Dhru Purohit Show - Big Idea: Struggling with High Blood Pressure and Inflammation? You Might Need to Improve Your Nitric Oxide—Here's How

Episode Date: June 30, 2025

This episode is brought to you by Cozy Earth and Maui Nui. Each year, nearly 700,000 lives are lost to cardiovascular disease—and half of those individuals had no warning signs before their event. One major contributing factor? Low levels of nitric oxide, a vital molecule that supports healthy blood flow and keeps blood vessels flexible. The good news is that lifestyle changes—like diet, exercise, and proper supplementation—can naturally boost nitric oxide levels, helping to reduce your risk and support long-term heart health. Today on The Dhru Purohit Show, we’re revisiting one of our most talked-about moments with Dr. Nathan Bryan, all about why nitric oxide is the most underrated molecule for both short- and long-term health. Dhru and Dr. Bryan explore the connection between low nitric oxide levels and major conditions like heart disease, high blood pressure, Alzheimer’s, sexual dysfunction, and metabolic decline. They also dive into the biggest blockers of nitric oxide production, the top foods and lifestyle choices to naturally boost it, signs of deficiency, and so much more. Dr. Nathan Bryan is a leading expert in molecular medicine and nitric oxide research, with over 20 years of groundbreaking work and dozens of global patents. He’s the founder of Nitric Oxide Innovations, a company developing nitric oxide-based therapies to improve health worldwide. In this episode, Dhru and Dr. Bryan dive into: What happens in the body when we don’t produce enough nitric oxide (1:17) The link between nitric oxide and heart health (3:30) How nitric oxide is produced in the body (11:22) Habits that boost nitric oxide production (15:07) How mouthwash inhibits nitric oxide production (17:05) Nasal breathing and nitric oxide production (29:18) The impact of proton pump inhibitors on creating nitric oxide (32:23) Foods to avoid and transitioning to an anti-inflammatory diet (40:16) High blood pressure and its link to nitric oxide (42:17) Final thoughts (44:58) Also mentioned: Full episode with Dr. Nathan Bryan This episode is brought to you by Cozy Earth and Maui Nui. Right now, get 40% off your Cozy Earth sheets and sleepwear. Just head over to cozyearth.com/dhru and use code DHRUP. Right now, Maui Nui Venison is offering my listeners a limited collection of my favorite cuts and products. Just go to mauinuivenison.com/dhru to secure your access now —but hurry, supply is limited! Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi everyone, Drew Prode here. We all know that maintaining a healthy blood pressure and inflammation markers are two major keys to preventing chronic disease. And you may have heard about nitric oxide in the context of heart health or maybe even related to athletic performance. But what if I told you that nitric oxide might be the earliest marker, or at least one of the earliest markers, in the development of chronic disease? and that it has a far-reaching impact affecting everything from your cardiovascular health, energy levels, and cognition. This is why nitric oxide is sometimes referred to as the miracle molecule.

And in today's episode, I'm sharing a portion of my conversation I had with Dr. Nathan Brian all about how nitric oxide is produced in the body and how simple lifestyle habits can dramatically improve your nitric oxide levels and your overall health. Dr. Nathan Bryan is, by the way, an international leader in molecular medicine and nitric oxide biochemistry. He's been involved in nitric oxide research for the past 20 years, and his main seminal discoveries have resulted in dozens of U.S. and international patents. So with all that being said, let's dive into my conversation with Dr. Nathan Bryan. What happens in the body when we don't produce enough nitric oxide.

What's actually not taking place or what does take place that's actually not good for us? Well, thanks, Drew. It's great to see you, and thanks for the invitation to join you. And you make a very important point. So to answer your question, we know that loss of nitric oxide

is the earliest event in the onset and progression of most, if not all chronic diseases. So if you become deficient in nitric oxide, what happens? Usually the first sign and symptom is an increase in your blood pressure. or sexual dysfunctional what we call erectile dysfunction. That occurs in both men and women. Two out of three Americans have an unsafe elevation and blood pressure.

50% of men over the age of 40, self-report, some degree of erectile dysfunction. So those are the main two. The other kind of that are not as obvious to the general public, but it's clearly been elucidated in the basic sciences is you develop insulin resistance and metabolic dysfunction. Your triglycerides go up. You become exercise intolerance. So if you get shortness of breath walking up a flight of stairs or just going for a casual walk, then that's a symptom of nitric oxide deficiency.

