Nitric Oxide: #1 Type Of “Gas” That’s GOOD For You
When taking a long car trip, it’s common sense to fill up your gas tank. After all, if you don’t have enough gas in the tank, you won’t get very far.
Of course, if you have a leak in the tank and don’t know it, you’ll have to stop more frequently to refill, wasting both time and money.
On the other side, overfilling a full tank won’t do you any good either. You won’t get there faster or be able to drive longer. You’ll simply spill the gas, again wasting both time and money.
Interestingly, your body works the exact same in regards to a certain gas. Too little and you could have heart issues, hypertension, lower exercise potential, and even impaired sexual performance. But too much gas in the tank doesn’t help.
The key is knowing what this gas is and exactly how much you need to fill your tank for optimal performance.
Say Yes to NO…
This critical gas is nitric oxide. Nitric oxide (NO) is formed from the amino acid L-arginine, thanks to an enzyme called nitric oxide synthase.
Nitric oxide has been shown to be an important biological regulator and a fundamental component in the fields of neuroscience, physiology, and immunology. It’s so critical in fact that it was proclaimed “Molecule of the Year” in 1992 by the journal Science.
The key to nitric oxide’s health benefits lies in its signaling ability:
- It is a vasodilator, signaling arteries and veins to relax and open up, thus improving circulation and lymph flow.
- It helps maintain normal blood pressure and heart function.
- It works to fight infection.
- It is an important regulator of brain and digestive function.
- Nitric oxide metabolism helps you sense pain, temperature, and pressure.
Big stuff for a pretty simple molecule. But how do you get more of this great gas? Therein lies the rub.
Can Aminos Boost Nitric Oxide?
Because nitric oxide is a gas, you cannot simply supplement with it. Instead, most research focuses on the use of the amino acid L-arginine to boost nitric oxide.
And given its abilities to improve blood flow through arteries, it’s no surprise that researchers tend to focus on nitric oxide’s ability to improve heart function, athletic performance, and even sexual performance.
When it comes to nitric oxide and your heart, much of the research concerns blood pressure. High blood pressure causes the inactivation of nitric oxide, an important molecular regulator of blood pressure. Because NO expands blood vessels, inactivating it causes your blood pressure to go up even more. This in turn inactivates even more NO and end up in a vicious cycle of increased nitric oxide inactivation and ever higher, uncontrolled blood pressure.
It gets really interesting when you factor in diabetes. See, diabetes causes blood flow to slow over time. In fact, in people with diabetes, researchers frequently see decreased blood flow to key organs, namely the heart, kidneys, eyes, skin, and even nerves. Additionally, many people with diabetes often have 50 percent or less nitric oxide in their system, as compared to a healthy individual.1
And, as blood flow slows—whether due to diabetes or high blood pressure—oxygen levels are also reduced. Since oxygen is needed to activate nitric oxide synthase, the enzyme that produces NO from L-arginine, nitric oxide production slows even further.
The answer to both blood pressure woes as well as diabetes is to increase blood flow by improving vasodilation, which means boosting nitric oxide levels. The question is does L-arginine help?
L-Arginine and Heart Health…
To determine if L-arginine could boost nitric oxide levels and thereby lower blood pressure, one researcher gave 29 participants 1,050 mg of L-arginine twice a day for one week.2 Ten of the participants had borderline to high blood pressure levels, while the other 19 had normal levels.
At the end of the week, systolic blood pressure was reduced in 62 percent of participants, with a non-significant average decrease in all patients of 4 mmHg. Diastolic blood pressure was reduced in 69 percent of participants, with an average reduction of 3.7 mmHg.
But, when you broke it down by severity of condition, the borderline to high participants had an average systolic reduction of 11 mmHg, while the “normal” had a mere 0.22 mmHg reduction. On the diastolic side, borderline to high saw a 4.9 mmHg reduction, with normal having a 4.5 mmHg reduction.
Since this was an open label study, all patients knew they were getting L-arginine to see if it lowered their blood pressure. Therefore, it is possible that the differences seen may be due to the placebo effect.
However, in an attempt to look at the direct physiological effect of L-arginine on the vascular system, the researchers assessed vascular compliance using digital pulse wave analysis (an analysis tool that helps detect early signs of heart disease). They found that vascular elasticity improved in all participants by an average of 23 percent.
This suggests that L-arginine does improve vascular elasticity and allows for vasodilation to reduce blood pressure.
As this study shows, for those with normal levels, the supplement was virtually inconsequential. However, just one week of L-arginine was able to reduce blood pressure levels in people with borderline to high blood pressure.
This gives me the impression that the supplement is most effective in people with nitric oxide deficiencies or those with conditions that pre-dispose them to low nitric oxide.
