One of my goals as a provider is truly preventative medicine. It’s essential to get out ahead of disease or event rather than deal with the consequences. One tool in this fight is to understand the strategies for treating the condition when it’s already established and find low side effect and natural ways to support the body. To me, that’s the essence of building a solid nitric oxide (NO) support plan for my patients.
Next to aspirin, nitroglycerin is the other essential medication given to the patient who shows up to the emergency department with a myocardial infarction. Why? It is a drug that works by increasing NO release from endothelial cells allowing for the vasodilation essential to protecting the heart. NO, a signaling molecule in the cardiovascular system has been recognized for its role in smooth muscle relaxation, inhibition of leukocyte aggregation and attenuation of vascular cell proliferation; all essential components of a healthy blood vessel.
Long thought to be second in line to arginine as the NO support nutrient, citrulline has demonstrated it capacity to be as good, if not entirely surpass, arginine in this area. In reality, the mechanism of citrulline rests entirely on its conversion into L-arginosuccinate and subsequent conversion to arginine itself. The research relating to arginine directly supporting healthy nitric oxide levels has been mixed. However, the American Heart Journal conducted a meta review in 2011 that looked at L-arginine’s role as a substrate of nitric oxide synthase as well as the relationship to blood pressure. They identified 11 RDBPC trials that clearly demonstrate arginine’s role as a substrate and the subsequent ability to support healthy blood pressure levels.
Most of the literature focuses heavily on lysine’s necessary inclusion to an arginine formula to prevent a potential viral exacerbation. But lysine both on its own, and along with proline, has many attributes worthy of inclusion in a vascular support product. In 2014 it was found in an animal study that lysine intake was able to aid in supporting the health, integrity and mitigate the level of calcification of the vessel wall. It is theorized that proline aids in the binding of lipoprotein (a) thus diverting aggregation along the vessel wall and subsequent oxidative stress.
The dire consequence of cardiovascular disease is the heart attack. At that point, NO is stimulated by nitroglycerin to protect the heart and the patient’s life. Why not get out ahead of this and put a plan in place to support as much NO as possible in an effort to support your patient’s cardiovascular health?
Am Heart J. 2011 Dec;162(6):959-65
J Am Soc Nephrol. 2014 Sep;25(9):1954-65