Transcript of Dr Nathan Bryan on The Diary Of A CEO Podcast

At least in the U.S., and I think these statistics probably are worldwide, 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 angiotensin 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.

Dr. Bryan’s Journey into Nitric Oxide Research

STEVEN BARTLETT: Was there 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 science, but for some reason you chose nitric oxide as the thing that you chose to focus on? What was that Eureka moment?

DR NATHAN BRYAN: For me it was when I was a student at LSU School of Medicine. This was the late 90s, maybe early 2000s, but a Nobel Prize had just been awarded for the discovery of nitric oxide. The three U.S. 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 had just won the Nobel Prize for the discovery of nitric oxide came and spoke and gave a lecture before the student body.

I had a chance to have a conversation with him afterwards and was fortunate to be invited to have dinner with him that night. And he made a very poignant statement to me. He said, “If the scientific community can figure out how to restore the production of nitric oxide, it will change the world and it will change the landscape of medicine.” Because even then, 25-26 years ago, 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 thought, 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 76 years old. In 1984, he had a car accident that left him paralyzed from the mid back down. So the majority of my life, even as a kid, I was treating dad’s wounds, decubitus ulcers, pressure ulcers, on his feet, on his butt. And he developed these non-healing wounds. He was diabetic, he was paraplegic, poor blood flow, hypertension, and he developed a non-healing wound.

No wound care doctor 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 period of 4 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 60-something year old, paraplegic, diabetic, sedentary old man.

Personal Motivation

STEVEN BARTLETT: What you went through as a young man to me appears to be such an important sort of through line 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 read about your family, your early upbringing, the divorce of your parents, and then ultimately your dad getting in a car accident and being paralyzed. Is that an accurate suspicion?

DR NATHAN BRYAN: You know, certainly it directed kind of 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 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.

STEVEN BARTLETT: It’s still with you now, isn’t it?

DR NATHAN BRYAN: Yeah, but when I 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.

Dr. Bryan’s Background and Expertise

STEVEN BARTLETT: 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 have you studied? Where have you been?

DR NATHAN BRYAN: I was in molecular and cellular physiology. Got a PhD in molecular and cellular physiology. 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 100 peer-reviewed scientific publications. I’ve edited several medical textbooks on the subject. I taught in medical school and then I resigned from academia several years ago during COVID to focus on the next phase of my career – taking this 25 years of science and research and discovery and now bringing that to the fore for safe and effective product technology, drug therapies to eradicate a lot of these poorly managed chronic diseases that we’re faced with today.

Understanding Nitric Oxide’s Function

STEVEN BARTLETT: 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.

DR NATHAN BRYAN: So it dilates, it dilates the smooth muscle. It’s not affecting the cells per se, but it’s dilating the smooth muscle that surrounds the blood vessels, which is relaxation and dilation.

STEVEN BARTLETT: 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.

DR NATHAN BRYAN: That’s right.

STEVEN BARTLETT: 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?

Nitric Oxide and Aging

DR NATHAN BRYAN: Well, yeah, there are a lot of things that occur with aging, right? We lose growth hormone with age, we lose many hormones. Nitric oxide is a hormone that 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 have to repair. And if we can repair and replace dysfunctional cells, then we combat or at least prolong the aging process.

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 have high blood pressure, they have diabetes, they have erectile dysfunction, they have learning and cognitive impairment, and those are all symptoms of nitric oxide deficiency.

And to the contrary, we see 50, 60, 70-year-old patients that would fit on a 30 or 40-year-old scale on that graph. So 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 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.

STEVEN BARTLETT: And when you say you’ve got the vascular age of a 36-year-old, how does one measure that? You look at the sort of vascular health of your…

Measuring Biological Age

DR NATHAN BRYAN: So there’s several objective measures of biological age. Obviously we can’t affect our chronological age, but we can certainly affect our biological age. What you can do, there’s databases now called carotid intima-media thickness. So they take an ultrasound and look at your carotid arteries and they can look at what’s called smooth muscle hyperplasia, or the thickness of the intima and compare it to a database of age-matched individuals.

Another way is looking at what’s called flow-mediated dilatation 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 other markers looking at histone modification of the DNA methylation profiles. There’s a company or technology called GlycanAge that looks at certain markers that can then define a biological age for each individual.

STEVEN BARTLETT: 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 and 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?

