No.1 Nitric Oxide Expert: Why You’re Always Tired and It’s Not Your Fault

I'm absolutely convinced this will eradicate and cure Alzheimer's. Really, the data don't lie and I'm a data guy and that the future of medicine and healthcare around the globe is going to be dependent upon this. Dr. Nathan Bryan is the biochemist whose cuttingedge research suggests how one crucial molecule can impact our health, brain function and longevity. That molecule is nitric oxide. Nitric oxide is a ziggling molecule in the human body which regulates things like blood flow and oxygen delivery. And the loss of nitric oxide production is the earliest event in the onset progression of age- related chronic disease. So things like erectile dysfunction, diabetes, Alzheimer's, high blood pressure, which is the number one driver of cardiovascular disease, which is the number one killer of men and women worldwide. And 50% of the patients that are treated with prescription medication don't respond with better blood pressure because they aren't targeted toward nitric oxide. But most people have never heard of this. They don't know that if you can't walk up a flight of steps or exercise moderately for 15, 20 minutes, then you're nitric oxide deficient. They don't know that most toothpaste and mouthwash is killing the oral microbiome that's partly responsible for production of nitric oxide but no one is interested in curing human disease because medicine is a business and the epiphany for me came because my dad had a car accident and he developed these non-healing wounds and I saw the failure of the standard of care to treat dad's wounds and so I just thought that there had to be a better way and simply by giving nitric oxide I've healed this wound within 6 months. That's crazy. So, how do I improve my nitric oxide levels? It's what you shouldn't be doing, and we'll cover those step by step. Number one, you have to avoid. This has always blown my mind a little bit. 53% of you that listen to the show regularly haven't yet subscribed to the show. So, could I ask you for a favor before we start? If you like the show and you like what we do here and you want to support us, the free simple way that you can do just that is by hitting the subscribe button. And my commitment to you is if you do that then I'll do everything in my power, me and my team, to make sure that this show is better for you every single week. We'll listen to your feedback. We'll find the guests that you want me to speak to and we'll continue to do what we do. Thank you so much. Dr. Nathan Brian, you have committed much of your life to writing about and educating people on a subject that I know absolutely nothing about. But from doing the research for today, I'm pretty shocked that I don't know more about this subject. So for those people who have just clicked to listen to this conversation, can you tell them the mission you're on and why it's so important? Yeah. Well, thanks so much for having this conversation with me. I think that illustrates the problem, right? Someone as informed as you don't know anything or never heard of nitric oxide. So, it's important for us to just make a distinction between um like nitric gas that people, you know, inhale and that used if you played like uh some of those racing car games, you press a button and the car goes really fast. If you That's nitrous. Nitrous nitrous. These are two separate things. No, very Yeah, very good point. So, this is not nitrous oxide. Nitrous oxide is I mean a medicine is a dental anesthetic, right? It's a gas. It's called laughing gas. That's N2O. That's the chemical formula. What we're talking about is nitric oxide or NO, one nitrogen, one oxygen. But yeah, they sound very similar, but they're completely different. This molecule is is foundational for human health and longevity. So nitric oxide is a gas. It's a naturally produced molecule. It's a signaling molecule in the human body. And so it's it regulates things like blood flow and oxygen delivery. And it mobilizes our own stem cells to help us recover and repair and replace dysfunctional cells. that uh improves energy production inside the cell and it regulates blood flow. You know, when we begin to exercise, if we want to recall memory, that's dependent upon adequate blood flow to the organs. If we're, you know, it's intimately involved in sexual activity and dilation of the sex organs for sexual function. So, what we're finding is that the older we get, the less nitric oxide we naturally produced. And now today, that's recognized as the earliest event in the onset and progression of age- related chronic disease. So my mission is to inform and educate the global population on how important number one what nitric oxide is, how it's produced in the human body, what goes wrong in people that can't make it, and then perhaps most importantly, how do we prevent that age related decline in nitric oxide production so everybody can be empowered to take control of their own health and prevent age related disease? And that's what the science tells us, but as you illustrated, most people have never heard of this. I mean, this graph, which I'll put on the screen for anyone watching, kind of illustrates what you're talking about. And quite notably, this decline seems to start when you're 30 years old, which is how old I am right now. So, well, you know, that's if you look at population based studies at different age groups, we see about a 10 to 12% decline in what we call endothelial function per decade. So, that means so nitric oxide is a gas. It's produced in the endothelium. So the endothelium is the single layer of cells that line every blood vessel throughout the body. So the function of these endothelial cells is to regulate vascular tone and to regulate you know solute exchange and extravisation or transport of molecules across that endothelial layer. And so when your endothelial cells can no longer make nitric oxide gas, they no longer dilate. So the blood vessels become constricted. You start to get inflammation. you get stiff arteries, plaque deposition, and that's what starts cardiovascular disease or atlascerosis, which So someone that's struggling with their nitric oxide levels at the moment, what kind of symptoms would they experience? Well, we know there's a hierarchy, right? So the first sign and symptom of nitric oxide deficiency is usually erectile dysfunction. And when you think about this, when we're stimulated or we're about to have intimacy with our partner, we have to dilate the blood vessels. So in erections in both men and women are dependent upon dilation of the blood vessels to get engorgment to get increase in blood flow. And that's what an erection is. But if those blood vessels can't make nitric oxide, the blood vessels don't dilate. So there's no increase in blood flow. There's no engorgment. And that's by definition what we call in erectile dysfunction. And it's the same in men and women, right? Whether it's the penis or the clitoris or the labia, you have to have an increase in blood flow. And without nitric oxide, there's no increase in blood flow. So that's number one. And we call that the canary in the coal mine because for years, people thought it was a lifestyle disorder, right? Well, erectile dysfunction. Yeah. But now it's recognized that it's a symptom of loss of nitric oxide and really an accelerated form of cardiovascular disease. So we have to focus on the vascular component of erectile dysfunction. What other diseases are linked to nitric oxide deficiency. So if if you don't correct the ED then what you start to see is an increase in blood pressure. And when you think about this mechanistically. So we have you know a finite volume of blood that's pumping throughout our body every day every second. And if you can make nitric oxide the blood vessels are more dilated. So now we're pumping that volume through, you know, more dilated blood vessels. But if we lose the ability to produce nitric oxide, now you don't get the dilation. Now you have smaller blood vessels. You're pumping that same volume of blood through smaller pipes. And simple physics tells us that blood pressure goes up. Okay? So you're going to have cardiovascular challenges. Well, you're going to have high blood pressure or hypertension. And at least in the US, and I think these these statistics probably are worldwide, but two out of three Americans have an unsafe elevation in blood pressure. And 50% of the people that are given prescription medications to treat their blood pressure do not respond with better blood pressure. It's because most of the drugs out there, whether they're ACE inhibitors, what's called angotensin receptor blockers, calcium channel antagonists, the main classes of drugs that treat high blood pressure, aren't targeted toward restoration of nitric oxide. So that's why we call that resistant hypertension. They're resistant to traditional therapies. And the reason they're resistant is because it's a nitric oxide problem and those drugs aren't designed to affect nitric oxide production or improve it. Was there a an aha moment in your career where you became particularly interested in this subject? Because you could have committed your life to studying any facet of health or or science, but for some reason you chose nitric oxide as the thing that you chose to focus on. What was that eureka moment? You know, for me it was I was a student at LSU School of Medicine. Um, this was the late 90s, maybe early 2000s, but a Nobel Prize had just been awarded for the discovery of nitric oxide. There were three US scientists that were awarded the Nobel Prize in physiology and medicine in 1998. And I was very fortunate at the time. I was a young student, probably a first year student, and Lou Ignaro, who had just won the Nobel Prize for the discovery of nitric oxide, came and spoke and gave a lecture before the student body. And I had a chance to have a conversation with him afterwards and I was fortunate to be invited to have dinner with him that night. And he made a very poignant statement to me. He goes, "If we if the scientific community can figure out how to restore the production of nitric oxide, it'll change the world and it'll change the landscape of medicine." because even then what is that 25 26 years ago that it was recognized that a loss of nitric oxide production is leading to the onset and development of many poorly managed age- related chronic diseases. So I go that's a very profound statement from a guy who just won the Nobel Prize. But that was the first kind of eureka moment for me that stimulated the interest. But then my dad and I talk about it in the book is a dad is 76 years old. In 1984 he had a car accident. It left him paralyzed from the midback down. So the majority of my life, even as a kid, I was treating dad's wounds, decubitous ulcers, pressure ulcers on his feet, on his butt, and he developed these non-healing wounds. He was diabetic, he was parapolgic, poor blood flow, hypertension, and he developed a non-healing wound. And no wound care doc that I took him to could heal this wound. So I started