If you forget where you left your keys and you start developing mild cognitive disorders, then that's a loss of regulation of blood flow to certain regions of the brain that's secondary to a loss of nitric oxide production. So all of those things, really every single thing we know about, you know, global health problems can be traced back to insufficient nitric oxide production. It's amazing once you start to truly learn. And I saw a podcast of years recently where you're on a colleague of ours podcast. And as you are breaking down every single way that our body can say, ouch, when it doesn't have enough nitric oxide, even me who studies this subject and has

had many people on this podcast talk about the importance of nitric oxide, I've been sort of amazed. And I've been not only amazed, but it's had me want to double down and make sure I take care of the basics to ensure that I'm producing enough nitric oxide. And we're going to cover some of those basics. You know, one that you didn't mention that I'd just love to talk about a little bit more before we break down the mechanism and what nitric oxide is, is endothelial health. Talk about nitric oxide and endothelial health and why the key to cardiovascular disease and avoiding cardiovascular disease or minimizing the likelihood of a cardiovascular vent or stroke is so tied

into endothelial health and nitric oxide? Well, you know, it's a concept and subject matter that's very dear and near and dear to my heart because I've been studying nitric oxide and endothelial function in basket biology for more than 25 years. And the fact that cardiovascular disease remains the number one killer of men and women worldwide is simply unacceptable because we know what causes cardiovascular disease. We know how to diagnose it and we know how to treat it, prevent it and cure it. and it all surrounds the endothelial production of nitric oxide.

So just for your audience, they're obviously well educated, but the endothelium is the cells that line all blood vessels throughout the body. Your endothelium is your largest organ. And it's the function of those endothelial cells that basically control blood flow to every organ, tissue, and cell in the body. It's what mitigates and controls inflammation, oxidative stress, and immune dysfunction, the key contributors to all chronic disease.

So when you develop endothelial dysfunction, and we characterize that by the inability of the endothelial cells to produce nitric oxide gas. And that was the first pathway to be discovered back in the late 70s, early 80s, on how nitric oxide is actually produced. So when we get a signal, like when we get sheer stress, when we begin to exercise,

or you have the release of some agonists, like acetylcholine, histamine, bradychinin, that signals the endothelial cells, to produce nitric oxide. And as long as that enzyme, which we call nitric oxide synthase, is coupled and functional, then the endothelial cells produce nitric oxide, you dilate the blood vessels, you suppress inflammation, and you have normal vascular function, and we call that good endothelial function. But when you have oxidative stress that leads to gnawes uncoupling, then all these activators

and stimulators that would normally produce nitric oxide, you don't get any nitric oxide produced by the enzyme in the endothelium, and that's what we call endothelial dysfunction. And as you can appreciate that it's endothelial dysfunction that's at the root cause of every major chronic disease. So you lose the ability to control and regulate blood flow to those organs, those vascular beds. You have an increase in inflammation where platelets, monocytes, and neutrophils start sticking to the lining of the blood vessel. You get transmigration of immune cells, cholesterol fat, that then starts the plaque deposition,

plaque instability, plaque rupture, and that's heart attack and stroke. So the mechanism of onset and progression of cardiovascular disease that leads to heart attack and stroke is completely elucidated. There is no question in the scientific literature about what causes cardiovascular disease and now how we can safely and effectively prevent, treat, and cure the number one killer of men and women worldwide. Well, we'll come back to cardiovascular disease because I have so many questions about that and some personal experience on sort of looking at my endothelium health with my cardiologist that I'd

love to chat with you about. But let's start again at the basics here. We have mostly a late audience that's listening. We've done some episodes on this, but it's always a good refresher. What is nitric oxide and how is it produced inside of the body? Now, look, it's a gas. And, you know, one of the kind of interesting things about the importance of nitric oxide in human physiology is it's a gas. And once it's produced, it's gone in less than one second. But while it's produced, it activates a number of what we call second messenger. So it has receptors, it binds to it, and then starts these entire signaling cascades that regulate basically every single cellular and biological function. So it's a gas produced in less than a second,

and it's a signaling molecule. So it's how cells in the body communicate with one another. And so we've touched on a lot of the physiological effects of nitric oxide. But really, that's what it is. It's a signal, and it controls oxygen delivery, it controls circulation and blood flow, controls vascular inflammation. So our ability to heal, the other thing it does is it stimulates our own, or mobilizes our own stem cells to differentiate and go to sites of injury and repair and replace dysfunctional tissues. So as you know, humans are regenerative beings.

