Nitric Oxide: The New Kid On the Block
Illustration © D. Yael Bernhard
Nutrition is one of the most rapidly-developing fields of science. Vitamins, first named “vital amines” as they were thought to be proteins, were discovered only a little over a century ago.1 Beginning with yeast concentrate and rapidly progressing to pills, supplements became widely available by the 1950s, and increasingly popular in the 60s and 70s. Imagine what life was like before we knew about nutrients such as vitamin A, so vital for healthy vision, or folic acid, so crucial for the formation of a fetus – to name just a few. Those of us who grew up in the late 20th century were the beneficiaries of these discoveries. Maintaining dietary vitamins and minerals seemed like the ticket to good health, encapsulated in a convenient multivitamin. Many people choose to look no further, as if nutrients and supplements are one and the same.
Yet science isn’t static, and new nutrients are constantly being discovered, as well as their sources. Many cannot be absorbed from a pill. Some are endogenous, formed within the body itself. On the cusp of the 21st century, one such compound was discovered when American physician and researcher Dr. Louis Ignarro identified a completely new player in human health: nitric oxide (NO), a cardiovascular signaling molecule consisting of one atom of oxygen and one of nitrogen. NO is found in all mammals, and is also generated in the atmosphere by lightning in a thunderstorm.
Imagine discovering a good neighbor who, heretofore unknown, has been quietly living in your community. In this era in which people travel freely, conduct business via video chat, and make more friends online than on the street, we can often miss out on meeting our own neighbors. Imagine finding out this new kid on the block is not only friendly, but protective, rising as needed to help others. That’s how I felt when I first learned about nitric oxide. It was like discovering I have a secret buddy living inside me.
First and foremost, nitric oxide relaxes blood vessels, and thereby lowers blood pressure. It has an anti-inflammatory effect on the epithelial cells that line arteries, veins, and capillaries. It acts in concert with neurotransmitters, and plays a role in mediating cellular immunity.2 It seeks out and neutralizes reactive oxygen species (ROS), or free radicals – the rogue compounds that cause oxidative stress and inflammation throughout the body. NO even interacts with mitochondria, our cellular energy factories, and helps regulate cell survival or programmed death known as apoptosis. Think of a volunteer helper who takes out the garbage, sweeps the floors, and airs out the house.
Nitric oxide itself is also vulnerable to oxidative stress, but antioxidants from the food we eat come to its aid, working to neutralize free radicals. Triggered by an enzyme called nitric oxide synthase, NO rises in response to aerobic exercise in order to increase circulation to muscles and bones. The air we breathe also contributes to NO in our bodies. Your nasal passages infuse your inhalation with NO, which travels to your lungs, relaxing and expanding bronchial tubes – one of several reasons why it’s better to breathe through your nose. Cold showers or plunges also boost nitric oxide. In response to temporary cold shock – a form of beneficial stress known as hormesis – NO is released to dilate blood vessels and warm your body up.
Not to be confused with nitrogen dioxide (the air pollutant); nitrous oxide (the anesthetic gas used by dentists); nitrite or nitrate additives found in processed deli meats (which may cause the formation of cancer-causing nitrosamines);3 or nitrites and nitrates found naturally in fruits and vegetables – nitric oxide is a gas, fleeting and volatile, with a half life of just two to three minutes. It therefore cannot be measured, but its presence or absence may be determined symptomatically. It exists throughout our bodies, yet is ten times more concentrated in the brain.4 This “miracle molecule” is literally mind-expanding! Its anti-inflammatory effect on blood vessels in the brain may make the difference between cognition and decline, or between health and dysfunction of any kind, as inflammation is increasingly understood to underlie almost all cardiovascular and chronic disease.5 No wonder Dr. Ignarro won the Nobel Prize in 1998 for this important contribution to medical science.
Originally used to develop a blood pressure medication, NO is what makes Viagra work, and may soon be used for treating long Covid. Some scientists have postulated that the real benefit of statins lies in their triggering of NO, not their lowering of LDL cholesterol, which does not correlate with reduced heart disease or better health outcomes. Nitric oxide, however, does correlate – in fact, its discovery began as Dr. Ignarro’s quest to uncover the link between obesity, lack of exercise, and heart disease. People who are obese and/or sedentary have significantly lower levels of NO, and this may be the reason why this segment of the population suffers higher incidence of heart attacks.6 Nitric oxide maintains vascular tone, prevents arterial plaque, and inhibits platelet aggregation and the formation of blood clots. It plays a part in regulating blood sugar as well: insulin requires nitric oxide in order to get out of the bloodstream and into the cells, especially muscle cells. The liver requires NO in order to change glucose into glycogen, the main energy storage molecule for all mammals. Even skin benefits from nitric oxide’s shielding effects against the damage of oxidative stress from the sun.
