Health benefits of Nitric oxide

Healthylife Pharmacy9 March 2022|3 min read

Nitric oxide is a molecule produced by virtually every type of cell in the body. It is responsible for many important body processes such as blood pressure reduction, circulation of nutrients and oxygen and healthy reproduction and is associated with improved exercise performance in athletes. You may be familiar with nitric oxide used as an inhaled gas to relax smooth muscles and dilate blood vessels to help with breathing in medical situations. 

Nitric oxide in the body

Nitric oxide is synthesizes from the amino acid L-arginine. It is a vasodilating substance (widens blood vessels) released by endothelial cells (cells which line various organs and cavities of the body). It acts as a cellular messenger (between cells and organs) and an effector molecule (a small molecule that selectively binds to a protein and regulates its biological activity). It is a free-radical; an important chemical in immune reactions; is involved in the regulation of cardiovascular homeostasis and the vasodilation of blood vessels. It is responsible for the control of blood flow and blood pressure. Nitric oxide is produced by neurons (nerve cells) and is used by the nervous system as a neurotransmitter to regulate functions such as digestion, memory, vision and the flow of blood. 

Nitric oxide is important for many health concerns

Cardiovascular health

Nitric oxide lowers blood pressure by relaxing the muscles lining the blood vessels and allowing them to widen, decreasing pressure on blood vessel walls. It was also found to have an inhibiting effect on vascular smooth muscle cell proliferation and platelet adhesion -  associated with atherosclerosis. Increased blood flow allows for improved delivery of oxygen and nutrition.

Diabetics

Diabetes is often associated with ulcerations, damaged blood vessels and poor wound healing. Nitric oxide is valuable for diabetics. Along with of improved blood circulation, increased oxygen and nutrient delivery, it can aid in improved healing of wounds.

Wound healing

Improved healing of wounds is not only advantageous for diabetics, but includes wound healing for all people. Nitric oxide could be involved in the process of skin wound healing from beginning to end including roles in cell proliferation, differentiation and apoptosis, angiogenesis, matrix deposits and remoulding. 

Antimicrobial properties

Nitric oxide plays an important role in the innate immune systems response against foreign organisms such as bacteria.

Reproduction

Nitric oxide influences many areas of reproduction.

  • In females - nitric oxide influences successive processes of reproduction such as menstrual oestrogen regulation and the progressions of pregnancy from follicular development through to delivery of a baby. Foetal development can be impaired if nitric oxide supply is insufficient through pregnancy.
     
  • In males - nitric oxide effects progressive reproductive processes such as sperm development to maturation and capacitation (the ability to penetrate and fertilize the female egg). A deficiency of nitric oxide can result in reduced sperm vitality and infertility (insufficient sperm). Nitric oxide can help with erectile dysfunction by relaxing the smooth muscles of the penis allowing it to fill with blood – resulting in an erection.

Physically active and athletes

Nitric oxide can enhance physical performance. It does this through relaxation of smooth muscles resulting in increased blood flow, delivering much needed oxygen and nutrients to working muscles.

Brain function

Nitric oxide may play a role in the treatment of age-related degenerative disease such as dementia.

COVID-19 Research has shown low nitric oxide levels in the body (not only related to age) is associated with high-risk groups of COVID-19 infection, increasing severity and symptoms related to COVID-19.

Increasing nitric oxide production in the body

Nitric oxide is naturally produced by nearly all cell types in the body and nitrates are found naturally occurring in high amounts in many vegetables, processed meat and dairy products. When consumed in the diet, nitrate is converted to nitric oxide. Nitrate is also reduced to nitrite by various bacteria found in saliva and the gastrointestinal tract. Nitrite can have both a positive and negative effect on the body, with some pathways leading to the formation of nitric oxide whilst others may result in N-nitrosamine formation (considered cancer causing).

Diet

Eat your greens. Celery, lettuce, spinach, kale, cress, chervil and arugula contain naturally occurring nitrate which, when consumed, convert to nitric oxide.