The human body heals itself provided we give it what it needs and that the human body gets the signal to go and repair and replace dysfunctional tissue. And that's really the most important anti-aging effects of nitric oxide. Now, because the odor we get, the less nitric oxide we make, the less we're able to heal and repair and recover from injury. But if we have sufficient stem cells around and we have nitric oxide to tell those stem cells, hey, wake up, mobilize, go do your job and repair these dysfunctional tissues or cells, then we heal. And I think that's the basis, and what I think is the holy grail in anti-aging medicine and really any regenerative medicine. genitive medicine. What are some of the habits that we have that contribute to the production of

nitric oxide? Let's talk about that first because then an area that you're very passionate about is the habits that many of us have that decrease nitric oxide. So what are some of the habits and what are the ways that we naturally encourage healthy production of nitric oxide in the body? After a long day of meetings or podcasting, travels and workouts, or just trying to stay on top of life, there's nothing better than sinking into a bed that feels like pure luxury. And for me, that experience starts with Cozy Earth's sheets, which is why I'm super pumped to tell you about Cozy Earth, one of the sponsors of today's episode.

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lifestyle and habits such as moderate physical exercise, a balanced diet and moderation, lots of green leafy vegetables, 20 to 30 minutes of sunlight exposure today, those are the three main stimulators or activators of nitric oxide production. So it really boils down to diet and lifestyle, maintaining a healthy microbiome. So these are really simple kind of lifestyle strategies and common sense techniques that you can use to not only promote nitric oxide production, but to prevent this age-related decline that leads to age-related disease. So I want to tease out some of the ones that you talked about in the beginning. Some of these areas of what happens to the body when we don't have enough nitric oxide,

and then we're going to get into action items and other things in a minute. So one of the things that you mentioned is that when we don't produce enough nitric oxide, we are not as metabolically healthy. So connect those dots for us. What is it about the absence of healthy levels of nitric oxide that can impact things like insulin signaling? Well, when we talk about cellular metabolism, there's kind of a broad aspect about that. So certainly one is, you know, substrate availability and energy production. and obviously that involves insulin signaling, glucose uptake,

and maintenance of healthy insulin and glucose levels in the body. The other is terms of mitochondrial function, how well the mitochondria can utilize oxygen to produce cellular energy. So all of those are kind of what I refer to as metabolism and energetics of the cell. So in terms of nitric oxide, and we published this, I believe in 2011, we were the first research lab to show that nitric oxide is absolutely essential for insulin signaling. So let's talk about insulin resistance in metabolic disease and type 2 diabetes. So the insulin is secreted from the pancreas.

The insulin secretes and it binds to insulin receptors on most cell types, but primarily they're fat, skeletal muscle, and in liver cells. That's what controls glucose uptake and maintenance of hypoglycemic index. Nitric, if your cell can't produce nitric oxide, then there's end. there's a disruption in insulin signaling, and we call that insulin resistance. Because when insulin starts the signaling cascade, all of those converge on nitric oxide synthase enzyme, but if that enzyme is uncoupled and dysfunctional, you don't make nitric oxide so there's a disruption in that cellular communication.

But the terminal step in insulin signaling and glucose uptake is a protein called glute four, which signals to go to the membrane buying glucose and bring it inside the sill and clear it from the circulation. So if that cell can produce nitric oxide, then you don't get glucose uptake. You develop hyperglycemia. That signals the body, hey, I need more insulin. So the pancreas secretes more insulin. Now you have hyperinsulinemia, hyperglycemium, and that's the inflammatory response

that leads to the vascular damage and all the metabolic perturbations in patients with insulin resistance type 2 diabetes. So if you can make nitric oxide or we can give a source of nitric oxide, you can potentiate insulin signaling, you can complete that signal in the cell and you can lead to increase glucose uptake, downregulate the insulin secretion from the pancreas, and completely overcome the metabolic disturbances of insulin resistance. So nitric oxide is required for insulin signaling and glucose uptake. It's fascinating when you really understand that. You know, we know that 80% of Americans, at least, are not metabolically healthy by the standard definition of what

metabolically healthy looks like. And then it becomes a catch-22 because if you are not producing enough nitric oxide, you're more likely to develop diabetes and some of these other aspects of poor metabolic health. But then once you have those, you don't produce enough nitric oxide in the first place, so it becomes a downward cycle. It's almost like if we look at our society today and our modern industrialized, westernized society, it's like if you wanted to create the perfect recipe to destroy this super important molecule that's in the body that's responsible for so many different functions, you'd put somebody in the Western diet, the Western world, the Western version of stress, and that'd be the perfect recipe to destroy nitric oxide.

You know, if a terrorist group or another country was doing this to us, we'd be up in arms. But right now, we're not because, in a way, we don't realize that we're doing this to ourselves. Would you agree with that? No, absolutely. Look, this is subtle biological warfare. And I always, you know, sometimes jokingly, but it's really not a joke. It's very serious. And it's a life and death situation.