making a topical nitric oxide, and I've healed this wound within a per four years of non-healing. I healed it within 6 months simply by giving nitric oxide and getting blood flow to that wound, killing the infection in the wound. And this was in a 60something year old paraplegic diabetic sedentary old man. What you went through as a young man to me appears to be such an important sort of throughine with all the work that you do and chose to do. There is this overarching question which is even like why did you go into medicine? Why did you want to help people? Where did that come from in you? And I feel like there's clues in that to some degree based on what I I read about your family, your early upbringing, the divorce of your parents, and then ultimately your dad getting in a car car accident and being paralyzed. Is that an accurate suspicion? You know, I certainly it directed kind of my my life because I witnessed the failure of the standard of care to treat dad with what I thought should be pretty simple. I mean we have again the most advanced technology medical technology best medical schools in the world and yet we can't treat a wound we can't address the hypertension we can't address the diabetes medically and so I just thought that there had to be a better way it's still with you now isn't it yeah but I you know I see um you know dad when think I'm having a bad day. I just think, look, I'm not in a wheelchair. I got my health. So, no matter how bad I think, I got it. It could always be worse. So, I just wake up every day with a grateful heart. And, you know, some days are good, some days are bad, but I always realize it could always be better, but it could be a hell of a lot worse. So, I don't complain. And who are you? What are all the reference points? What's the experience you've had in your career that have filled up your sort of buckets of knowledge that you bring forth today? Like what what have you studied? Where have you been? I was in molecular and cellular physiology. Got a PhD in molecular and cellular physiology. And that was I was recruited by Fred Murad, one of the other guys who shared the Nobel Prize to join the faculty at the University of Texas Health Science Center in Houston, which is the world's largest medical center, but it's part of the University of Texas system. So I was recruited as a professor of molecular medicine, published probably well over a hundred peer-reviewed scientific publications. I've edited several medical textbooks on the subject. I taught in medical school and then I resigned from academia I guess several years ago uh during COVID to focus on the next phase of my career is taking this 25 years of science and research and discovery and now bringing that to the four for safe and effective product technology drug therapies to eradicate a lot of these poorly managed chronic diseases that you know we're faced with today. So let me get this straight. I'll repeat back to you what I think I understand about nitric oxide and you tell me if it's accurate. So this nitric oxide is a chemical that is in all the blood cells of my body and it allows my blood cells to basically expand open up so blood can flow through there. So if I it dilates it dilates the smooth muscle. So it's not affecting the cells per se but it's dilating the smooth muscle that surrounds the blood vessels that leads to relaxation and dilation. Fine. So my blood cells would then expand your blood vessels and more blood would go through there. But if I'm deficient, that mechanism doesn't work and my blood cells wouldn't expand ultimately expand through the relaxation of the muscles. That's right. And therefore, I would have higher blood pressure which can lead to a series of downstream diseases and consequences. And so when we look at the graph that I showed a second ago where we're seeing for anyone that can't see this graph because you're listening on audio, we're seeing nitric oxide levels in young people up to the age of roughly around 20 are optimal. And then from about 30 to 70, there's this tremendous sort of 80 90% drop. When I look at that graph though, my question becomes, is that not just aging? Is that not just normal? Is that not just inevitable? Well, yeah, there are a lot of things that occur with aging, right? We lose growth hormone with age. We lose u you know, many hormones. Uh nitric oxide is a is a hormone that we we first discovered nitric oxide as a hormone back in 2007. But to understand aging, you have to understand what leads to aging. So aging from my perspective is the inability to repair and replace dysfunctional cells. Right? every day we wear ourselves out and we just got to and if we can repair and replace dysfunctional cells then we combat or at least prolong the aging process. So what the science tells us in nitric oxide is this that loss of nitric oxide production is the earliest event in the onset progression of age- related chronic disease. So as that graph implies it is part of the aging process but it doesn't have to be right because today we know we can shift that curve to the left or to the right. So we can accelerate it. And you see this today with 18, 20 year old kids that are have high blood pressure, they have diabetes, they have erectile dysfunction, they have learning and and cognitive uh impairment and those are all symptoms of nitric oxide deficiency. And to the contrary, we if we see 50, 60, 70 year old patients that would fit on a 30 or 40 year old scale on that graph. So this this doesn't have to be the case. We know how to prevent this age- related decline in nitric oxide production. You know, I'm I'm the best example. I'm 51 years old, but I've got the vascular age of a 36 year old because I employ these principles to prevent this age- related decline in nitric oxide production. And when you say you've got the vascular age of a 36-y old, how how does one measure that? You look at the sort of vascular health of your You can So, there's there's several objective measures of of biological age. Obviously, we can affect our chronological age, right? But we can certainly affect our biological age. So what you can do, there's databases now of what we call croted inima media thickness. So they take an ultrasound and look at your corroted arteries and they can look at what's called smooth muscle hyperlasia or the thickness of the inima and compare it to a database of age matched kind of really it's you're comparing against your colleagues. So that's one way. Another way is looking at what's called flow mediated dilitation or endothelial function. And again through database of hundreds of thousands or millions of patients you can figure out where you fall on that spectrum on endothelial function. And then there's um you know other mark markers looking at histone modification of the DNA methylation profiles. there's a company or technology called glyen age that looks at certain markers uh that can then define a biological age for each individual. So by age 40 we have lost about 50% of our ability to produce nitric oxide in our blood vessels and we lose 10 to 12% of nitric oxide production per decade. This is all according to your book. And by age 70 to 80, nitric oxide levels in blood vessels can be 75% lower than in young adults. A Japanese study found a 75% reduction in nitric oxide production in people aged 70 to 80 compared to 20 year olds. Interesting. So in terms of chronic disease that is downstream from me losing nitric oxide level. Can you give me a bit of a menu of chronic disease that is associated with this nitric oxide deficiency? Yep. We've touched on them. So erectile dysfunction um 50% of the men over the age of 40 self-report erectile dysfunction. That's in the US. So think about that. 50% self-report. I think the numbers are higher because most 40 year olds that I know are never going to admit that they have erectile dysfunction. So I think the numbers are even worse. So that's one. High blood pressure. Again, 50% of the patients that are treated with prescription medication don't respond with better blood pressure. That's a huge problem because high blood pressure is the number one driver of cardiovascular disease, which is the number one killer of men and women worldwide. Number three, metabolic disease and diabetes. We published in 2011 that nitric oxide production is necessary for insulin signaling. If the cell can't make nitric oxide, you develop insulin resistance. So, diabetes, a global pandemic. Nine out of 10 Americans are metabolically unfit. The other thing is exercise intolerance. If you if you try to start an exercise regimen and you can't walk up a flight of steps or exercise moderately for 15, 20, 30 minutes, then you're nitric oxide deficient. And then the other one is uh obviously Alzheimer's because Alzheimer's is a vascular disease. It's reduced blood flow to the uh to the brain we call focal eskemia. There's insulin resistance. You know Alzheimer's has been called diabetes type three. So you can't get it glucose into the cell. That's the primary energy source or substrate of the brain. Oxidative stress and immune dysfunction. And then you get um misfolded proteins and that shows up as the tangles and the amaloid plaque that we see in Alzheimer's patients. So if we can restore and nitric oxide corrects every single thing we know about Alzheimer's. It improves blood flow to the brain. It improves glucose uptake. So it overcomes the metabolic aspect of Alzheimer's. It reduces inflammation. In fact, a number of my patents are on a method of reducing inflammation. It inhibits the oxidative stress we see in in Alzheimer's and neurological disease. And it prevents the immune dysfunction. And when you do that, when you restore blood flow and you get nutrients and oxygen in and you take out the metabolic waste products, there's no misfolding of protein. So you don't get the amaloid plaque, you don't get the tangles. So this simple molecule nitric oxide gas I'm absolutely convinced will eradicate and cure Alzheimer's really because it it addresses every physiological root cause of Alzheimer's if you can get it administered therapeutically to patients early enough or no I think that's a very key because the success or failure of any clinical trial any drug in any clinical trial is dependent upon the design of the clinical trial and what patients at what stage of disease that you enroll these patients. So what are the inclusion criteria and what are the exclusion criteria and there's a stage in every disease whether it's heart disease, kidney disease, Alzheimer's where you've reached a point of no return. There's really no medical therapy that's going to reverse that disease because it's progressed to a state that's irreversible. So I think what we try to do is take take patients early in the process what we call vascular dementia mild cognitive impairment early Alzheimer's because what I want to be able to demonstrate is two things number one can we stop the progression of disease once it's started can we stop the progression and then number two is we want to enroll patients far enough along to