L-arginine’s blood-pressure lowering ability is further substantiated by a meta-analysis reviewing 11 placebo-controlled trials, in which subjects were supplemented with L-arginine at doses ranging from 4 to 24g/day.
The review found that L-arginine significantly lowered systolic and diastolic blood pressure.3 Even when the authors refined the search further to only include studies that were four weeks in length or longer and to subjects who were not using medications for hypertension, they still found that L-arginine was effective at lowering blood pressure levels.
Finally, a randomized, double-blind, placebo-controlled study (gold standard) looked at the use of L-arginine in bar form.4 Researchers divided 41 people with peripheral arterial disease into three groups:
- Two HeartBars a day;
- One HeartBar, one placebo bar daily; or
- Two placebo bars a day.
Patients with peripheral artery disease experience leg pain when walking relatively short distances (referred to as claudication). All participants had both pain-free and total walking distances measured by variable-grade, treadmill exercise testing. Researchers also assessed quality of life by using the Medical Outcome Study, a 36-question survey that assesses physical limitations, social limitations, body pain, mental health, vitality, and general health.
After two weeks of treatment, those eating two HeartBars a day enjoyed a 66 percent increase in pain-free walking distance, as well as a 23 percent increase in the total walking distance. They also noted improvements in their quality of life. There were no significant changes in the one HeartBar per day group, or in the placebo group.
Better yet, the effects were maintained after 10 weeks. Additionally, even the one HeartBar group enjoyed an improvement in walking distance after 10 weeks.
But the news isn’t all good. There are some studies that have found that L-arginine does not help to boost nitric oxide levels. One meta-analysis looked at the effectiveness of oral supplementation of L-arginine in patients with unstable coronary artery disease.5 Their data indicated that L-arginine had no effect on clinical outcomes.
So, mostly good news when it comes to L-arginine and heart health. But what about performance—both athletic and sexual?
Athletic Supporter, Not Booster…
There is a lot of excitement in both of these areas regarding the use of L-arginine to boost nitric oxide levels. When it comes to athletic performance, it has been hypothesized that increased nitric oxide production may increase delivery of oxygen and nutrients to active muscles resulting in improved muscle tolerance and recovery.
But do the studies prove this out? Well, it depends.
On the plus side, one placebo-controlled study found that L-arginine helped to boost nitric oxide levels and reduce oxygen output (not to mention reducing blood pressure) during moderate exercise.6 Similarly, a 2010 study from the American Journal of Clinical Nutrition found that heart transplant patients who were given L-arginine supplements after surgery enjoyed an improvement in exercise capacity.7
In a separate randomized, placebo-controlled, double blind study, 15 men were divided into two groups.8 One group received 6 grams of L-arginine a day while the other received a placebo. Researchers found that while the L-arginine did increase blood volume in the biceps, there was not a change in strength performance.
Other studies cast doubt on L-arginine’s effectiveness. For example, one randomized, crossover, placebo-controlled study of 10 elite college male athletes tested the effect of L-arginine on nitric oxide production, as well as lactate and ammonia metabolism.9 They found that 6 grams of L-arginine a day for three days had no impact on these biomarkers, nor on performance.
Similarly, two other studies looked at foods or beverages rich in L-arginine and their effect on physiological parameters of exercise.
The first had nine athletes follow three different diets over three consecutive days.10 The first was a control diet, the second was high in arginine-rich foods, and the third was the control diet plus a supplement containing 15 grams of L-arginine. Researchers found that neither the diet nor the supplement improved oxygen uptake, heart rate, blood lactate concentration, or athletic performance.
The second study involved eight healthy men and a drink that contained either 10 grams of essential amino acids plus 10 grams of L-arginine, or a control beverage.11 They found that L-arginine did not boost nitric oxide production nor muscle blood flow.
So, some yes, some no. I think the takeaway here is, for the elite athlete, L-arginine has little to no effect. However, in the compromised or less-active individual, L-arginine appears to be effective.
This may be because the trained athlete has near optimal cardiovascular function and there is little to improve. Those with cardiovascular disease or deficits, need more improvement and L-arginine may help at least maximize their reduced physical capability.
Because nitric oxide helps to encourage blood flow, there is much discussion about the use of L-arginine as a natural “little blue pill,” if you will. However, the research isn’t crystal clear on this point.
On the plus side, in one randomized, double-blind, placebo-controlled study, researchers tested the effects of high-dose L-arginine in men with erectile dysfunction.12 They found that the high dosage did improve sexual function.
However, a review of other randomized, placebo-controlled studies found the opposite.13 In that review, researchers found no evidence that supplementing with L-arginine changed blood flow in the penis.