But if I wanted to make you sick and I wanted to make you dependent upon pharmacotherapy for the rest of your your life. I would put you on a Western diet. I would tell you to follow the government's food pyramid or recommendations on food. I would give you a proton pump inhibitor or an antacetate to completely suppress stomach acid production. I'd give you a cholesterol lowering medication to get your cholesterol below 200 where you could make testosterone, you could make estrogen or vitamin D, you disrupt the lipid rifts in the cell membrane, you prevent cell signaling, you disrupt nitric oxide production. And I would put fluoride in the municipal water supply and kill the oral microbiome.

I would overprescribe antibiotics to kill the gut microbiome, to kill the oral microbiome. That's how I would completely destroy a human's life and make them completely dependent upon pharmacotherapy and extract as much value as I could from those individual patients. So this is biological warfare and everything we've learned about nitric oxide biochemistry and physiology over the last 30 years points to the fact that all these things disrupt nitric oxide production. And then when you can't make enough nitric oxide, you get inflammation, oxidative stress and immune dysfunction, you lose regulation of blood flow, you have heart attack and stroke, and that's the end of the story. So this is biological warfare that fortunately we understand and now we can mitigate it completely reverse.

It's fascinating. You know, there's one item that you're so powerful. about that you left out, you kind of hinted towards it, you said you'd destroy the oral microbiome. In addition to everything you mentioned, antibiotics and poor diet and high stress and the Western life, you'd get everybody, which I think I heard from you, that 200 million Americans use mouthwash. You'd put everybody on mouthwash, which would be another crucial component of destroying nitric oxide. No, that's right. Why is mouthwash so bad for us if we care about our long-term health, we care about longevity,

and if we especially care about this topic, nitric oxide. Well, you know, we got interested in this about 20 years ago, and there was the huge microbiome project trying to characterize all the bacteria that live in and on our body. And we've learned so much through that. You know, the bacteria that live in and on our body outnumber on human cells 10 to 1. So these bacteria are not kind of pathogenic, infectious. These are what we call symbionts. So they provide a critical metabolic function to the human host.

And so we destroy these bacteria at our own peril. So whereas most of the microbiome project was kind of focused on the gut microbiome, but 20 years ago, we got interested in the oral microbiome because there was some emerging data showing that there were some nitrate-reducing bacteria or nitric oxide-producing bacteria that were essential for regulating systemic blood pressure. Now, that was a completely new concept in terms of vascular biology and the regulation of systemic blood pressure. So we started this whole project of trying to characterize what bacteria were responsible for producing nitric oxide and then regulating blood pressure. And we found,

we fully characterize these bacteria on the dorsal part of the tongue. We know a lot about them. But most importantly, if you eradicate these bacteria by using mouthwash, then it leads to an increase in blood pressure. You lose the protective benefits of exercise. And you become I'm nitric oxide deficient. And these are the numbers, I think, I got from, I can't, some, maybe the World Health Organization or some statistics that two out of three Americans wake up every morning and use mouthwash. So they're killing not only the bad guys, and they actually advertise this,

kills 99.9% of the bacteria in your mouth. That is a very bad idea because you're disrupting the good bacteria that are providing essential metabolic functions. One of the most important is generating nitric oxide or reducing nitrate. to nitrite. And when you eradicate that process, your blood pressure goes up, which is the number one risk factor for the number one killer of men and women worldwide heart attacks, and you lose the protective benefits of exercise. And this is really where people have that aha moment because I think for the most part, humans have good intentions. So we try to do what's the best for us.

We try to do things that keep us healthy and free from sickness and illness. So they tell us, you know, the bacteria, and this has been going on for hundreds of years, it's called the oral systemic link. If you have oral dysbiosis or periodontal disease, gingivitis, it leads to an increase in the risk of cardiovascular disease. So they take a sledgehammer approach and goes, oh, well, you've got to kill all the bacteria. Well, there's a lot of collateral damage. We can now isolate the pathogens while maintaining the good healthy oral microbiome and really do the host a favor. But there's clear evidence now that if you use mouthwifference, it kills the good bacteria as well as the bad.

You decrease nitric oxide production. Your blood pressure goes up. We're now finding that your early onset of things like erectile dysfunction, mild cognitive disorders. You lose the protective benefits of exercise. And so I tell people the most important thing you can do if you're doing this is stop using mouthwash. And the other thing people don't realize is fluoride.

