Paul Saladino· MD
anything that increases nitric oxide but doesn't increase it too far has been found to reduce the risk of cardiovascular disease anything that reduces nitric oxide has been trying to increase the risk it's really as simple as that nitric oxide is essential for cardiovascular health so what sort of things damage nitric oxide production while smoking obviously does it diabetes does it and so the kind of things that we know there's a couple of others that people don't know there's pee pee I don't want to highlight that but I mean there's a there's a clear biochemical pathway by which peepee is reduced nitric oxide synthesis and observational studies have shown that it can increase or double the risk of cardiovascular disease and so ironically of course we give people aspirin to protect them against heart disease for blood clots and then in order to protect their stomach we give them pee pee eyes so actually you're probably increasing the risk of heart disease simultaneously I mean this is a kind of Bunker stop we get into so I mean there are many things that can reduce nitric oxide and certain things that can increase it sunshine is one of your best sunlight on the skin creates nitric oxide and it a study in Denmark on women showed that the women who avoided sun exposure the risk of avoiding sun exposure was equivalent to smoking in other words these women by avoiding the Sun were causing themselves as much harm as they would have done by smoking 20 cigarettes a day that's that's the nonsense that we get up to other things that increase that reductase price price exercise be true a little increase your nitric oxide will do that relaxation that'll do it as well so try and get your nitric oxide up I mean it's one of the things that you know that viagra does is it increases nitric oxide synthesis obviously in the penis and that opens up the blood vessels and allows you to have an erection and also magico said viagra is now used for people who've got pulmonary hypertension high blood pressure and of arteries in their lungs because it opens up the arteries and and reduces the blood pressure it was originally announced as an enjoying example which many people don't know so nitric oxide is is is I would say but it's not the absolutely only thing but also nitric oxide stops blood clots forming it's released by endothelial cells to speak to each other to increase their resistance it goes to the bone marrow to produce to produce endothelial progenitor cells increase production distill progenitor cells you need this stuff it's absolutely critical you can say any more than that it's critical and and just so listeners can understand it's produced within the endothelial cell generally by an enzyme called eNOS endothelial nitric oxide synthase and there's other enzymes I nos inducible nitric oxide synthase and there's an enzyme that breaks down nitric oxide and that I believe if I'm thinking about it correctly that is what viagra is inhibiting is an enzyme that's kind of breaking down nitric oxide PD phosphor phosphodiesterase 5 or something like that right yes that's my understanding of it a pde5 inhibitor so i just want to highlight a few things for people here and give some perspective on all of this one of the things that I thought about earlier that I will I'll just bring up now are you familiar with research that shows that non-steroidal anti-inflammatory drugs affect the glycocalyx negatively because I bet they do I know that what they do do is the increased blood coagulation right I've kind of put their negative effect no more to the increase in blood clots forming but I haven't looked at that actually I mean I've looked at so many things maybe have looked at it just forgot but be interesting to find out to do them all I see is when I look at things I get things on three basic things it's three mechanisms do they damage the endothelium is an increased blood learning or to the interfere with the healing system and non-steroidals interfere with the healing system because that's what they're designed to do there aren't the inflammatory right in there so they also increased blood clotting so I haven't looked at their direct effect on endothelial cells but I suspect they probably have got one as well yeah yeah I wonder I wonder about that and I just think it's interesting to highlight for people that so many of the drugs that we are commonly using in Western medicine can have both good and bad effects on the endothelium good and bad effects on things that we are doing in the body proton pump inhibitors I want to highlight this for people I pulled up a paper let me actually just do a let me see if I can do a screen share for those of you guys on YouTube you'll see this for those who are not on YouTube you can look at the Instagram sniff it that I'll make of this long-term use of proton pump inhibitors dose dependent relationship associated risk of ischemic stroke in myocardial infarction proton pump inhibitors inhibit the production as we're talking about they're gonna decrease the nitric oxide they're used in the gut they're used in the stomach when we get excess acid production and use of PP is was associated with increased risks of first-time ischemic stroke and MI particularly among long-term users at high doses this is probably not something we want to be doing to ourselves you guys why are we using proton pump inhibitors to treat gastro esophageal reflux in millions and millions of