One thing to note about these latter studies is the discrepancy in dosage, with the positive study using significantly higher dosages than the others. This may suggest the higher dose is more likely to be effective. Since the first study was placebo controlled, it is unlikely the positive effect was psychological.
So where do we go from here?
Should You NO? Maybe…
In a nutshell, here’s what the research regarding L-arginine shows:
- It can help boost nitric oxide, thereby improving blood pressure, heart health, and vascular issues in people with diabetes.
- It improves blood pressure levels in those with borderline to high blood pressure.
- It helps improve exercise endurance in people who have undergone a heart transplant.
- High doses promote better sexual response in men with erectile dysfunction.
- It does not appear to improve athletic ability or biomarkers of exercise performance in elite athletes.
- Lower doses may not affect blood flow to the sex organs.
Given this, I conclude that the effectiveness of L-arginine depends largely upon your current nitric oxide status. Like the gas in your car, if you have enough nitric oxide, you probably don’t need more. But if you’re deficient, improving NO levels may improve your health as well as your athletic performance.
Of course, the million-dollar question is, how do you know if you’re deficient? First of all, if you have a pre-existing condition such as high blood pressure or diabetes, it is probably safe to assume you have less than optimum nitric oxide levels.
Another way is to do a simple at-home test. Several companies sell nitric oxide test kits. You simply place your tongue on the test strip and check the color with the panel on the box to see if you are deficient or have adequate levels.
If you want a mild boost, I recommend starting with incorporating more arginine-rich foods into your diet. These include:
- Cold-water fish
Exercise is another highly effective way to increase nitric oxide levels. Aim for a combination of moderate to intense aerobic exercise and strength training 30 to 60 minutes a day at least five days a week.
If your nitric oxide levels are quite low, then L-arginine may be your best bet. According to the Mayo Clinic, up to 9 grams a day (taken in divided doses) is safe and effective. Ideally, you’ll want to aim for 3 grams taken three times a day.
Just be sure that the product you choose is free of preservatives, fillers, binders, excipients, flow agents, shellacs, coloring agents, gluten, yeast, lactose, and other allergens. Ideally you’ll also be able to find independent analysis completed by a third party to verify the active ingredients as well as identify any contaminants.
And remember that no supplement can undo a poor diet or lack of exercise. To really keep your body running in peak condition, you need to incorporate an arginine-rich diet full of whole, real, unprocessed foods, plenty of exercise, and possibly an L-arginine supplement to ensure you have enough gas in your engine for years to come.
Remember, keep an open mind to new ideas, but ALWAYS do your own homework…and combine that with common sense to figure out what’s best for YOU.
1Nitric oxide – Its Role in Health and Diabetes. Anodyne Therapy Web site. http://www.anodynetherapy.ca/nitric_oxide_part10.html.
2Miller AL. The effects of sustained-release-L-arginine formulation on blood pressure and vascular compliance in 29 healthy individuals. Altern Med Rev. 2006 Mar;11(1):23-9.
3Dong, JY, Qin, LQ, Zhang, Z., et al. Effect of l-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am Heart J. 2011;162(6):959-65.
4Maxwell, AJ et al. Nutritional therapy for peripheral arterial disease: a double-blind, placebo-controlled, randomized trial of HeartBar. Vasc Med. 2000;5(1):11-9.
5Sun, T et al. Oral L-arginine supplementation in acute myocardial infarction therapy: a meta-analysis of randomized controlled trials. Clin Cardiol. 2009;32(11):649-52.
6Bailey, SJ et al. Acute L-arginine supplementation reduces the O2 cost of moderate-intensity exercise and enhances high-intensity exercise tolerance. J Appl Physiol. 2010;109(5):1394-403.
7Doultreleau, S et al. L-arginine supplementation improves exercise capacity after a heat transplant. Am J Clin Nutr. 2010;91(5):1261-7.
8Alvares, TS et al. Acute L-arginine supplementation increases muscle blood volume but not strength performance. Appl Physiol Nutr Metab. 2012;37(1):115-26.
9Liu, TH et al. No effect of short-term arginine supplementation on nitric oxide production, metabolism and performance in intermittent exercise in athletes. J Nutr Biochem. 2009 Jun;20(6):462-8.
10Bescos, R et al. Effects of dietary L-arginine intake on cardiorespiratory and metabolic adaptation in athletes. Int J Sport Nutr Exerc Metab. 2009 Aug;19(4):355-65.
11Tang, JE et al. Bolus arginine supplementation affects neither muscle blood flow nor muscle protein synthesis in young men at rest or after resistance exercise. J Nutr. 2011 Feb;141(2):195-200.
12Chen, J et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int. 1999;83:269-73.
13Kim, N et al. Role of arginase in the male and female sexual arousal response. J Nutr. 2004;134(10 Suppl):2873S-2879S.
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