You know, fluoride's in toothpaste, it's an antiseptic, it's a neurotoxone, and it kills your thyroid. it. And many people are using fluoride-based toothpaste. And so to me, it's no coincidence or no mystery why Americans are the sickest population on the planet. Because you alluded to it, everything we do is disrupting nitric oxide production and putting us on a very slippery slope for cardiovascular disease, metabolic disease, insin-resistant diabetes, Alzheimer's, everything we know about the etiology of every major chronic disease. It's so powerful when you realize that truly, if we care about the future health of this

country, obviously the people that are alive, but future generations to come that are not alive right now, we have to have a national uprising when it comes to health. And that's where I feel like podcasts, many of my colleagues that are in this space, books, educators like yourself, people that are doing research like yourself, where now the information can get directly to the public, whereas before we had so many gatekeepers involved, and that's how we perpetuated, you know, nine out of ten dentists think that you should brush with fluoride,

and, you know, you would feel that there was this term that was often used, you know, fairly recently during the pandemic, the science is settled. So let's move on. We'll cover the next thing. What's the next prescription we have to put people on? And as we know now, the science isn't settled. The science is an ongoing discussion, and we have to be willing to question things

if we're actually going to be willing to turn things around. So that's my little monologue on the situation. I can see you nodding your head, so it sounds like you agree as well. You're right. I mean, I taught in medical schools. I taught future physicians when I was at University of Texas medical school. And, you know, I've published over 100 peer-reviewed scientific papers. So here's what I've learned over kind of that early part of my career,

20 years in academic medicine, is that the general public doesn't read scientific papers on PubMed. And there's so much resistance in the curriculum of teaching physicians, future physicians, that the curriculum's already established, and it's very difficult to change that, because really that's the financial model of medicine. And medicine is a business, and we can't forget that.

So I don't refer to patients anymore or people who go see physicians, patients. You have to consider them customers. Their business just, and I'm not bad-mouthing physicians, because I think most physicians out there are really good-hearted people who have the best interest of their patients in mind. But the system in which they're trained in and they control them and control their medical licensing and control how they diagnose, treat, and patients is all a financial model. So I think that's why these podcasts and really ways to reach the public directly without having to go through a physician and these so-called gatekeepers, but the information's out there.

And then we have informed consumers that are properly educated so they can make. informed decisions on what's best for them and their help. And now what we try to do is we empower the patient to go and ask the questions, the tough questions to the physician. And now what we're finding it's kind of a complete loop because then it forces the physicians, because no physician wants to be asked a question he doesn't know the answer to. So it forces them to go kind of update and educate themselves on this emerging science and then opens their eyes.

And then now we have more informed people both consumers. and healthcare practitioners that will hopefully be, you know, motivated to learn this new science. But, you know, there's 190,000 scientific papers published on nitric oxide in the scientific literature. So for me, and that's kind of why I left academia, we have all the information we need. I don't need to go do more research, basic science, and figure out how does the human body make nitric oxide, what goes wrong in people that can't make it, and how do we fix it? We have that information. So now my objective and really mission,

personal and professional mission is to not only create awareness and education around nitric oxide, but bring safe and effective nitric oxide-based therapies or product technology to every major market segment in the world. And when we do that, when we accomplish that, it will change the world, it will change health care, and it will now empower patients to be able to take care of themselves. And it will be the original mission of medicine is to, you know, inform the patient to where they know how to heal themselves and to avoid going to a physician. That's the objective. Powerful.

You know, I want to go back to the basics of nitric oxide. You know, talk to us a little bit about nasal breathing and what role that plays in the process of creating nitric oxide in the first place. I'd love for you to cover that a little bit. Yeah, so we talked about endothelial dysfunction. And the nitric oxide synthase enzyme is found in the endothelium. Well, that enzyme is also found in the epithelium. found in the epithelial cells. So the endothelium is what lines the lining of blood vessels.

The epithelium is what lines the guts and the nasal sinus is kind of the outside world. And so when we do deep breathing or nasal breathing, there's mechanoreceptors on these epithelial cells that when we activate them, it turns on the enzyme that makes nitric oxide. So when we practice deep breathing, nasal breathing, it stimulates and activates nitric oxide production. And then that nitric oxide that's produced in the epithelium will be delivered into the upper and lower airways. It's a broncholidilator. So you'll dilate the bronchial. And you'll get better oxygen uptake and oxygen delivery. But just like if you develop endothelial dysfunction, then those same conditions occurred in the epithelial cells. So you have epithelial dysfunction.

Now, if that enzyme is uncoupled in the epithelial cells and you do deep breathing or nasal breathing, that enzyme is unable to produce nitric oxide. So you don't get any nitric oxide produced if you have an uncoupled gnaz. So when we've been able to detect that, we can measure exhaled nitric oxide in young people that have a coupled gnawes enzyme and do deep breathing exercise.

