Nitric Oxide. Essential for Health and in COVID-19 Infections.

nitric oxide, covid-19


Nitric oxide deficiency is a major factor in virtually all illnesses. Because it’s essential for circulation and microcirculation, both the prevention and cure of a disease requires an adequate level of nitric oxide. Nitric oxide plays an essential role in cardiovascular health. Clinical trials in people who have consumed nitrates in their diet have shown improvements in blood pressure, endothelial function, and arterial stiffness. Also, an appropriate level of nitric oxide has been correlated with improved platelet function and increased exercise performance. Other benefits include better transmission of neural impulses, better mitochondrial biogenesis (formation of new mitochondria in aged cells), improved metabolic syndrome and erectile dysfunction.

Certain immune cells produce nitric oxide, which acts as a defense molecule against bacteria and other pathogens. It also regulates the activity, growth and death of many types of immune and inflammatory cells.

Released from the inner layer of cells – the endothelium of blood vessels, nitric oxide relaxes blood vessels and keeps them flexible, allowing them to dilate, stimulating blood flow. Nitric oxide also has anti-inflammatory effects and helps prevent the development of arterial plaque. As we age, our cells produce less nitric oxide, so the blood vessels become less flexible, which contributes to hypertension, inflammation in the blood vessels, and atherosclerosis (plaque buildup) – that is, cardiovascular disease. And there is a vicious circle: high blood pressure, inflammation and atherosclerosis, in turn, affect the production and action of nitric oxide.

Causes of Nitric Oxide Deficiency.

The human microbiome has a special role for health and it’s located in several places in the body. The oral microbiome is the first step in the process of reducing nitrates in the diet to nitrites and then to nitric oxide. Without the healthy bacteria in this oral microbiome acting on the nitrates, the process is stopped. An imbalance in the intestinal microbiome will also affect the oral microbiome. Also, the use of mouthwash with synthetic and toxic compounds, as well as antibiotics, kill pathogenic bacteria but also healthy ones, that have a protective role.

Proton pump inhibitors reduce hydrochloric acid (HCL) in the stomach, a second critical compound needed for this conversion to nitric oxide. These drugs are also associated with elevated cardiovascular events, most likely due to their impact on nitric oxide production.

In addition, nitric oxide decreases by about 10-15% over a decade of life, clearly contributing to a declining level of vitality in the elderly.

Symptoms and Effects of Nitric Oxide Deficiency.

Some of the symptoms that have been linked to a nitric oxide deficiency are:

  • regulation of the inflammatory response
  • sleep disorder
  • cognitive impairment and / or decline
  • impaired resistance to exercise
  • regulation of the inflammatory response
  • erectile dysfunction
  • compromised neurotransmission

Many researchers who have analyzed nitric oxide and its impact over a period of decades, have found that its depletion can be the basis of any disease, no matter where it is in the body.

Especially with regard to COVID-19 infections, it should be noted that nitric oxide can block the replication of dangerous viruses. Nitric oxide is an antimicrobial and anti-inflammatory molecule with key roles in pulmonary vascular function in the context of viral infections and other lung diseases. Nitric oxide plays key roles in maintaining normal vascular function and regulating inflammatory cascades, which contribute to acute lung injury and acute respiratory distress syndrome (ARDS).

Vulnerable populations in the current COVID-19 pandemic may have lower levels of endogenously produced nitric oxide. Patients with chronic vascular inflammation, such as type 2 diabetes, metabolic syndrome, chronic obstructive pulmonary disease, obesity, and autoimmune disorders may produce less nitric oxide.

The intake of nitric oxide in proinflammatory conditions prevents the cytokine storm, restores functional capillary density, essential for oxygen release and waste disposal, and protects oxygen-sensitive organs, such as the kidneys. Administration of nitric oxide in the early stages of COVID-19 infection could limit progression to ARDS, especially in vulnerable patients, who may have low levels of nitric oxide.

About 50-55% of the population has genetic methylation defects, contributing to toxicity problems, which will alter the normal course of nitric oxide production.

In its normal state, nitric oxide synthetase (NOS) converts the amino acid L-arginine to nitric oxide (NO), where L-citrulline is the precursor of nitric oxide. This pathway by L-arginine is negatively affected in the presence of heavy metals, oxidative stress, pollution and drugs such as antacids. An activated MTHFR mutation also contributes to this change in the usual process and depletes tetrahydrobiopterin (BH4).

BH4 is a vital cofactor for many enzymes in the body, including those involved in the formation of nitric oxide (NO), as well as for the key neurotransmitters dopamine, serotonin and epinephrine. BH4 plays a critical role in both heart and cognitive health. Vitamin C, methylfolate and curcumin contribute to an optimal level of BH4.

If a MTHFR mutation is active, resulting in either over-methylation or sub-methylation, both involve a low availability of cofactors, such as zinc, selenium, B vitamins, choline. These factors contribute to decreased circulation and microcirculation with lower levels of nitric oxide.

Foods that Are the Basis of Nitric Oxide Production.

Plant nitrates are not the same as nitrites and nitrates found in processed meats (deli). They are converted to harmful nitrosamines, which are linked to an increased risk of cancer. So this distinction is essential! Nitrates from vegetables and fruits are the basis of nitric oxide production.

Arugula and beets have the highest content of nitrates needed to produce nitric oxide! Spinach, green leaves, coriander leaves and cabbage are also very rich sources of nitrates.

Celery, leeks, radishes, endives, fennel, eggplant, rhubarb, basil and carrots are also decent sources of usable nitrates.

Fruits and vegetables rich in vitamin C can improve the level of nitric oxide by increasing its bioavailability, as well as by maximizing its absorption.

Watermelon is the richest source of L-citrulline, an amino acid that can be converted to nitric oxide.

Spirulina is rich in healthy vitamins and minerals, protective chlorophyll of cells and can increase the level of nitric oxide.

Nuts and seeds have a high content of L-arginine, an amino acid involved in the production of nitric oxide. Walnuts in particular are beneficial for the production of nitric oxide.

Garlic can stimulate nitric oxide levels by activating the enzyme that helps convert nitric oxide from the amino acid L-arginine.

The antioxidant with the role of mitochondrial stimulation, CoQ10 is found in meat, poultry and seafood and helps maintain nitric oxide reserves in the body.

Other Beneficial Actions to Increase Nitric Oxide Production.

Exercise can significantly increase the body’s intrinsic production of nitric oxide. Also, following a proper diet for your metabolism and a healthy lifestyle are fundamental to all healing processes. Without proper energy regulation, nutrient balance and without a healthy gut / microbiome, everything will start to suffer. With imbalances in pH, electrolytes, blood pressure, blood sugar and body temperature, all metabolic systems can be adversely affected.

Starting with a balanced oral microbiome and ending with an adequate level of hydrochloric acid in the stomach, there are some important steps that ensure an efficient metabolism of nitric oxide. Moderate sun exposure also supports nitric oxide production as well as vitamin D synthesis.

For specialized consultation for your health problems you can schedule an appointment here.