arousal.

4. Supports Brain Health

Nitric oxide is also known to be a key player in brain health. It has been shown to be an important messenger in various organ systems, but it’s particularly important to the central nervous system, where it acts as an intermediary in cell communication in the brain.

Research conducted at the University of Leicester reveals how nitric oxide can change the “computational ability” of the brain, which points toward NO’s ability to help neurodegenerative diseases, such as Alzheimer’s disease. A scientific article published in 2015 highlights how a decrease of nitric oxide may explain the impaired ability of patients with Alzheimer’s (and other neurodegenerative diseases) to learn new information.

5. Aids Immune System

Many immune system cells produce and respond to nitric oxide. It plays a key role in the immune system and helps fight off disease.

A scientific review published in the Indian Journal of Biochemistry and Biophysics highlights how nitric oxide is “important as a toxic defense molecule against infectious organisms.” How so? One group of immune cells in particular, activated macrophages, inhibit pathogen replication by releasing a variety of effector molecules, including NO. This is just one nitric oxide pathway that helps fight off infection in the body.

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6. May Boost Bodybuilding and Athletic Performance

Many athletes and bodybuilders take nitric oxide pre-workout because they believe it helps them work out harder and for longer. Is there any truth to this? Studies have provided mixed results.

One scientific review of 42 studies concludes that nitric oxide supplements may “improve tolerance” to aerobic and anaerobic exercise in untrained or moderately trained healthy subjects, but there doesn’t appear to be such a benefit for highly trained individuals. The review also points out that the majority of research has been conducted with a young male population, so additional research is warranted for female and elderly subjects.

Ways to Naturally Increase

Possible symptoms of a nitric oxide deficiency include hypotension, insomnia, anxiety, loss of libido and erectile dysfunction. Thankfully, there are many natural ways to boost nitric oxide levels in the body.

Are you wondering how to increase nitric oxide naturally through your diet? There’s really no such thing as “nitric oxide foods,” but there are foods that are known to boost nitric oxide in the body. These foods contain nitrates, which are then converted to nitrites.

Nitrites then are converted into nitric oxide in the body. Roughly 80 percent of dietary nitrates come from eating vegetables. If you look at any nitric oxide food chart, you’ll definitely find beets and beetroot at the top.

Foods rich in nitrates include:

  • red beets
  • leafy greens, including arugula (of leafy greens, this has been shown to be the best nitric oxide booster), Swiss chard, spinach and lettuce
  • endive
  • leeks
  • radishes
  • celery
  • broccoli
  • fennel
  • Chinese cabbage
  • turnips
  • cucumbers
  • carrots
  • cauliflower
  • herbs, like parsley and dill
  • pomegranate juice
  • oranges
  • bananas

Since the cells use arginine to create nitric oxide, you can also consider increasing your arginine intake through high-protein foods rich in arginine, including grass-fed beef; wild-caught fish, cage-free eggs, dairy products like cultured yogurt, kefir, raw cheeses, seeds like pumpkin and sunflower seeds, seaweed, and spirulina.

A 2016 study published in the journal Nutrients reveals that a higher dietary intake of arginine is associated with increased blood levels of nitrites and nitrates, which are a measure of nitric oxide production in the body. To increase citrulline (another nitric oxide booster) intake through your diet, watermelon is the best source. 

Supplements and Dosage

Supplements known to possibly boost nitric oxide in the body include:

  • Beet supplements: When you eat beets, nitric oxide levels can naturally increase in the body. Beets have been shown to be such an impressive nitric oxide booster that they are also available in supplement form as a juice, powder or capsule. A study published in 2018 found that drinking beetroot juice increased exhaled nitric oxide in healthy individuals. While research is still in its early stages, a scientific article published in 2014 concludes that “dietary nitrate supplementation appears to represent a promising new approach for enhancing aspects of the physiological response to exercise, such as muscle efficiency and oxygenation, which might augment performance.”
  • L-arginine supplements: To increase levels of nitric oxide for ED, some people choose to take a L-arginine supplement. According to Mayo Clinic, some specific conditions where L-arginine supplements may be helpful include angina, high blood pressure and erectile dysfunction. What does L arginine do sexually? Some research shows that taking oral L-arginine might improve sexual function in men with erectile dysfunction due to a physical cause.
  • L-citrulline supplements: When considering nitric oxide supplements for ED, L-citrulline is another option. Research shows that patients with erectile dysfunction are more likely to be low in the precursors to NO, which are L-citrulline and L-arginine. It appears that low levels of L-citrulline and L-arginine my increase erectile dysfunction risk by reducing the concentration of nitric oxide in the body. L-citrulline may also offer help for hypotension. One study published in the Journal of Applied Physiology found that L-citrulline was more effective than L-arginine at lowering blood pressure and enhancing exercise performance.

Recipes

These are some delicious recipes to try that are loaded with vegetables rich in dietary nitrates that can help boost nitric oxide levels in the body. Try the following:

Risks, Side Effects and Interactions

In the environment, nitrogen oxides are created naturally from things like wildfires, lightning and soil emissions. Man-made sources include internal combustion engines, power plants, fertilizer applications and agricultural burning.

Can too much nitric oxide be harmful? Nitric oxide is a toxic gas at high concentrations.

Inhaled nitric oxide can be dangerous. Sometimes it is used for newborn babies that have respiratory failure due to pulmonary hypertension. Inhaled nitric oxide side effects can include blurred vision, confusion, dizziness and sweating. More serious side effects can include rapid heart rate and bluish-colored lips, fingernails or palms.

Nitric oxide supplements side effects vary depending on which nitric oxide supplement you choose:

  • Beetroot supplement side effects and interactions include sometimes making urine or stools pink or red.
  • L-arginine supplements side effects and interactions include abdominal pain, bloating, diarrhea, gout, blood abnormalities, allergies, airway inflammation, worsening of asthma and low blood pressure
  • L-citrulline side effects and interactions include potentially causing a dangerous drop in blood pressure, along with other drug interactions.

According to a paper published in 2016 in the journal Nitric Oxide, there currently is no valid, reliable test available to the public for testing nitric oxide levels in the body. There are saliva nitric oxide test strips on the market today, but they are “not likely to accurately assess nitric oxide bioavailability,” according to the paper.

Check with your health care provider before taking a nitric oxide supplement, especially if you are currently pregnant, nursing, being treated for a medical condition, or are taking other medications and or/supplements.

Final Thoughts

  • Nitric acid uses include lowering high blood pressure, boosting brain and immune health, increasing workout performance and improving ED/sexual arousal.
  • Is nitric oxide good or bad for your health? Similar to other key compounds found in the human body, in optimal amounts it can be a health booster in a variety of ways.
  • Nitric oxide can be most easily and safely be increased via dietary sources. Foods high in nitric oxide really are foods that are high in nitrates, which boost nitric oxide production. These foods include beets, leafy greens like arugula, endive, leeks, parsley, broccoli and fennel.
  • The top nitric oxide supplements don’t actually contain nitric oxide, but they do contain ingredients that are known nitric oxide boosters. One of the best nitric oxide supplements may be beetroot juice, powder or capsules since beetroot is known for its naturally high nitrate content.
  • Two amino acids, L-arginine and L-citrulline, also boost nitric oxide production in the body. They are also available in supplement form to increase NO.
  • Exercising on a regular basis also helps enhance the production of nitric oxide in the body.

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