We can do that same measurement in exhaled patients with endothelial dysfunction. They do deep breathing and they don't get any nitric oxide produced. So we have to get to the root cause of that. And so we have to recouple the non-thole dysfunction. enzyme, restore the enzymatic activity of that enzyme. And now when we do deep breathing or nasal breathing, now we can actually generate nitric oxide and get the benefits of that. Lowers blood pressure. You know, it activates the parasympathetic nervous system. It's calming. But you have to restore

the function of that enzyme. So for most of the people that are listening today, if they're breathing pattern, you know, separate from diet and stress, which we'll get to in a second, if they are breathing as human beings were designed to breathe during sort of day-to-day function, and we've had people like James Nestor on the podcast, Dr. Luignaro, who I mentioned to you earlier, and so our listeners are a little bit familiar with this, but it's good to connect the dots and hear your perspective. So if most people who are listening today are generally throughout the day breathing through their nose and don't have sleep apnea that they know of, many people have sleep apnea and they don't know it, they haven't been diagnosed yet, would you consider that their breathing routine is in a good place

to, at least on the breathing side, produce nitric oxide? Or do you encourage additional sort of yogic breathing or sort of classes or any other intentional breathing methods to further enhance or optimize nitric oxide production? I want to give a quick shout out to one of my go-to snacks. I always keep some of these in my pocket, and this is a company. I'm a huge fan of it's Maui Nui. And the question you really should be asking yourself is, what if your next snack, not only fueled your body with clean protein, but also help you restore balance to an entire freaking ecosystem. That's not hypothetical. It's exactly what Maui Nui-Venison is doing. These are hands down my favorite protein stack. Whether I'm headed to a podcast, recovering from a workout, or just need something quick between meetings,

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then we have to restore the breathing that actually delivers oxygen. But here's the issue with nitric oxide production. Oxygen is never the limiting factor in nitric oxide production. El-arginine is never limiting. rate limiting in nitric oxide production. So it's the oxidation of tetrahydrobopterine, which is an essential co-factor for nitric oxide production. So if we can maintain BH4 reduction,

then that maintains the coupling of this gnaz enzyme. You get this beautiful five-electron oxidation of arginine to make nitric oxide. So if we can maintain the redox balance of BH4 to BH2, then we maintain the coupling and function of that enzyme. And fortunately, through my 20 years of research, we know how to do that, and we've identified product technology that does that. So to answer your question, it's obviously very important to practice these breathing techniques, but if you don't have the functional enzyme that makes nitric oxide, then you're

going to have limited kind of benefits of that. So what we do, what we try to practice is, number one, an anti-inflammatory diet that prevents the oxidation of BH4, moderate physical exercise. You know, I'm not a big fan of reaching that anaerobic threshold, but then oxygen becomes limiting for mitochondria. You get into fermentation, you get lactic acid buildup, and you have poor recovery. So all of these things that we talked about when we opened up the podcast,

moderate physical exercise on anti-inflammatory diet, and you maintain a normal healthy redox balance, it prevents BH4 oxidation. The NOS enzyme maintains its coupling and maintains nitric oxide production. So it's really that simple, but you can't fix one without the, the other.

You know, just like we talked about mouthwash, one of the things that you're very passionate about educating people on are this classification of medications called proton pump inhibitors. Help our audience understand, for those that are not familiar, what is that? When is it used? And how does that not only impair nitric oxide production, but also could be linked to, or maybe linked to or is linked to, you'll tell us higher incidences of cardiovascular events for individuals who are on it long term. So yeah, proton pump inhibitors. We'd love for you to talk about that. Yeah, so this is a class of drugs that are broadly classified as an acids. So they're FDA approved

for the acute treatment of gastroesophageal reflux disease. So if you have esophagitis or you get reflux, then you prescribe these medications. The FDA approval was only for acute use. These drugs have never been approved for chronic use. And so what we're finding now is that, I don't know, maybe 10 or 12 years ago, you may recognize that these drugs went from prescription only to over the counter. So you have prolosec, previsit, OTC. So now people can take these every day without the guidance or the oversight of a physician,

and they take them for 10, 12, 15, the rest of their life. And so here's what we're finding from not just the epidemiological data from chronic use, but at the cellular level of mechanistically what these drugs are doing. So these are called proton pump inhibitors. They suppress hydrochloric acid production from the pridal cells in the lining of the stomach. And so when you suppress stomach acid production, you can't break down proteins into amino acids. And for me, it's the basis of all autoimmune disease. Because when you can't break down proteins into amino acids,

we have these peptide fragments that are absorbed across the lining of the gut. We develop antibodies against them. And now we develop a food-borne allergy. And these become antigens that our immune system then recognizes. Then we develop autoimmunity because we don't know what self versus non-self. The other important discovery was that these class of drugs inhibit an enzyme called DDAH. And this enzyme metabolizes or leads to an accumulation of a molecule called asymmetric dimethyl l-Arginine, and that's called ADMA. Now, ADMA is an inhibitor of nitric oxide production.