where we can show regression so can you move can you move the needle back and so That's a very kind of a specific and finite patient population. When you design a clinical study, number one, at the at the absolute worst, we want to stop progression. At the absolute best, we want to show that we can regress disease. And that's the goal of therapy is that you understand the mechanism of disease to the extent that you can treat it, you can prevent it, you can reverse it, and you can cure it. Is there something you believe that the traditional world of medicine and maybe the traditional media don't believe? Yeah, I believe in the truth and I come from a very objective scientific background. So everything that we do is based on objective uh data. I say this because I was listening to your interview before and there were several moments in the interview where you'd reference that. You'd say things like they don't they don't want you to know this or they don't they won't tell you this. No, absolutely. Because you know the we talk about epiphies and eureka moments in science, but for me one of the kind of complete change in paradigm in the way that I think was changed in when I was in academia and teaching in medical school and doing research in in an academic institution. And you start to think what we in the scientific community we un we've cured every disease every disease known to man we've cured it in rats and mice. So then the question is why isn't this translated into patient care? Why can't we do this in humans? Number one in in animal experiments we control their environment. We control their food. We control their life cycle. We control everything about them. You can't do that in everybody has a different diet. Everybody has different drug therapy that they're on or hygienic practices. But then what I realized was because when I was in academia, we wanted to create this consortium, a center of excellence for diseases. Because my thought process was, you know, western medicine is siloed, right? If you have a heart problem, you go to a cardiologist. You've got a GI problem, you go to gastronurologist. If you got a neurological problem, you go to a neurologist or psychiatrist. But none of these disciplines talk to one another. So if you go to that neurologist is going to treat that condition much different than the cardiologist would, much different than the GI doc would. But what if we're looking at the exact same root cause? And so my philosophy, well, let's create a center of excellence and let's bring everybody in the room. Let's bring the GI docs, the the neurologists, the cardiologists, the geneticists, the pulmonary docs, the kidney docs, the renal docs, and let's let's understand this kind of wheel and cog because everything occurs at the mitochondria subcellular level and energy production and then basically everything can can manifest from that. But what I quickly realized when you when you go to for instance MD Anderson and trying to treat cancer, no one is interested in curing human disease. Because the epiphany for me came because medicine is a business. It's a for-profit business. In fact, it's the largest business and economic model in the world. Trillion dollar annualized market. And most of these drug companies who influence and pay and support scientific journals, JAMAMA, New England Journal of Medicine, the major publications, the major journals, and they're influencing regulation and policy and FDA. And so when you figure out that there's undue influence by these for-profit companies, because the number one rule of business, as you know, as an entrepreneur and a business guy, is acquire a customer and keep that customer as long as you can. call it lifetime value of that customer. And that's what medicine is. They get you they you acquire you as a customer. They put you on a drug. That drug has side effects. They have to put you on another drug to mitigate the side effects of that drug. Now you got side effects from that polyarm pharmacy. They have to put you on another drug to mitigate those side effects. And now you look up and people who are 50 to 60 years old and older are on 10, 12, 18 different medications. That's the best financial model in the world. So it's a great financial model but it's at the expense of our health and the health of everybody living on in the world and in the US you know we have the sickest population in the world now for the first time in the history of western medicine have discussions between physician and patient how do we wean you off this drug that conversation has never had before because it's always if this doesn't work come back and I'll prescribe you more drugs let's do the opposite you come back and let's understand the root of cause of disease let's say okay well if we are addressing this, you don't need this medication. And if you don't need this medication, you don't need this medication. And now, for the first time, you start weaning patients off of drugs. And what happens? You're now impeding upon the market share of these multi-billion dollar drug companies who make their living buying influence, regulating policy, influencing policy. And the FDA is a stepping stone to a board seat of big pharma. Every former FDA official in the US for the past 20 or 30 years goes on to become multi-million dollar salaried employee from big pharma. It has to stop. Despite spending nearly 20% of the United States GDP on healthcare, the US ranks last overall on health outcomes among high income countries, including having the highest infant mortality rates and lowest life expectancy. It's like unbelievable. No, I mean that's that's depressing. I mean, but those are the facts and the you have to understand those those are indisputable data, right? And so when people hear that they go they this but when you look at kind of the system and I don't blame doctors because doctors are get into this field, you know, I was on the admissions committee to UT medical school for a number of years. So we interviewed a lot of these young kids, figure out what their motivation was. Will they have a successful career in medicine? And almost everyone I mean there's always the exception but everyone gets into medicine because they want to make make a difference. They're driven by curiosity and most of them want to leave a lasting legacy and help people. That's what drives uh entry into healthcare. But when you look at the system in which they're trained in, it prevents them. It basically handcuffs them. Because when you figure out the pay, the economic model of medicine, once you make a diagnosis, now you've got a diagnosible disease to which you have a finite number of responses, right? If you make this diagnosis, that's called an ICD10 code, which is reimburseable and that's how you get paid. So once you make a diagnosis, you only have a finite list of things you can do. You can't ask that question and go, well, what's really causing this? and spend, you know, 90 minutes with that patient because most physicians have to see 60, 70, 80 patients a day to pay the bills to cover their overhead. So, it's a factory. You come in, you look at, you've got a a transcriber, you make a diagnosis. Okay, I can I'm going to prescribe this medication. Come back in two weeks or six months and we'll see where you are. And then it's just it's a term, it's a meal. But as you me, the data don't lie, right? sickest population, highest infant mortality in the most industrialized nation in the world. And according to the data, Americans are spending about 13 years of their life living with disease. And that is significantly higher than many other highincome western countries. So although life expectancy, you know, might be 70 80 years old, you're going to spend almost 15 years of that time living with disease. So your health span is um really probably the more important thing to be focusing on, not your lifespan. And so when we talk about nitric oxide, I've heard you describe it as the molecule of longevity. For sure. Why why' you say that? Why do you say that? Well, again, longevity is this emerging field that's driven by how do we live longer? How do we increase our health span and longevity? Right? Because I think we can all agree that nobody wants to live to be 100 years old if we spend the last 25 of that years incapacitated in a diaper, unable to get out of bed, right? That's not living. So when I look at longevity, I look at kind of what are the hallmarks of longevity? What defines longevity, right? How do we live longer, healthier life free of disease? And really there's three objective measures. There is a stem cells. You know, this whole field of regenerative medicine is based on mobilizing our own stem cells or deploying u stem cells throughout the body to repair and replace dysfunctional cells. So these stem cells are cells that can basically act as like band-aids, repairs for any part of our body. Well, we call them pur potent stem cells. So mean that and some of these are bone marrow derived. Some of these are what we call stromal vascular fraction that you get from the atapost tissue or the fat. Pur potent would mean pur potent means they can that stem cell can go and become a neuron. That stem cell can go to the heart and become a functional meioy. It can go and become a macrofase or an immune cell, white blood cell. So pur potent means it can become many things whatever it needs to be. In some cases, the amount of stem cells present in our bone marrow get smaller with age. The number of cells decrease with age. But fortunately or unfortunately, the older we get, the more fat we deposit. And so we have a number of stem cells in our fat. So we increase the number of stem cells in our fat. So the problem with aging and longevity is when we lose the ability to mobilize our own stem cells. We can't we can't repair and replace dysfunctional cells. So we have these what we call zombie cells or scinsesscent cells. They're there but they can't do their job. They're dysfunctional and that's what leads to age. Number two, it's telomeirs. And telomeirs are the ends of the chromosomes of our DNA. And so the they're the very end. So it's like the um the the tips of the sho strings, right? That prevent the sho string from fraying. Yeah. And those are like the telomeir. So as long as you have a functional telomeir and it prevents it from getting shorter then shorter telomeir shorter lifespan longer telomeres longer lifespan. So when telomeirs get shorter it decreases our lifespan and longevity. And then the third one is mitochondrial function. Every age- related chronic disease you have a lower number of mitochondria per cell and the mitochondria that are present aren't functional. So you get a what's called an uncoupling of the electron transport chain inside the inner mitochondrial membrane and you can no longer effectively produce cellular energy or ATP. So nitric oxide is the foundational longevity longevity molecule because nitric oxide is the signal in the body that tells our stem cells to mobilize and differentiate. Without nitric oxide you have less number of