Eat your beets. Beetroot contains high amounts of nitrate and has been associated with improved exercise performance, improved blood flow and the reduction in blood pressure. 

Watermelon is high in L-citruline - an amino acid involved in the production of nitric oxide in the body. 

Supplementation

Nitric oxide can be increased in the body by supplementing with amino acids - L-arginine and L-citrulline which are used by the body to create nitric oxide.

L-arginine is a supplement used for conditions such as angina, high blood pressure, peripheral arterial disease (PAD), wound healing, immune maintenance, the supporting the removal of waste through the kidney and erectile dysfunction. Arginine, as both a precursor and doner of nitric oxide, may be of benefit for suffers of age-related cognitive degenerative disease, and other disease related cognitive decline. Arginine is available as in supplement form and found naturally in red meat, fish, poultry, wheat germ, grains, nuts and seeds, and dairy products.

L-citrulline is a non-essential amino acid which can be made in the liver and is a by-product produced when L-arginine is converted to nitric oxide. L-citrulline can then be recycled back to L-arginine. L-citrulline is found in watermelon. 

Beetroot juice. Supplementing with beetroot juice has been shown to increase nitric oxide levels.

Avoiding nitrates

Not all nitrate is good though, and too much may be associated with cancer development. Nitrate is commonly used as a curing agent in the processing of some meats.

It is used for preserving, to enhance taste and aroma and to reduce the risk of bacterial contamination in preserved meat.

Some N-nitroso compounds have been implicated in the development of gastric cancer. Alternatives being currently researched include plant-based extracts which offer antioxidant and antimicrobial activities.

Reduce the amount of nitrate consumed by choosing nitrate-free or reduce consumption processed meat altogether.

The good news is the amount found in vegetables are within an acceptable range that will not exceed the maximum permittable intake of nitrate in the body. And besides, vegetables offer many healthy antioxidant nutrients.

Reference

  1. https://www.britannica.com/science/nitric-oxide
  2. Roles of Nitric Oxide in the Regulation of Reproduction: A Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8640491/
  3. The Nitrate-Independent Blood Pressure–Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683004/
  4. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dietary-nitrate-lowers-ambulatory-blood-pressure-in-treated-uncontrolled-hypertension-a-7d-doubleblind-randomised-placebocontrolled-crossover-trial/861AE199C4AC69A6970527BA2BF77591
  5. Beetroot juice increase nitric oxide metabolites in both men and women regardless of body mass https://pubmed.ncbi.nlm.nih.gov/26653541/
  6. The effect of nitric oxide releasing cream on healing pressure ulcers The effect of nitric oxide releasing cream on healing pressure ulcers - PubMed (nih.gov)
  7. [Expressions of NOS isoforms and roles of NO during skin wound healing] [Expressions of NOS isoforms and roles of NO during skin wound healing] - PubMed (nih.gov)
  8. Development of Antimicrobial Nitric Oxide-Releasing Fibers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468281/
  9. The effects of dietary nitrate supplementation on endurance exercise performance and cardiorespiratory measures in healthy adults: a systematic review and meta-analysis https://pubmed.ncbi.nlm.nih.gov/34243756/
  10. Nitric Oxide: The Missing Factor in COVID-19 Severity?† https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788438/
  11. Reduction of Nitrite in Meat Products through the Application of Various Plant-Based Ingredients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464959/
  12. Nitrosamines - an overview | ScienceDirect Topics
  13. L-arginine - Mayo Clinic
  14. The Effects of Oral l-Arginine and l-Citrulline Supplementation on Blood Pressure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683098/
  15. https://www.verywellhealth.com/citrulline-4774848
  16. https://www.webmd.com/heart/arginine-heart-benefits-and-side-effects
  17. Involvement of nitric oxide in learning & memory processes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121276/
  18. Mechanistic evidence for red meat and processed meat intake and cancer risk: A follow-up on the International Agency for Research on Cancer Evaluation of 2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/
  19. NITRATE IN LEAFY GREEN VEGETABLES AND ESTIMATED INTAKE https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412236/
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