So there's two ways the body makes nitric oxide. Perhaps we forgot to mention that. We talked about the NOS enzyme, but the other is through diet through the reduction of nitrate to nitrite to nitric oxide. If you suppress stomach acid production, you prevent nitric oxide from both pathways. So this is like global nitric oxide inhibition by taking an acid, specifically the proton pump inhibitors. And so you inhibit the gnaz production of nitric oxide. You prevent the nitric oxide that's produced from green leafy vegetables, vegetarian diet, the metabolism by the oral bacteria that generates nitric oxide in the lining in the stomach.

So mechanistically, we know exactly what happens through proton pump inhibitor therapy. Now, if you look epidemiologically, where you take the protein, populations of people, and this was published by my good friend John Cook at Houston Methodist I think in 2015, and he mined a database of, I think, 35 to 40,000 patients who had been taken PPIs for three to five years, and then he compared it to an age-match group that hadn't taken these drugs. And the patients that had been on PPI's for three to five years had about a 35 to 40 percent higher incidence of heart attack and stroke. Wow. This isn't risk. These are actual heart attacks and strokes.

So now we understand that these drugs, number one, aren't safe. And inhibiting stomach acid production is, again, one of these things that if I wanted to make you chronically ill, I would give you a PPI for the rest of your life and tell you to take it every day for the rest of your life. Because your body cannot and will not heal without stomach acid. You can develop autoimmune disease. You're going to become nitric oxide deficient. And you're going to develop ever-known chronic disease known to mankind. Yeah, it's such a powerful.

lesson for a lot of folks that obviously are suffering, which is why they're reaching for these drugs in the first place, but are they using a quick fix that is creating a longer term issue versus it takes a little bit work, it takes a little bit of work, but there's plenty of resources out there on, okay, why do you have all this extra stomach acid and how do we actually help your body regulate? From the literature that's out there, and I know this is not your exact area, of expertise, but just so people don't feel like the answer is just to stop medication, what should they be doing if they're on these proton pump inhibitors? It's a lot of the basics that you've talked about before, but do you want to chat about that

for a second? Yeah, the other problem, without stomach acid, you know, we need stomach acid. There's a reason that we as humans make stomach hydrochloric acid in the lining of the stomach. So we need acid to absorb things like iron, B vitamins, saline, saline, and so. Chromium, Trace minerals, nutrients, iodine. And so if we can't make stomach acid, then we become nutrient deficient. And going back to the days of Linus Polling, you know, he said every major human disease is basically some nutrient deficiency. So if you can't absorb nutrients, then the body doesn't have the raw material it needs to regenerate cells that work properly.

And so now, so what do we got to do? We got to fix the problem. So we always ask the question. I'm trained as a biochemist and physiologist. So what is the reaction mechanism to make hydrochloric acid in the pridal cells? Well, these cells need sodium bicarb. They need sodium chloride. They need iodine.

They need nitrate, and they need zinc. But yet, if you've been on these drugs, you don't absorb iodine, you don't absorb zinc, and you lose the buffering capacity throughout the entire body. So to fix this, I tell people, I'm not against pharmacotherapy. I'm trained as a drug discovery biochemist. So we're in the process of making safe and effective drugs. But you have to understand the mechanism of these drugs. And so what we try to understand is let's give the body what it needs

so the body can actually fix itself. So you can't just stop these drugs cold turkey because you're going to get rebounds, hyperchloric acid or hypersecretion of HCL, and it's going to exacerbate the condition. So I tell people you've got to slowly wean off these drugs. and then once you, you know, if you're taking one, one pill a day, then take that one every other day, and then after three or four days, take it every two to three days, do that one or two times, and then you can completely wean off these drugs.

But now, how do we fix the problem? So this is going to take time. You didn't develop these conditions overnight, so it's not going to, you can't expect them to be corrected overnight. So if you tell people, take a tablespoon of apple cider vinegar before every meal. So apple cider vinegar is just acetic acid with an apple flour. flavoring. And so that'll acidify the lumen of the stomach. Now when you consume your meal, you're able to break down proteins into amino acids. You're actually able to absorb things like

iodine, iron, zinc, B vitamins. Now the cell has what it needs to actually make and secrete stomach acid and it regulates it. And so then it's basically self-fixing. And you don't need drug therapy for this. You just need to replete the nutrients and then acidify the lumen of the stomach with apple cider vinegar. But over time, it's basically self-fixing. But over time, you can actually get off the apple cider vinegar because your prydocils are now have what they need to make sufficient hydrochloric acid to digest your food. Powerful. I love that tip. Along with that would you add in? Because again, there's probably various degrees of people where they are with their diet that are listening, that moving to an anti-inflammatory diet, moving away from ultra-processed