circulating stem cells. Nitric oxide activates the enzyme toase which prevents telomeir shortening. Without nitric oxide you don't get activation of tomeorase telomeir shorten and then nitric oxide is the signal in the cell that tells the cell I need more mitochondria and I need these mitochondria to be more efficient generate more cellular energy with less oxygen. So when you when you restore nitric oxide you address all three aspects of longevity and there's no other molecule on the body that does that. You know Brian Johnson, don't you? Yes. What do you think of Brian Johnson? You know, I would never replicate or try to um do what he does. I don't think it's the proper approach, you know, and I I don't I don't mean to criticize people because this whole field of biohacking, you know, you get people who have no science background, no medical background, no biochemical background, and yet they're out there influencing millions of people that follow them. And many times they're giving really bad advice. Not intentionally. It's because of ignorance. They just don't know. They don't know the science. They don't know the medicine behind it. So before you go and follow any influencer or biohacker, number one, look at their credentials. And if they don't have any science background, if they're, you know, formal technologist or, you know, come from anything besides science and medicine, you really need to do a little bit of deep dive and make sure that what they're giving you is scientifically valid or recommending. He seems to be a fan of um the role of nitric oxide as it relates to longevity though. He seems to have said positive things about um nitric oxide and its impact on improving your cardiovascular health. Yeah. I think as we advance the science and we we do more to communicate the complex science into you know layman's terms where the the non-scientists non-medical professionals can understand it and appreciate it. I think more people are going to pick up to that. But there's also some well-known biohackers with influences of, you know, millions of people that still say that nitric oxide is a toxin that inhibits mitochondrial respiration and it should be avoided. Is there such thing as having too much nitric oxide though? Because if people hear this conversation today and they rush out and they I don't know overdo their nitric oxide by doing a bunch of uh therapies. Yeah. Is that a risk? Absolutely. You know, we know water is essential, right? But we can drink too much water and kill ourselves. You see it on the news, you know, a couple times a year called hypotonic lis. So, yeah, dose dictates poison. And so, what we have to do is make sure maintain the integrity of the field to make sure that if there are nitric oxide products out there that number one, you don't overdo it and and lead to, you know, health issues or kill a consumer, kill a patient. That could kill the entire field. But we also understand that there's only two signs of toxicity for nitric oxide. So it's really pretty straightforward. Number one, if you take too much nitric oxide, you're going to get an unsafe drop in blood pressure because think about this. If you if you take nitric oxide or you're enhancing nitric oxide production through whatever means, it's going to lead to systemic vasoddilation. Now you've got that same volume of blood pumping through much larger pipes and you're going to have a drop in blood pressure. And if you lose profusion pressure, you're not going to be able to peruse the brain because you got to pump against gravity and you're going to get lightheaded and you'll pass out. And if that's prolonged, it leads to es schemic end organ damage and organ failure and it can be deadly. So that's number one. And then number two is a condition called met hemoglobinia. And that's a big word meaning that your it oxidizes the iron of hemoglobin and reduces your oxygen carrying capacity. So you'll become cyanotic. You'll get blue around the lips. your extremities will turn will turn um you know white from lack of profusion or lack of oxygen but you never see that I mean you really never see clinical met hemoglobinia fortunately your your blood pressure will drop to an unsafe level long before you get any accumulation of met hemoglobinia so on this point of longevity then one of the points you mentioned there was telmir length and I've heard about telmir length because I've heard about studies they've done in rats and I think other rodents around telmir length so it was discovered that indiv individuals with shorter telomeres had a death rate nearly twice of those with longer telomeres. And you're telling me that there has been research done that shows how nitric oxide can increase telmir length. Absolutely. So we we understand at the DNA level at the nuclear level that nitric oxide is is what's called a collocicalizes with estrogen recep receptor to allow for the turning the the cell to turn on transcription and translation of the tomeorase enzyme. So it's not only affecting the genetic transcription of that protein but it's also regulating the function of the enzyme. So without nitric oxide you have less telomeir tomeorase enzyme and that tomeorase enzyme isn't functional. Okay. So nitric oxide has an impact on the tomease tomeorase enzyme. That's right. Tomeres enzyme. So what happens with each cellular division those telomeirs can get shorter. Yeah. Right. But as long as that tomeorase enzyme is active it prevents the shortening of the very ends of the chromosome. Okay. And just for people that don't understand the um with every replication as we age, we're continually replicating ourselves to restore and repair them, but in that replication process, harm is occurred sometimes. Yeah. And different cell types have different replication rates, right? So the the epithelium of the gut is highly regenerative, right? It's it's a replicatable uh you replacing these cells all the time because it's the outside environment that you're having to continue to replace those cells. neurons to the exact opposite aren't regenerative by nature. So we don't typically make I mean we can it was once thought that you can't regenerate neurons but today we know we can but yeah so it affects different organ systems differently but the data are clear shorter telomeres shorter lifespan. The other thing that um I wanted to talk to you about before we really get into the heart of how do I improve my nitric oxide levels keep them at a healthy range while I age is nitric oxide's relationship with the oral microbiome. Yeah. I had a conversation on this podcast not too long ago about the oral microbiome. Again, another subject I hadn't thought much about, but is there a relationship there? No doubt. I mean, this is this is probably 20 year old science um where we find that, you know, probably 20 years ago, the microbiome project was complete. And what that means is that the bacteria that live in and on our body were completely mapped out and these communities were identified in the gut, started in the gut, the gastrointestinal tract. And then, you know, you can you can culture the the this the skin flora. There's bacteria that live on our skin. There are bacteria that live in our colon. There are bacteria in women that that that reside in the in the vagina. And so all of these different ecologies of bacteria that live in and on the body are there to do things to help the human host, right? We call this symbiosis. We're providing benefit to the bacteria and the bacteria providing benefit to the human host. And so if you use antibiotics or antiseptics to kill the bacteria that live in and on our body, you get human disease. I mean that's clear. And the the best example is that there's no physician in the world that would recommend you or I take an antibiotic every day for the rest of our lives. Right? Do you agree with that? Yeah. And why is that? Because the antibiotics are killing the good bacteria. They kill the infectious pathogen bacteria, but they also destroy the entire microbiome. And when you disrupt the microbiome, you get systemic disease. You get vascular disease, you get Alzheimer's, you get uh leaky gut syndrome, you get autoimmune disease, you get high blood pressure, you get yeast infections, uh you get overgrowth of candida, you get parasites. So the bacteria are really the police of the human kind of surveillance, right? So the n we have 10 times more bacteria cells that make up the human than we have human cells. So we're 10 times more bacteria than we are human. And so if you destroy that microbiome, then it leads to systemic disease. We live in a culture where we're constantly trying to kill bacteria, right? like especially post pandemic we're using all kinds of hand washes and antiseptics and obviously the the big I guess chemicals that we all typically use are things like mouthwashes with uh which are again trying to just clean out all the bacteria from our mouths what how would you caution someone on using these things and even the like the antibacterial Yeah it's bad news really we give it to our children because we want our kids to be clean and not to have kids need to be dirty you find and again you look at epidemological data peop kids who grow up in the in a rural area they're out in the environment they're rolling in dirt they're they're got dirt on them and they have um you know they're inoculated with a lot of bacterium those kids are the healthiest people and and you look later in life they have lower incidence of cardiovascular disease diabetes they have better immune dysfunction less autoimmune disease so there's this whole hy hygienic principle or hygienic hypothesis of disease and I don't think it's a hypothesis anymore. I think it's proven out. So for me, I go back and I go, "What? Why are we doing this? Why are we using fluoride rinses in dental offices? Why is there fluoride in our toothpaste? Why is there fluoride in the municipal water of 72% of municipalities in the US when fluoride is a known antiseptic? It's a chemical toxicant. It's a a thyroid toxic. It kills your thyroid and it's a neurological toxin." And so when you go back and look at the history of dentistry over a hundred years ago, it was first identified that oral bacteria can be found in the plaque that killed someone from an acute heart attack. Right? People who died from sudden cardiac death, they'll take the thrombus or the embleis that oluded that coronary artery and they basically biops it and they find oral bacteria in that plaque that caused the heart attack or stroke. So that told us there's an oral systemic link. There's bacterial transllocation of the pathogens. That's why bleeding gums are a problem because you've got bacteria in the mouth. If you got bleeding gums, there's open blood vessels for those bacteria to get into our blood supply. Now they become systemic, cause inflammation, plaque rupture and heart attack and stroke. So 100 years ago with reason with good reason they go, well let's treat with an aneseptic. We have to kill all the bacteria in the mouth. So if you have bleeding gums, there's no