If increasing your performance and endurance in the gym (and in the bedroom) and improving your cardiovascular health are on your list of health goals, you might consider nitric oxide supplements as a way to achieve them. But do they actually work?
First of all, nitric oxide is not the same as nitrous oxide, also known as laughing gas, or the substance that gets you a little high at the dentist. So what is nitric oxide?
What is nitric oxide?
“Nitric oxide is a gas, a free radical, and is recognized to play a role in several physiological systems,” said Alex Rothstein, M.A., instructor in the exercise science program at the New York Institute of Technology. I say. It is synthesized from the essential amino acid L-arginine.
Nitric oxide acts as a vasodilator. In other words, it helps open blood vessels. As a result, many people take the precursor L-arginine to improve problems such as erectile dysfunction and heart health.
Nitric oxide’s role in vasodilation is also important in regulating blood pressure, says William Workman, MD, an orthopedic surgeon and sports medicine specialist at DISC Sports and Spine Medicine in Walnut Creek, California.
Many small blood vessels and capillaries remain dormant during exercise until your heart rate increases, and nitric oxide allows blood to flow to these areas, allowing your muscles to function, thus improving fitness performance. It has a reputation as a useful substance.
Other important functions of nitric oxide are its role in neurotransmission, hormonal signaling, and blood vessel relaxation, says Marco Ángeles, owner of the coaching platform Coach You Better and an exercise science instructor at San Diego City College. (CSCS, MS, CSCS) explains.
What is a nitric oxide supplement?
Often our supplements don’t actually contain nitric oxide. They only contain their precursors L-arginine and, in some cases, L-citrulline. “Supplementing with these compounds provides the body with the building blocks for nitric oxide production,” Ángeles says. L-Arginine also helps the body produce proteins.
“Research results are mixed and the literature shows that ingestion of precursor molecules increases nitric oxide and subsequently improves markers of heart health, exercise capacity, and treatment of erectile dysfunction (to name a few). It’s not strongly supported by this,” Ángeles said.
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Potential benefits of nitric oxide
Here’s what we know so far about nitric oxide and its potential benefits.
Nitric oxide may improve fitness performance
One of nitric oxide’s main functions is to widen blood vessels and increase blood flow, or vasodilation, Rothstein says. This delivers oxygen and nutrients to your muscles during exercise, improving performance and helping you exercise longer.
Some studies have shown that L-arginine, found in nitric oxide supplements, may improve fitness performance in runners, cyclists, and swimmers. However, other studies have shown little effect.
“Studies are mixed regarding the purported benefits of nitric oxide supplementation and fitness performance,” Ángeles says. “There is some evidence to suggest that supplements have an effect on endurance, but not on overall time trial performance.”
A small study also shows that L-citrulline may help improve aerobic performance and reduce post-workout muscle soreness.
A review of several studies on the effects of dietary components related to nitric oxide and exercise performance found mixed results. The review concluded that nitric oxide supplements may “improve tolerance” to aerobic and anaerobic exercise in people who are unwell. or moderately trained people, but highly trained people do not seem to benefit.
Further research is needed to know for sure whether supplements actually play a role in training performance. (However, these supplements may help you get additional benefits from lifting.)
May improve blood pressure
High blood pressure occurs when the force of blood pushing against the walls of blood vessels is too strong. This can lead to health problems such as heart disease and stroke. The theoretical mechanism for supplementing L-arginine to increase nitric oxide production is its role in regulating blood flow and blood pressure.
I might be able to stay in bed for a long time
Nitric oxide-assisted blood flow regulation plays a role in a variety of body functions, including maintaining an erection.
A 2020 study showed that L-arginine supplements may increase the effectiveness of common erectile dysfunction medications, but research in people without erectile dysfunction is limited. Therefore, the general benefits are not completely known. Some studies suggest that L-citrulline may also be helpful in treating erectile dysfunction.