foods and moving away from hyper sort of palatable, hyper-sugary foods is going to be generally the things that you're going to want to do in addition to that because many of these ultra-processed foods are part of the reason that you're having the problem in the first place. Do you agree with that? Do you have any thoughts? Now, look, I'm a big fan of a balanced diet in moderation. I'm not a big fan of extreme diets like straight vegan, straight carnivore. I think we've evolved, you know, to get our nutrients from many different sources. But I think the problem is, you know, everybody's busy. The Western diet is replete with processed foods with a lot of food additives and artificial sweeteners, artificial flavorings, and the human body is never designed to see these artificial

chemicals. And so it kind of confuses the cells on what to do with it. And it causes disruptions. So, yeah, I think it's important to avoid processed food, especially high carbohydrate, you know, a lot of sugar. You know, I'm a pretty simple person. I'm a meat eating, in Scotch drinking Texan and I, you know, I eat my beef, we raise our own beef, we grow our own food. So I know exactly what we're putting in the food that we eat, how we grow our food, no herbicides, no pesticides. I do soil samples so I know that the food that I eat and the vegetables we grow are replete in every major nutrients. Most Americans aren't afforded that opportunity to be able to grow their own food. But I think every community has local farmers or farmers

market where they can go and get to know their local growers and, you know, support the local growers. But, you know, I think it's critically important to avoid soft drinks, especially things with aspartame, sucralose, sugar-free sodas. Because I think the evidence is clear to me that a high-carbohydrate, highly processed, high-sugar diet is what leads to metabolic disorders and most, if not all chronic diseases. I want to talk about high blood pressure for a second. With somebody who has high blood pressure, which there's this deep link and connection to nitric oxide, what can they begin to start to do to unwind that and start to heal or restore the body's natural ability to heal itself? No, it's a great question.

It's a huge public policy issue and global health issue because it's the number one risk factor for heart attack and stroke. So if you can normalize your blood pressure, you know, for every, I think one millimeter drop in blood pressure, you reduce the risk of heart attack and stroke by like 2%. So a 10% reduction in your blood pressure leads to a really significant reduce in risk in heart attack and stroke. So there's high blood pressure has many different etiologies. I would say in kind of reviewing the literature, probably 90% of the hypertensive cases are due to simple nitric oxide deficiency. Nitric oxide is the main vasodilator that dilates and regulates vascular. or tone. And if you lose that, then you get this chronic constricted state.

So you have the same amount of volume going through a smaller pipe, so you have an increase in pressure. So I tell people, stop doing the things that disrupt nitric oxide production. If you use in mouthwash stop, get rid of fluoride, buy fluoride-free toothpaste, get a home filtration system that removes fluoride from the water supply. If you're on in acid, you have to stop. Get 20 to 30 minutes of sunlight exposure a day. And then start exercising. that went some more green leafy vegetables and when that doesn't work or, you know, when we have product technology that does it for you.

And if that doesn't work, what we're finding is the other 10% of the people that have high blood pressure, it can be due to heavy metal toxicity. So they have an increase in metal for mercury amalgam fillings, cadmium lead, exposure to heavy metals. So these will scavenge any nitric oxide that's being produced before it has a chance to activate the smooth muscle and dilate the blood vessel. And then the other, which is very small percentage, are people with, you know, adrenal tumors that hypersecrete, you know, mineral corticorchordes,

and lead to an increase in blood pressure. And those patients are really easy to pick out because they're non-responsive to any class of medications. And then you just got to go to an ultracell of the adrenal glands, see if they got an adrenal tumor, then remove it, and then their blood pressure normalizes. But that's a very small percent of the population. Most, I would say 90 percent or more,

it's a nitric oxide problem. So then all we all we've got to do is restore their nitric oxide production. When we talk about long-term health and longevity, nitric oxide production probably isn't the first thing that comes to mind. But as you've heard today, nitric oxide is a master regulator of your health. And when we don't produce enough nitric oxide, we're at the risk of developing everything from erectile dysfunction to cognitive decline to sleep disorders, cardiovascular disease, and even stroke. This is why I've done several episodes on this podcast. about this important topic of nitric oxide. And if you enjoyed today's conversation and want to

dive in a little bit deeper, you can listen to the full-length interview that I did with Dr. Nathan Brian. I believe there's two of them, and you can find both of them in the episode show notes below. In this episode that was taken from today's conversation, we dive further into the early signs of low nitric oxide levels, how to test your nitric oxide levels, and a lot more. And if there's someone in your life who you think would benefit from this information, do me a favor. Screenshot this podcast or send them the link on Spotify or iTunes so that they can get a chance to get caught up to speed and potentially improve their health as well. Until next time, Drew Proid signing off. Thank you for tuning in.