Chronic Diseases Linked to Nitric Oxide Deficiency

DR NATHAN BRYAN: Yep, we’ve touched on them. So erectile dysfunction. 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.

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 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 obviously Alzheimer’s, because Alzheimer’s is a vascular disease. It’s reduced blood flow to the brain, what we call focal ischemia. There’s insulin resistance. You know, Alzheimer’s has been called diabetes type 3 so you can’t get glucose into the cell that’s the primary energy source or substrate of the brain. Oxidative stress and immune dysfunction. And then you get misfolded proteins, and that shows up as the tau tangles and the amyloid plaque that we see in Alzheimer’s patients.

So if we can restore nitric oxide, it 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 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 amyloid plaque, you don’t get the tau tangles. So this simple molecule, nitric oxide gas, I’m absolutely convinced will eradicate and cure Alzheimer’s, really, because it addresses every physiological root cause of Alzheimer’s.

STEVEN BARTLETT: If you can get it administered therapeutically to patients early enough or no, I…

Clinical Trial Design and Disease Progression

DR NATHAN BRYAN: I think that’s 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?

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 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 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 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 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.

STEVEN BARTLETT: Is there something you believe that the traditional world of medicine and maybe the traditional media don’t believe?

DR NATHAN BRYAN: I believe in the truth. And I come from a very objective scientific background. So everything that we do is based on objective…

STEVEN BARTLETT: I say this because I was listening to your interview before, and there were several moments in the interview where you referenced that you’d say things like, they don’t want you to know this or they won’t tell you this.

The Business of Medicine

DR NATHAN BRYAN: No, absolutely. Because, you know, we talk about epiphanies 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 when I was in academia and teaching in medical school and doing research in an academic institution.

And you start to think what we in the scientific community understand—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 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 with humans. 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 gastroenterologist. If you’ve 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 was, let’s create a center of excellence, and let’s bring everybody in the room, let’s bring the GI docs, the neurologists, the cardiologists, the geneticists, the pulmonary docs, the kidney docs, the renal docs, and 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 manifest from that.

But what I quickly realized, 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, JAMA, 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 for 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 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 get side effects from that polypharmacy, 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 in the world. And in the U.S., you know, we have the sickest population in the world now. For the first time in the history of western medicine, we have discussions between physician and patient about how do we wean you off this drug. That conversation has never been 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 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 multimillion dollar salaried employee from Big Pharma. It has to stop.

STEVEN BARTLETT: Despite spending nearly 20% of the United States GDP on health care, the US ranks last overall on health outcomes among high-income countries, including having the highest infant mortality rates and the lowest life expectancy. It’s like unbelievable.

The Nitric Oxide Connection to Longevity

DR NATHAN BRYAN: No, I mean, that’s depressing. But those are the facts and you have to understand those are indisputable data. When people hear that, they go this is terrible. But when you look at the system, I don’t blame doctors. I was on the admissions committee to UT Medical School for a number of years. We interviewed all of these young kids, figured out what their motivation was, if they would have a successful career in medicine. Almost everyone gets into medicine because they want to make a difference. They’re driven by curiosity. Most of them want to leave a lasting legacy and help people. That’s what drives entry into health care.

But the system in which they’re trained prevents them, it basically handcuffs them. When you figure out the economic model of medicine, once you make a diagnosis, you’ve got a diagnosable disease to which you have a finite number of responses. If you make this diagnosis, that’s called an ICD10 code, which is reimbursable, and that’s how you get paid.

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 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 make a diagnosis, prescribe medication, tell them to come back in two weeks or six months. It’s a turnstile. But as you mentioned, the data don’t lie. We have the sickest population, highest infant mortality in the most industrialized nation in the world.

STEVEN BARTLETT: 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 high income Western countries. So although life expectancy 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 really probably the more important thing to be focusing on, not your lifespan. When we talk about nitric oxide, I’ve heard you describe it as the molecule of longevity. Why do you say that?

The Three Pillars of Longevity

DR NATHAN BRYAN: Longevity is this emerging field that’s driven by how do we live longer and increase our health span. I think we can all agree that nobody wants to live to be 100 years old if we spend the last 25 years incapacitated in a diaper, unable to get out of bed. That’s not living.