May lower risk of heart disease
In addition to helping improve blood pressure, nitric oxide may reduce the risk of heart disease, especially for people who don’t exercise regularly, Rothstein says.
“For these people, increased L-arginine may promote vasodilation that would not occur unless they started exercising,” he added. “People who, for whatever reason, don’t get enough arginine through their diet can make up for the lack of this nutrient with supplements.”
Supplements may also reduce the cardiovascular effects of type 2 diabetes. Nitric oxide production is also inhibited in people with type 2 diabetes, which impairs the health of blood vessels and increases the risk of heart disease and high blood pressure.
May help with respiratory diseases
A study by a team of Chinese and American researchers has found that inhaled nitric oxide may be a treatment for patients with severe coronavirus infections. It is believed that the vasodilatory properties of nitric oxide may serve as an effective treatment not only for the new coronavirus, but also for other respiratory and cardiovascular diseases associated with the virus.
Are nitric oxide supplements safe?
Experts are divided on whether you should take it, as there is no clear evidence that it is effective. However, Dr. Workman says that taking these is generally harmless for most people, and there’s no need to take them in excess (see below for information on side effects and who shouldn’t take them) ). “If you feel like you can’t get back to the level you want, it’s worth a try,” he says.
There is no generally recommended dose for nitric oxide supplements. However, Professor Rothstein says, “Studies investigating L-arginine have typically used doses of 6 to 13 grams, which seem to be well tolerated by most people.”
Angeles recommends that anyone considering taking nitric oxide supplements, especially if you have high blood pressure, heart disease, or other health conditions, or are taking medications, consult your doctor first. I recommend it.
According to experts, the human body naturally produces sufficient amounts of nitric oxide, so supplements are generally not needed. Additionally, supplements aimed at improving nitric oxide may contain large amounts of other ingredients, such as caffeine, according to a statement from the U.S. Anti-Doping Agency.
Also keep in mind that supplements are not regulated by the U.S. Food and Drug Administration like prescription and over-the-counter drugs, Angeles added.
Nitric oxide side effects
Gastrointestinal issues such as vomiting and diarrhea are the most common side effects of nitric oxide supplements, according to Rothstein.
Too much nitric oxide can cause “massive vasodilation,” which can cause a drop in blood pressure and lead to stroke, Dr. Workman says.
Dizziness and headaches can also occur, Angeles said. “More serious side effects are allergic reactions and difficulty breathing.”
Who should not take nitric oxide?
According to recent research, people with conditions such as liver cirrhosis, guanidinoacetate methyltransferase deficiency, and low blood pressure should use caution with nitric oxide.
If you have any of these medical problems, you may be at higher risk for supplement side effects. Also, if you have kidney disease, herpes, or heart disease, you should be very careful with your nitric oxide intake. People who have had a heart attack and then take nitric oxide are not only at risk for repeated heart attacks, but also at risk for gastrointestinal disease.
Can you get nitric oxide in food?
Yes, and Dr. Workman says that food sources of nitric oxide are always preferred over supplements. “They’ll be getting an almost unlimited number of beneficial ingredients in the form of antioxidants and vitamins on top of that,” he added.
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The precursor compounds of L-arginine and L-citrulline are found in protein-rich foods (both compounds are amino acids), such as beans, legumes, red meat, dairy products, fish, nuts, and seeds. Les says. . “For healthy people, a proper diet is sufficient to support the proper production of nitric oxide in the body.”
Vegetables, especially leafy greens like beets, spinach, and arugula, are rich in nitrates, which are associated with increased levels of nitric oxide in the body, says Natalie, RD, MS, RD, a New York City-based dietitian.・Mr. Rizzo says:
“One study found that when cyclists drank beetroot juice two to three hours before exercise, their peak power and pedaling speed increased,” Rizzo says. “Another review also shows that beetroot juice may improve overall endurance and power in athletes.”
Beets have also been linked to improved muscle strength and endurance, improved cognition during exercise, reduced inflammation levels, increased antioxidant function, improved cognition, and more.
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