Dietary nitrate
A route that does not need the enzyme. The nitrate-nitrite-NO pathway bypasses nitric oxide synthase entirely, which matters because it works best exactly where the enzymatic route fails — in hypoxia and acidosis. it requires oral bacteria: antiseptic mouthwash abolishes the conversion and the blood-pressure effect with it.
In depth
Dietary nitrate, reduced by oral bacteria to nitrite and then to nitric oxide. Blood-pressure lowering is its best-replicated outcome. Antibacterial mouthwash interrupts the first step — the pathway depends on a bacterial population most people never consider.
What drives it
Micronutrient status increases it.
Dietary nitrate from leafy greens and beetroot. Carried by the intermediary-metabolism, micronutrient and clinical reviews. doi 10.3390/nu18132141 · PMC9967593
Gum health increases it.
It requires oral bacteria - antiseptic mouthwash abolishes the conversion and the blood-pressure effect with it. Carried by the intermediary-metabolism, micronutrient and clinical reviews. doi 10.3390/nu18132141 · PMC9967593
What it drives
It increases Blood flow (nitric oxide).
A route that does not need the enzyme - the nitrate-nitrite-NO pathway bypasses nitric oxide synthase, and works best exactly where the enzymatic route fails, in hypoxia and acidosis. Carried by the intermediary-metabolism, micronutrient and clinical reviews (PMC9967593; doi 10.3390/nu18132141; PMC12673670; doi 10.1016/j.molmet.2023.101755). Verbatim: “This appears to be mediated in part through a XOR-dependent reduction of nitrate to NO, as well as enhanced eNOS activation via increased Akt and eNOS phosphorylation”. doi 10.3390/nu18132141 · PMC9967593
It reduces Blood pressure.
Blood-pressure lowering is the best-replicated outcome. Carried by the intermediary-metabolism, micronutrient and clinical reviews. doi 10.3390/nu18132141 · PMC9967593
It increases Physical performance.
Reduced oxygen cost of submaximal exercise. Carried by the intermediary-metabolism, micronutrient and clinical reviews. doi 10.3390/nu18132141 · PMC9967593
Blends that modulate it
Each blend page names this pathway and carries the study behind its claim.
See it on the map
Open the causal map to follow this pathway upstream and downstream, arrow by arrow, each with its study.