As if these benefits weren’t enough to enhance and extend human health, nitric oxide also lowers uric acid, a major contributor to diabetes, cancer, and metabolic syndrome. Uric acid was discovered over a century before its nemesis, yet has only been recognized recently as the uncomely scoundrel that lurks within, generating disease and thriving on sugar, processed food, and alcohol. Like an arch rival in a Dickens novel, nitric oxide expels uric acid from your inner neighborhood.
In merely three decades since the discovery of nitric oxide, more than 30,000 scientific papers bearing its name in the title have been published, with twice as many referring to it in some way. The signaling pathways of this amazing molecule are connecting all kinds of dots in the world of pharmacology, expanding not only blood vessels but potential ideas for healing applications. Good nutrition, however, will always be the optimal source.
Conversely, low levels of nitric oxide lead to vasoconstriction, and are directly associated with hypertension, vascular leakage, atherosclerosis, and cardiovascular disease. What lowers nitric oxide levels within your body? If you’ve been reading previous articles in this newsletter, you can probably guess: sugar in all forms (including fruit juice, artificial sweeteners and alcohol sweeteners), refined starch, alcohol, soft drinks, and processed and fried foods. These foods and beverages create excess insulin, free radicals, and uric acid, all of which impede the functioning of nitric oxide. Relieving NO of these burdens frees it to fulfill its true purpose: to keep your cellular energy running smoothly and your blood vessels supple and open.
I’m delighted to discover this incredible ally in my neck of the woods! My friendly vasodilator is on hand to help around the house in ways I never imagined. I make it my business to throw a small welcome party for this guardian angel every day, both by exercising and by eating antioxidant-rich foods such as whole fruits and veggies, turmeric, parsley, berries, and dark leafy greens, all of which protect and promote nitric oxide.7 Ginseng root, stinging nettles, and various Chinese herbs have also been studied for their potential to boost NO.8
Nitric oxide is biosynthesized within the body by L-arginine, an amino acid found in all complete (animal) proteins. Almonds are also high in L-arginine – provided the phytic acid in the skin of the almond does not impair absorption.9 To remove this anti-nutrient, my almonds are soaking in water as I write these words, and will soon be drained and dried in a dehydrator. Foods rich in nitrates also boost the production of NO, such as beets, arugula, raw garlic, organ meat, muscle meat, dark leafy greens, dark chocolate (choose one with a high polyphenol content), fatty fish such as sardines, mackerel, and salmon; and various mushrooms including certain Pleurotus (oyster mushroom) species, Ganoderma applanatum (artist’s conk), and more. 10
These foods are among my favorite sources of deep nourishment. It seems NO and I have some friends in common. Any friend of nitric oxide is a friend of mine.
To your good health –
Yael Bernhard
Certified Integrative Health & Nutrition Coach
Yael Bernhard is a writer, illustrator, book designer and fine art painter with a lifelong passion for nutrition and herbal medicine. She was certified by Duke University as an Integrative Health Coach in 2021 and by Cornell University in Nutrition & Healthy Living in 2022. For information about private health coaching or nutrition programs for schools, please respond directly to this newsletter, or email dyaelbernhard@protonmail.com. Her art newsletter, “Image of the Week,” may be found here. Visit her online gallery of illustration, fine art, and children’s books here.
Information in this newsletter is provided for educational – and inspirational – purposes only.
https://www.ewg.org/news-insights/news/how-avoid-added-nitrates-and-nitrites-your-food#
https://www.nature.com/articles/s41591-019-0675-0
https://www.healthline.com/nutrition/how-to-increase-nitric-oxide
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324039/
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051670
https://www.healthline.com/nutrition/stinging-nettle
Acharya,K.;Yonzone,P.;Rai,M.;Rupa,A.Antioxidantandnitricoxidesynthaseactivationproperties of Ganoderma applanatum. Indian J. Exp. Biol. 2005, 43, 926–929.