translloca transllocation of that in the systemic circulation and we can prevent heart attack or stroke. That was a hundred years ago and we've learned a lot in those hundred years. Number one, it wasn't recognized that we have a microbiome on our body in our body. So now when I ask dentists all the time, why do you use floor? And they go, well, it's been used for hundred years. And I go, I don't care what the question is. That's the worst answer you could provide just because we're doing it because that's the way we've always done it. Right? So now we have to understand how do we selectively kill the pathogens while maintaining a healthy microbiome. And so this this field started probably in the I mean some of the first papers were published probably in the 90s showing that there were if you use mouthwash it destroyed the microbiome and we saw an increase in blood pressure. These papers were published in the late 2000s. We we published on this probably in like 2008 2009. We created what's called an association. So people who had the healthiest and most diverse bacteria in their mouth had the best blood pressure. People who had the least diverse oral microbiome and we we could not culture any of these nitric oxide producing bacteria appeared to have the highest blood pressure. So that's what we call association. It's not causation but it's a nice association. So in 2019 we published a paper showing okay let's now let's see if we do if we take normal intensive patients young healthy people with good nitric oxide good blood pressure and we just give them mouthwash twice a day for seven days to kill the entire oral microbiome and then we do tongue scrapings to see if we're killing the bacteria and we do blood pressure measurements and so we do that twice a day for seven days. Seven days we bring them back in. We measure their blood pressure and then we stop for four days. We say okay don't talk don't take mouthwash for four days then come back let's rememeasure your blood pressure and let's do tongue scrapings and figure out what's happening to this these bacterial communities. And what we found was that if you eradicate the bacteria within 7 days your blood pressure goes up. So if you use mouthwash within seven days your blood pressure goes up. I think it occurs earlier, but what we we looked at seven days. We only looked at day one at baseline, seven days, and then four days after stopping the mouthwash. But in one 21-year-old kid, his blood pressure went up 26 millimeters of mercury, which is, put that in context for me. That's clinically hypertensive. So for every 1 millimeter increase in blood pressure, that increases your risk of cardiovascular disease by 1%. So within 7 days, we increased this kid's risk of cardiovascular disease by 26%. Simply by giving him mouthwash. And explain to me in layman's terms the mechanism there. What's going on? Well, we're still trying to understand mechanism. Again, we're at the observational level. That's really indisputable because these bacteria, there's what we call nitrate reducing bacteria and humans do not have this enzyme. So nitrate is what's found in green leafy vegetables, right? These these plants assimilate nitrogen in the soil in the form of nitrate. We consume these vegetables. The nitrate is taken up in the gut. It's concentrated in our salivary glands. And the bacteria perform this metabolism of nitrate into nitrite and nitric oxide. And humans do not have the the functional enzyme to do this. So we're 100% dependent upon the bacteria. So then now because nitrate is inert in humans, we we rely on the bacteria to metabolize this molecule into a usable form where we can make nitric oxide. So when you're killing the bacterium now, the nitrate is just being recirculated, but you're you're you're urinating because it's it's it's filtered across the kidneys. You poop it out and you sweat it out. So it's completely unchanged unless you have the right bacteria. And what we're finding is that that oral production of nitride and nitric oxide being produced in the acid environment of the stomach is somehow regulating resistance arteries in dilation to normalize systemic blood pressure. So if I don't have a healthy oral microbiome, then you have an elevation in blood pressure. And much of the things you you're talking to me about today in terms of dietary um changes won't have any effect anyway because I need the bacteria to convert it into nitric oxide as it relates there are many benefits of of many nutrients in foods particular plants that confer some health benefits. But when we focus specifically on the benefits of nitric oxide from your diet if you don't have the right oral bacteria you get zero nitric oxide benefits from your diet. Now, you're going to get, you know, obviously hopefully vitamin A, vitamin C, vitamin D from foods, fiber, other phytonutrients, but in terms of the blood pressure lowering effects of a, for instance, a plant-based diet, if you don't have the right bacteria, you get zero benefits of that. Have you seen a link between oral health and cancer? Yes, absolutely. What have you seen? People that have dental infections, root canals, cavitations from previous extraction sites have typically cancer. It sets the stage for cancer cell growth and proliferation. So, and and I've, you know, I made a controversial statement on a on a previous podcast where I say number one, I'm not an oncologist, but people who have terminal metastatic disease, who aren't ready to die, who are sent home to die on hospice, somehow find me and go, can you help me with this cancer? And so the first thing I always send them to is a dentist to see do you have any active oral infections that may have led to the development of the primary tumor in the first place. But obviously it's it's metastatic meaning that it's now everywhere. It's it's it's migrated outside that primary tumor. But almost always without fail they have an active oral infection. And it may be a symptomatic infection to where they know it and they have a toothache or it may be an asymptomatic infection where they don't even know they got a dental infection. What percentage of cancer patients that you see that you then refer to a dentist have an oral infection? People with primary tumors, solid tumors. So we categorize these in bloodborne cancers, something like lymphoma, leukemia, multiple myoma, which is a bloodborne cancer. And those that have a solid tumor, yeah, a primary tumor that starts in the breast, the colon, the prostate, the lungs, or the liver without fail, 100% of them have dental infections. But cause and effect is not possible to establish here, right? Because cause and effect, no, I don't think we're there yet. I think probably as the science advances and people start to look at this because you may imagine if you have cancer and you've been to the best cancer doctors in the world and you've done surgery, you've done chemo, you've done radiation, you've gone through the standard of care and the cancer comes back, it's terminal, it's metastatic and you tell when I tell people, well, you need to go see a dentist. I mean, many people laugh and they go, "Have you what? What in the hell did you just say? I've got cancer. I don't have a dental problem." And I go, "Well, perhaps you do." Because again, if you go back and always look at back what's what's held true throughout ages and if you look at ayurveetic medicine, if you look at traditional Chinese medicine, if you look at acupuncture, you know, if you go back and you look, if you don't know what to look for, you're never going to find it. If you know what to look for, it's out there. It's in the published literature. But every tooth in the body is connected to an organ system, right? And so these are these are the meridians, the acupuncture meridians. You know, the analogy is they're circuit breakers. So if you if you trip a breaker in your home, there's no electricity going through that circuit. So your oven doesn't work, your refrigerator doesn't work, or your lights go out. Well, the body is electric, right? And how do we diagnose death? No electrical activity, right? Either through an EKG or an EEG. So the body is electric and we're we're batteries. And so if we get if that red light comes on on our phone, it says we have a low battery, everybody panics and goes and plugs it in and charges, right? And the human body is the exact same. We lose voltage over time. And if you've got a trip breaker from an infected tooth, there's no voltage. There's no circuitry going to that meridian that feeds individual organs. So the the best example is if you've got a root canal and a 100% of root canal teeth are infected and when you think and people go well that's not true. Well think about what a root canal is. You had a toothache at some point because of an infection. So you go to the dentist and they pull the nerve root out of that tooth. So you don't feel the pain anymore because there's no nerve root there. And they pull the blood supply out of that tooth. Now you have no blood supply to that tooth. And a tooth is a crystallin structure. It's a living organ with no blood supply and no nerve root. That's a dead tissue. So if you were to go in and we'd disconnect your gallbladder, for example, and just cut the blood supply to it, the nerve supply to it, within seven or 10 days, you'd be dead from sepsis. Nobody leaves dead tissue in the body. And so then what happens is when you leave the dentist, what do they do? They put you on an oral antibiotic. But they must have forgotten they took out the blood supply to that infected site. So an oral antibiotic isn't going to reach the sight of infection. I mean to me when you think when you sit back and think about this and go who the hell does this and why do they do it? Well it's because what we've always done. So then what happens is these anorobic bacteria they don't need oxygen. They're sitting there in an anorobic low oxygen environment and they're just eating away at your jawline. They're just like us do. They they they metabolize. They take stuff in. They poop waste out. Those waste products uh accumulate. it shuts down voltage and they eat away at your jawline. So then you've got osteom necrosis, osteomiitis and you don't even know it and an x-ray will not show it. And most dentists unfortunately still use x-rays instead of a higher resolution CT. It's really interesting. I was doing some research in preparation for this conversation around this subject of oral microbiome and cancer and the link there. And one particular study that was done um published in the New York Post but done by a team of researchers found that this was done at New York University as well. So it was published by the New York Post and done at New York University. They analyzed saliva samples of over 160,000 participants over 15 years. Are you familiar with this study? And they identified over a dozen bacteria species linked to a high risk of head and neck cancers with certain bacteria increasing the risk by 50%. Yeah. Of getting a cancer, which is pretty shocking. Um, literally I feel