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%  

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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 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  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 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 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 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 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% 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  

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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  

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 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 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 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  

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