There are two ways the body normally produces Nitric Oxide (NO). One is from the amino acid L-arginine. The enzyme nitric oxide synthase that converts L-arginine into nitric oxide becomes uncoupled and dysfunctional over time. In fact, we lose about 10-12% of our endothelial function per decade. Endothelial dysfunction is the earliest event in the onset and progression of most, if not all, chronic diseases.

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The other pathway to make nitric oxide is from inorganic nitrate and nitrite found naturally in some foods, particularly green leafy vegetables. However, this is dependent upon eating enough green leafy vegetables that contain sufficient nitrate. It is estimated that a typical Western diet only contains about 150mg of nitrate. We need about 300-400 mg per day to make sufficient nitric oxide. Therefore most people are not getting sufficient nitric oxide from their diet. Furthermore, there are many lifestyle choices and commonly used products that completely shut down nitric oxide production from this pathway. The use of anti-septic mouthwash disrupts the oral microbiome responsible for nitrate reduction to NO. Over 200 million Americans use daily mouthwash. Evidence reveals mouthwash disrupts NO production and causes an increase in blood pressure. The use of antacids, specifically proton pump inhibitors (PPIs) also inhibits NO production from both pathways. There are over 200 million prescriptions written for antacids every year. This puts most Americans deficient in NO. It is no longer a mystery why 2 out of 3 Americans have an unsafe elevation in blood pressure.

Nitric Oxide Production Decreases with Age

Nitric oxide production declines naturally over time. This is dependent on diet and lifestyle with some genetic predisposition. By the age of 40, on average, our bodies produce about half the nitric oxide production we had when we were in our late teens and early twenties. This is due to many factors including aging, oxidative stress, poor diet, lack of physical exercise, smoking, diabetes, high sugar diet, certain drug therapy, etc. all resulting in endothelial dysfunction and the progression of disease.