like texting my assistant and asking us to book a oral hygieneist and to change my mouthwash. No matter where I am in the world, it seems like everyone is drinking matcha. And there's a good chance that that matcha you're drinking is made by a company that I've invested more than seven figures in, who are a sponsor of this podcast called Perfect Ted, because they're the brand used globally by cafes like Blank Street Coffee and Joe in the Juice and many, many more. Not only can you get Perfect Ted Match in cafes, but you can now also make it at home much cheaper in seconds using our flavored matcha powders that I have here in front of me. Perfect Ted matcher is ceremonial grade and sourced from Japan. It is smooth. It is naturally sweet. Not like those bitter grassy matches that I tried before. Perfect Ted. And if you are one of those people that have told yourself you don't like matcha, it's probably because you haven't tried our Perfect Ted Matcher. And you can find Perfect Ted Matcher in the UK in Tesco, Sainsbury's, Holland and Barrett and in Waitro or Albertine if you're in the Netherlands and on Amazon in the USA or get the full range online at perfectted.com where you can get 40% off your first order with code Steven40. This one change has transformed how my team and I move, train, and think about our bodies. When Dr. Daniel Lieberman came on the diio. He explained how modern shoes with their cushioning and support are making our feet weaker and less capable of doing what nature intended them to do. We've lost the natural strength and mobility in our feet and this is leading to issues like back pain and knee pain. I'd already purchased a pair of Viva barefoot shoes. So I showed them to Daniel Lieberman and he told me that they were exactly the type of shoe that would help me restore natural foot movement and rebuild my strength. But I think it was planttoicitis that I had where suddenly my feet started hurting all the time. And after that I decided to start strengthening my own foot by using the Vivo barefoots. And research from Liverpool University has backed this up. They've shown that wearing Vivo barefoot shoes for 6 months can increase foot strength by up to 60%. Visit vivarefoot.com/doac and use code DOAC20 for 20% off. That's a vivobarefoot.com/dac. Use code DOAC20. A strong body starts with strong feet. If I've just listened to everything you've just said there and I want to improve my oral microbiome, what should I be doing? Well, I think the most important thing we've learned is what you shouldn't be doing. Yeah. Right. So, it's not what should we do, it's what we shouldn't be doing. Number one, we have to get rid of fluoride. You know, just this past weekend, I was speaking at a dental conference in Salt Lake City, and there were there people there from the National Toxicology Program, which in the US is the organization tasked with if there's any kind of risk of exposure of environmental toxicant. They're charged with doing the toxicology studies to see if there's an increased risk. What is the risk? And is there a safe level that is without risk? And what they report is that fluoride, there's no benefit of fluoride. And it's all risk. It lowers IQ in kids by as much as seven points and it shuts down your thyroid function and it's a neurotoxin. And as I mentioned before, most toothpaste has fluoride in it. And if you read the back of your toothpaste, it will tell you, at least in the US, I don't know about in other countries, but it says if you swallow this, call poison control because it's a poison. They're putting poison in toothpaste. And then if you also pay attention, it says only put a P-siz amount of toothpaste on your toothbrush. A P size. But everybody that I know fills the entire bristle of the toothpaste with toothbrush with toothpaste. So that's about 10 or 15, sometimes 20 P-size amounts of toothpaste. And a P-siz amount of toothpaste contains about half a milligram of fluoride. Now, if you're using 10 20 times more than that P size, now you're exposed to 5 milligrams, 10 milligrams of fluoride, and you don't even have to swallow it. This is a very small molecule, a molecular weight of 19. So, it's absorbed directly across the bugal mucosa, the oral cavity, and it becomes systemic. I'm not going to use it anymore. No, you shouldn't. What should I use instead? You have to use a non florinated toothpaste. And what about things like tongue scrapers? Now, tongue scrapers, the data, again, that's time- tested. That's an ancient practice. And even in our study, we found that people who do tongue scraping have a more diverse oral microbiome, and they seem to have better oral health. Why is this? My girlfriend's been banging on to me. She's always bloody right. My girlfriend's been banging on to me about tongue scraping for the last two years, and I've kind of just ignored her. I've just kind of Yeah, babe. Sure. And but when she's not in the bath bathroom, I'm not using her tongue scraper because it just looks strange. I for me based on what I knew about the oral microbiome and the microbiome generally I'm like should I be scraping off all my bacteria? Well if you're going to plant a garden do you plant a garden on untilled soil? Listen I know nothing about gardening. You're asking the wrong guy. So maybe yes I grow my own food. Okay. So you have to till the soil right? You got to break up the soil so the seeds actually can be irrated and you just break up that um that bofilm. Yeah. You take the back of the dorsal tongue. I mean, almost to the point of the gag reflex and you just pull that ideally copper tongue scraper forward and you're going to see this goop. Yeah. Coming in there, but it's it's like kind of like tilling the soil and it's it's increasing the diversity of the the dorsal part of the tongue, the microbiome. So, my girlfriend was right in that regard. Yes. But what we found was in that one kid, we saw the greatest increase in blood pressure. If you tongue scrape and use antiseptic mouthwash, that's the absolute worst scenario. Interesting. So, if you just think about this, you're tongue scraping, you're opening up the pores, and now you're using mouthwash. It's better to can easily penetrate deep in the crypts of the tongue and more effectively kill the bacteria. So, you want to tongue scrape and then use a toothbrush without fluoride toothpaste. Absolutely. And no mouth, no no antiseptic mouth rinse. Okay. And what about going to dental hygienists and things like that? Do you think that's a advisable idea? Because once every quarter or so um I'll go and see a dental hygienist just to get everything sort of cleaned out. No, I think that's a good proactive uh practice, but you know, because you need to look at the um the health of the gum tissue and the the gingal tissue and a routine clean and scraping the the plaque off the teeth and allow making sure you have good mineralization of the enamel of the tooth is good, but never let them do a fluoride rinse on you. Okay. Is there anything else on this subject of your microbiome and its relationship with nitric oxide that I need to be aware of before we move on? Yeah, we there's also data showing that if you use mouthwash, you lose the cardioprotective benefits of exercise. So, think about this. We know that diet and exercise is the best medicine. And many people aspire to do that. They they go and they they try to eat good. They avoid the temptations of sugars and sweets. They exercise every day to try to increase their longevity and cardiovascular health. If you do that and you're using mouthwash, you no longer get the benefits from exercise. And we've already established you don't get the nitric oxide benefits from diet. So two out of three Americans wake up every morning and use mouthwash. And two out of three Americans have an unsafe elevation in blood pressure. What's the mechanism there? Well, because you're you're killing the the the oral microbiome that's partly responsible for production of nitric oxide. Without nitric oxide, you get constriction of blood vessels and it leads to high blood pressure. That's crazy. And is there a link between our hormone levels, things like my testosterone levels and the nitric oxide? Yes. So, this is a two-way street. So, nitro So, in men, testosterone activates nitric oxide production. Okay. In women, estrogen activates and stimulates nitric oxide production. Okay. So as long as we have optimal sex hormones and as long as the enzyme in the lining of the blood vessel can functionally produce nitric oxide that explains the cardio protective benefits of hormone replacement therapy. Got you. So taking testosterone or um estrogen therapies helps to increase my nitro oxide levels as long as the enzyme is functional and coupled which means that we have to we have to understand the enzyology and the biochemistry of that reaction to where when it's exposed to testosterone it the cell can actually make nitric oxide in response. And there's a two-way relationship as well with exercise then because I've read in your book that um exercise activates and stimulates nitric oxide production. But you also just told me that if you want to get the great benefits of exercise, you need nitric oxide in the first place because else your blood cells are going to be very narrow, less oxygen traveling through you're going to do a worse workout as well presumably. Well, think about I mean there's other agonist too like vitamin D. I mean most Americans are deficient in vitamin D. uh people with low testosterone have erectile dysfunction and why is that? Because they're not stimulating nitric oxide production and they're not dilating the blood vessels. So they develop ED. So all of this, no matter what it is, whether it's related to vitamin D deficiency, which is activating and stimulating of nitric oxide, if it's low hormones, if it's poor diet, sedentary lifestyle, all of that can be explained by insufficient nitric oxide production. When I think about the role that food plays in my nitric oxide production, what should I be eating to increase um my nitric oxide levels or to keep them at a healthy level? I think it the same answer is for that too. It's it's not so much what we should be eating, it's what we should not be eating. Okay? So, we we'll we'll cover those step by step. Number one, you have to avoid sugar and high glycemic index foods because sugar is a toxin. It's a poison. And let's think about what sugar is. So when we eat sugar or drink sugar beverages, right? Whether it's sucrose, whether it's fructose, whether it's high fructose corn syrup, the end result inside the human is we see an increase in glucose. So elevation in blood sugar or blood glucose is diabetes, right? And now there's continuous glucose monitors that you can get anywhere and everybody does this. So if you eat something and it causes an increase in your blood sugar, blood glucose, then you should avoid that because glucose as the name implies is glue, right? It's sticky. And if we if you have a soda and you spill it on your countertop, you come back the next day, it's sticky, right? Well, that's