Nutraceutical innovation around boosting or reducing nitric oxide

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Industry interest in boosting nitric oxide, a potent vasodilator, has been increasing, with companies exploring the potential to boost levels for heart health or sports nutrition products.

Speaking with NutraIngredients-USA at the recent Expo West event in Anaheim, CA, Dr Mark Miller, principal of Kaiviti Consulting, LLC, explained that nitric oxide (NO) is made by the endothelium and that production is limited in cardiovascular disease.

“So the idea is how to correct that," he told us. "The two approaches the industry has primarily used is [firstly] to feed arginine or citrulline to make nitric oxide. And the other aspect is to limit nitric oxide degradation by oxygen free radicals. That marries with our interest in antioxidants – take antioxidants and you’ll raise your nitric oxide levels back to balance.”

By boosting nitric oxide, the blood vessels relax, blood flow improves, and blood pressure is controlled. In addition, Dr Miller was involved in research that showed that nitric oxide is effective in managing performance and fatigue in strength training, matching the results seen in aerobic states (J Am Coll Nutr. 2016; Vol. 35, No. 2, pp. 100-7). 

Immune response and inflammation

However, nitric oxide also plays a role during an immune response and inflammation, and in that case a different approach is needed – to reduce NO levels.

“There’s a dark side to nitric oxide,” said Dr Miller. “There is a different enzyme that makes nitric oxide from arginine that the immune system uses and it’s normally dormant. It’s turned off at the gene level. And when you have a bacteria or an invading species the immune system goes back into its tool kit and brings out this inducible nitric oxide synthase and it makes buckets of nitric oxide.

“These high levels of nitric oxide interact with oxygen and other free radical species and they make a really toxic chemical soup. You then have nitric oxide causing problems and you need a different approach in that setting.

“The approach is to use nature to switch that gene off again. So it’s normally dormant and it gets switched on during inflammation, so the idea is to switch it back off. Nature has given us some wonderful tools to do that. There are some really fantastic botanicals that work on the sensors and anchors that regulate protein that regulate that particular gene.”