what happens inside the body. That sugar sticks to everything. It sticks to proteins. It sticks to enzymes. It binds to hemoglobin. And sugar stuck to hemoglobin is what we call hemoglobin A1C. And what is that? It's a it's a marker of long-term glucose control. If you have hemoglobin A1C of greater than 5.7, you're diabetic. So, it's not just hemoglobin it sticks to. It sticks to the enzyme that makes nitric oxide. In in biochemistry and enzyology, enzymes have to be able to undergo confirmational changes, right? So, it transfers electrons from one donor to an acceptor and that's how biochemistry is is done. But if sugar is stuck to that enzyme, it locks it in some confirmation and it can't do its job for it can't make nitric oxide. So, sugar is an absolute poison and it kills many enzymes and binds to everything and it lowers nitric oxide production. Absolutely. That's why diabetics have a 10 times higher incidence of heart attack, stroke, all cause mortality mortality. That's why they develop neur neurological or peripheral neuropathy. That's why they have non-healing wounds. There's no nitric oxide. That's why they're developing diabetic retinopathy, macular degeneration, pancreatitis. I mean, all of that can be traced back to a lack of nitric oxide production because the sugar stuck to the enzyme. the sugar destroys the oral microbiome and completely changes the the ecology of the bacteria and completely shuts down nitric oxide production. Just a bit of a tangent there. You mentioned that's why they have open wounds that don't Yeah. diabetic ulcers. Okay. So, nitric oxide's playing a a role a healing role in wounds and scars. Absolutely. So, I've got this scar on my head. I was playing football the other day. someone ran into the back of my head and uh they they like they they passed out and um got taken away by an ambulance. But I was just left with this big like scar on the back of my head which I've had like glue stitched. So I'm wondering I'm like if I apply the nitric oxide serum it'll stimulate blood flow to that. It'll improve cellular turnover and and heal that wound and basically remediate the scar. And how do I do that? Is it Yeah. So you take one pump from each side. So one pump from this side and turn it around. One pump from the other. Yeah. And now if you apply that and mix it together. As soon as you mix it together, it starts to generate nitric oxide gas. So then that gas will diffuse into that tissue, it's going to increase blood flow and it's going to mobilize stem cells and it's going to improve cellular turnover and completely remodel that and heal that. And if it were an infection in there, it would kill the the the infectious bacteria. Okay. Well, we shall we shall see if that worked. So back on this point of food then. So sugar's bad. Sugar's bad. Yeah, you got to eliminate sugar. And I think the benefits of it like a straight ketogenic diet or a straight, you know, vegan vegetarian diet is just the elimination of sugar and carbs. Yeah. Right. But I think to answer your question, what should we be eating? I think you've got to eat a balanced diet in moderation. You know, Americans are overfed. All you got to do is walk around and see the the epidemic of obesity. Good high quality protein, good quality fats, and little or no carbs. And it's really that simple. And why did you write a book about beetroots? Beets. Yeah. The beets hit the uh really the airwaves back in 2012 in the London Olympic Games. Mhm. Uh there was a lot of data coming out at the time of the benefits of beetroot juice on enhancing athletic performance. And there was a a benefit of the nitric oxide being produced that could explain the improvement in athletic performance. The problem is these athletes were drinking liters and liters of beetroot juice and causing a lot of gastric discomfort, causing diarrhea. Their urine and their feces would turn red. And a lot of people interpreted, misinterpreted that as gastric bleeds or urinary bleeds. And then when I started looking at the products on the market, most of the bead products, the desiccated bead powders provided zero nitric oxide benefit. They didn't contain any nitrate, no nitrite. They were just we called them dead beats. they're they're a dead beat product. And so I thought if people if consumers are out there looking for beets because they've been shown to enhance their performance, but that enhancement in performance was dependent upon the beets ability to improve nitric oxide production in the body, then the non-scientist out there wouldn't know what to look for, right? They're buying products that aren't providing any benefit to them. And so years ago, we would do randomized placeboc controlled clinical trials, and we would take some of these commercial bead products that you can go to your local nutrition store or pharmacy, buy off the shelf, and we would use those as placeos in our clinical trials because it's the perfect placebo. So, what I tried to do in that book is educate, okay, what is it about beets that are so important? What's the mechanism and what is necessary in those beets that can improve nitric oxide production? So again, everything I do is intended to educate and inform the consumer so that they know how to make informed educated choices on the products they're taking or the foods they're eating or their oral hygienic practices. Trying to find the page in your book, but there was a page in your book where you describe beetroot as the most un as the most underappreciated food in the history of eating. Yeah, that may be in the beat the odds. Um, I thought it was in this book, but if you if you go back to historical times and you look at the the hieroglyphics on caves of the ancient cavemen, you know, people thought they were drinking wine because they would have these red stuff in this before battle. But what these ancient Egyptians were doing was they were drinking beet juice to improve their performance before they went into battle so that they were ready, they were energized, they improved their circulation. So that's the historical study on beets and obviously these were beets grown at a time when there were no herbicides, pesticides and the soil was probably fertile. So these beets were full of nutrients, probably full of nitrate that provided the the benefits of that. But unfortunately today the beets that are grown at least in America um really are nutrient depleted just like most of the food. So would you recommend people eat beetroots? No, because as would again through our survey that we published in 2015, we realized that you really can't eat enough beets to get enough nitrate to improve your performance. And the other caveat is that if you're using mouthwash, you've got fluoride in your toothpaste or fluoride in your drinking water that you're mixing the beet powder in, you're not going to get a nitric oxide benefit from it. There's a graph in front of me here, which I printed off, which shows the rise in antacid medications. Oh, yeah. from 2004 to so a 20-year period we're seeing um what is that almost a quadrupling of the use of ant acids and this is globally or is this in the US that's worldwide I believe yeah worldwide now this is the problem I mean these these ant acids what is an antacid so it's a medication that's given orally to suppress stomach acid production and as a biochemist and physiologist I can't think of nothing more damaging than to inhibit stomach acid production because stomach acid is required to break down proteins into amino acids. Whether it's you're eating animal protein or or plant-based protein, it's required for nutrient absorption. You need stomach acid to absorb B vitamins. You need stomach acid to absorb selenium, chromium, iodine, magnesium, iron. I mean, most nutrients, micronutrients are absorbed in the lumen of the stomach. And if the stomach cannot is not making stomach acid, then these nutrients are not absorbed. And most Americans, 75% of Americans are deficient in magnesium. 95% of Americans are deficient in iodine. I mean, it's a huge problem. These are the brands like Gavascon. No, these are like the the prylok, the previsids, the nexium, the prescription medications are omerazol, pentopresol. these you today in in the US I think it's probably worldwide you don't even need a prescription for these from your physician you can go to your local drugstore and you can buy these what we call proton pump inhibitors or PPIs what about Tums over the killer Tums so there's a difference in so Tums and things like baking soda are a buffer right sodium bicarb or calcium carbonate and it's a buffer right so if you if you have an acute bout of hyper secretion of acid. You can take a Tums or some buffer, some base alkaline substance to neutralize the acid. Neutralizing acid is completely different than inhibiting its natural production in the polyoric cells of the stomach. So what is the difference between some have you heard of gavascon before? Yes. Yeah. What's the difference between like a gavon? Well, there's there's certain classes of ant acids. There's what we call H2 blockers. There's proton pump inhibitors and then there's the natural buffers that are just kind of neutralizing the acid environment in the stomach. Gavascon I'm trying to think um what class that falls under. I don't think it's widely used here in the US. I mean the main drugs used here are Prolysk Nexium Previsid. Those are the overthec counter and then the main prescription medications are the omeraol and the pentoresol. Gabaskcon is a commonly used antacid brand and the active ingredients are aluminium hydroxide and magnesium carbonate. Oh, so Gavascon. So number one, it's got aluminum in it which you should should absolutely be avoided. Uh but yeah, that just it looks like a buffer. It's got an hydroxide, aluminum hydroxide, which is a strong base. So it's neutralizing the stomach acid production. But it's it's a neutralizing agent. But anything that contains aluminum, you should absolutely avoid. Um my as I mentioned her a few times today, but my girlfriend's a breath practitioner. She runs a business called barley breathwork.com hashtag ad. Um and one of the things she's talked to me a lot about is mouth breathing. And I know there's a a relationship between nitric oxide and how we choose to breathe whether it's through our nose or through our mouths. Can you explain to me that that link? You know, when we talk about the enzyme that's found in the lining of the blood vessels, we started this segment, that same enzyme is found in our epithelial cells, in our upper airways, in our sinuses. So, just like exercise can activate nitric oxide production in the lining of the blood vessels. Deep breathing, nasal breathing activates that enzyme in the epithelial cells of our sinuses. And so, when we do nasal breathing, it's activating the enzyme to make nitric oxide. And now we're delivering that nitric oxide gas into the the bronchules, the lower airway. It's dilating those bronchioles. Moreover, it's dilating the pulmonary arteries. So now we're improving oxygen uptake, oxygen delivery. And that's why nasal breathing and deep breathing has been shown to lower blood pressure. This is a pretty crazy graph I took from Google as well, which shows just how interested people are now getting in the subject of mouth breathing. Oh yeah. Again, going over the past uh 20 years. Yeah. I know I think there's a lot of people I mean obviously your girlfriend there's a Patrick Mchuan Mchuan in um Oh yeah the UK came into Dragon's Den I and I uh did a made a minoffer in Dragon's Den. Yeah. Yeah. No, I think that the the the benefits of that are pretty well and mechanistically we understand the benefits of it. So the the mouth breathers are not only bypassing this natural nitric oxide production pathway but when you mouth breathe it completely changes the microbiome. And you so you're not only bypassing the nitric oxide producing in the upper airway, but you're inhibiting nitric oxide production in the mouth from the microbiome because you're fully oxygenating the mouth. It's changing the pH of the saliva and completely changes the microbiome and completely shuts down nitric oxide production. Interesting. Interesting. So, so you have to I mean I'm a big fan of of mouth taping, but for me I know and I watch my kids, but sometimes there's anatomical issues where there's obstructive airways and airway obstruction that has to be corrected by dental appliances or some sometimes surgery. But the worst thing you can do is tape your mouth and your airway be constricted and you know suffocate. So before you do mouth taping, you need to get um you know some some imaging done from your dentist to make sure that your airway is is open to where if you forced to breathe through your nose, you can actually have oxygen exchange. And is there anything else that I could and should be doing to increase and improve my nitric oxide levels that we haven't talked about yet? Humming. You know, there are certain frequencies um we've done this and looking at nitric oxide coming out of the exhaled breath when you're humming. So certain frequencies can activate this enzyme and it's dependent upon the volume of the nasal sinuses. So there's not one frequency that would work in every single person because the volume of your airways and and oral cavity and sinuses was probably much different than mine. Give me an example. Show me. Well, if you just, you know, like ohms, like you do in meditation or just simple humming, you could actually, so if I had my ozone or gasphase analyzer here, I could hum and I could detect nitric oxide coming out of my exhaled breath because of the frequency of the because of the frequency and activating the the nitric oxide synthes enzyme. But if you take older patients and we've demonstrated this, it's published years ago and other other groups have demonstrated this older patients that their enzyme isn't making nitric oxide. Whether they do nasal breathing or whether they do humming, there's no nitric oxide coming out. So again, this is an activator and a stimulator, but it's dependent upon the function of the enzyme that makes nitric oxide. If your enzyme is broken, humming, nasal breathing, exercise isn't going to produce any nitric oxide. Is there anything else that I should be aware of if I'm trying to improve my nitric oxide levels? I think it's it's it's doing the things that disrupt it. Get rid of fluoride, get rid of mouthwash, stop using ant acids, stop eating sugar, anything that leads to an elevation in blood sugar, a balanced diet in moderation, moderate physical exercise, 20 to 30 minutes of sunlight a day. Sunlight. Sunlight. there are certain at both both ends of the visible spectrum both or the UV spectrum and the um full spectrum infrared. So those frequencies and vibrations again stimulate nitric oxide release. So the UV has enough energy to where it'll it'll knock nitric oxide bound to a cysteine and protein and then the UV spectrum will release nitric oxide bound to metals. So, you mean go out in the sunshine, but also those red light beds and stuff? Yeah, the red light I have an inf I have a red light bed. I have an infrared sauna that uses red lights in it and it's I use it every day for nitric oxide production. Yeah. And there's there's other benefits of light. You know, it can stimulate mitochondrial biogenesis. It improves energy production. It can lower blood pressure. But yeah, lots of benefits of light therapy. And yet, we're programmed to not go outside. If we go outside, put on SPF 60, and intoxicate oursel with these cancer-causing chemicals and sunscreen, I mean, makes no sense. What is the most important thing we haven't talked about that we should have talked about today, Dr. Nathan? You know, I think the future of Well, I I don't think I'm I'm I know. You know, there's three levels of conviction. You think, you believe, and you know. I'm at the point of knowing now that the future of medicine and health care around the globe is going to be dependent upon nitric oxide product technology because I think we can inform and instruct people to stop doing things or start doing things. But the most difficult thing to do is to change people's habits and to get people out of their comfort zone and stop drinking sugar soda waters. eliminate sugar to the best extent possible, get 20, 30 minutes of exercise a day, and completely change your diet. Compliance is an issue. People don't do that. They we're we're programmed to want to take a pill to overcome everything. And there's that pill, nitric oxide is very important, but it's not a silver bullet. It's not going to overcome all your bad habits, but what it is going to do, it's going to correct a lot of the things that your bad habits are leading to a deficiency of. Well, it's a good thing we have um a lot of people that are devoted to finding new solutions to old problems and you're certainly one of those people. And it's super fascinating because as you say, as I said at the start of this conversation, I had no idea about any of this stuff beforehand. I had no idea I'd not really even heard that the word nitric oxide. And maybe I'd heard it in passing, but um maybe I was confusing it with that NOS gas that people talk about and that some people inhale. And maybe because I hadn't added context and story and understanding to it, maybe I'd heard it in passing but didn't know what it was or meant. So, it's really wonderful that you're leading the charge in educating the world on nitric oxide because it's clearly a a really really important molecule in the the broader picture of our health. And the more we understand it, the more we ask questions about it and have curiosity about it, the higher the probability that we're going to be able to build some of these therapies that prevent us from ending up in a state as we've seen in some of these graphs where we're deficient in nitric oxide and then have to deal with the downstream consequences of that. So, thank you for all the work that you're doing. It's really, really important. I'm going to ask you one final question, which is the question left by our previous guest, Kim. They don't know who they're leaving it for, and they write it into this diary. So the question that's been left for you is are you happily or unhappily mated and why? Happily or unhappily mated? You know, one of my biggest challenges in life is maintaining balance, right? because I've been so focused on, you know, discovery and research and leaving a lasting legacy and and making innovations and and doing doing things in the scientific and medical community that many people said couldn't be done. And so my the problem is is there's always a deficiency. You know, I've got young kids. I spend a lot of a lot of time away. And you know, that's you know, I'm happily mated, but there's deficiencies, right? Because again my challenge is always maintaining balance work, home life kind of maintaining you know my spiritual my you know it's it's it's it's mental it's physical and it's spiritual health I'm trying to do better at that now but you know you can't there's always sacrifice right and we just have to pick pick our sacrifices and you know so I've got to I've got to choose to do better. Yeah, everything has a trade-off as many of my guests have told me. Thank you so much for the work that you do. Where do people if people want to find out more about you, if they want to read more, they should certainly get this book which you've just released called The Secret of Nitric Oxide. Um, I'll link it below for anyone that wants to have a read of this book. I highly recommend you do because it gives an even more comprehensive understanding of everything we've talked about today and it's incredibly accessible, which is always critically important to me. Um, but if they want to find out more, if they want to understand the products that you you sell and anything else, where do they go? Well, I I mean, obviously I'm I'm here to educate and informal nitric oxide. You know, this latest book, The Secret of Nitric oxide, bringing the science to life, really chronicles both my kind of journey through science and medicine as you revealed kind of my early years and kind of what motivated me to go into space. But I think more importantly, it tells the story of nitric oxide, what it is, what led to a Nobel Prize for its discovery, what you can do to prevent the loss of this molecule. So, you can go to nathan'sbook.com or you can get it anywhere books are sold, Amazon, Barnes & Noble. I've got a YouTube channel, Dr. Nathan S. Brian, nitric oxide, where we provide education, information, latest scientific information on nitric oxide. You can find me on social media, Instagram, Dr. Nathan S. Brian and then for those who want to follow our product journey and you know bringing forth safe and effective product technology that's none.com. So it's the letter N the number one letter number one.com. But you know we make products that release nitric oxide. Dr. Nathan Brian thank you so much for your time today being so incredibly generous but thank you so much for educating the world in such an articulate and accessible way on a subject that few of us knew very little about. It's incredibly important work and it's gonna it's inspired me to think again about my diet and about the decisions I make, the habits I have about exercise, about sunlight exposure, about my oral microbiome, all of these things. So, thank you so much for that. It's a real gift and I appreciate you taking the time today. Well, thank you so much. It's pleasure being with you. This has always blown my mind a little bit. 53% of you that listen to the show regularly haven't yet subscribe to the show. If you like the show and you like what we do here and you want to support us, the free simple way that you can do just that is by hitting the subscribe button. And my commitment to you is if you do that, then I'll do everything in my power, me and my team, to make sure that this show is better for you every single week. We'll listen to your feedback. We'll find the guests that you want me to speak to, and we'll continue to do what we do. Thank you so much. [Music]