When I look at longevity, I look at what are the hallmarks of longevity. What defines longevity? How do we live longer, healthier lives free of disease? Really, there are three objective measures:

1. Stem cells – This whole field of regenerative medicine is based on mobilizing our own stem cells or deploying stem cells throughout the body to repair and replace dysfunctional cells.

STEVEN BARTLETT: So these stem cells are cells that can basically act as, like, band aids repairs for any part of our body.

DR NATHAN BRYAN: Well, we call them pluripotent stem cells. Some of these are bone marrow derived. Some of these are what we call stromovascular fraction that you get from the adipose tissue or the fat.

STEVEN BARTLETT: Pluripotent would mean…

DR NATHAN BRYAN: Pluripotent means that stem cell can go and become a neuron. That stem cell can go to the heart and become a functional myocyte. It can go and become a macrophage or an immune cell, white blood cell. So pluripotent means it can become many things, whatever it needs to be.

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.

The problem with aging and longevity is when we lose the ability to mobilize our own stem cells, we can’t repair and replace dysfunctional cells. So we have what we call zombie cells or senescent cells. They’re there, but they can’t do their job. They’re dysfunctional. And that’s what leads to aging.

2. Telomeres – Telomeres are the ends of the chromosomes of our DNA. They’re like the tips of shoelaces that prevent the shoelace from fraying.

STEVEN BARTLETT: Yeah.

DR NATHAN BRYAN: As long as you have a functional telomere, it prevents it from getting shorter. Shorter telomeres, shorter lifespan; longer telomeres, longer lifespan. When telomeres get shorter, it decreases our lifespan and longevity.

3. Mitochondrial function – Every age-related chronic disease shows a lower number of mitochondria per cell, and the mitochondria that are present aren’t functional. You get 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.

Nitric oxide is the foundational 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 fewer circulating stem cells. Nitric oxide activates the enzyme telomerase, which prevents telomere shortening. Without nitric oxide, you don’t get activation of telomerase. Telomeres shorten.

Nitric oxide is also 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 restore nitric oxide, you address all three aspects of longevity. And there’s no other molecule in the body that does that.

On Biohacking and Bryan Johnson

STEVEN BARTLETT: You know Bryan Johnson, don’t you?

DR NATHAN BRYAN: Yes.

STEVEN BARTLETT: What do you think of Bryan Johnson?

DR NATHAN BRYAN: I would never replicate or try to do what he does. I don’t think it’s the proper approach. I don’t mean to criticize people because this whole field of biohacking includes people who have no science background, no medical background, no biochemical background, and yet they’re out there influencing millions of people. Many times they’re giving really bad advice. Not intentionally, it’s because of ignorance. They just don’t know the science or medicine behind it.

Before you follow any influencer or biohacker, look at their credentials. If they don’t have any science background, if they’re formal technologists or 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 recommending is scientifically valid.

STEVEN BARTLETT: He seems to be a fan of the role of nitric oxide as it relates to longevity. He seems to have said positive things about nitric oxide and its impact on improving your cardiovascular health.

DR NATHAN BRYAN: I think as we advance the science and communicate the complex science into layman’s terms where non-scientists and non-medical professionals can understand it, more people are going to pick up on that. But there are also some well-known biohackers with influences of millions of people that still say that nitric oxide is a toxin that inhibits mitochondrial respiration and should be avoided.

Can You Have Too Much Nitric Oxide?

STEVEN BARTLETT: Is there such thing as having too much nitric oxide? If people hear this conversation today and they rush out and overdo their nitric oxide by doing a bunch of therapies, is that a risk?

DR NATHAN BRYAN: Absolutely. We know water is essential, but we can drink too much water and kill ourselves. You see it on the news a couple of times a year called hypotonic lysis. Dose dictates poison. We have to maintain the integrity of the field to make sure that if there are nitric oxide products out there, you don’t overdo it and lead to health issues or kill a consumer or patient, because that could kill the entire field.

There are only two signs of toxicity for nitric oxide:

1. If you take too much nitric oxide, you’re going to get an unsafe drop in blood pressure. If you enhance nitric oxide production through whatever means, it’s going to lead to systemic vasodilation. You’ve got that same volume of blood pumping through much larger pipes and you’re going to have a drop in blood pressure. If you lose perfusion pressure, you’re not going to be able to perfuse the brain because you’ve got to pump against gravity, and you’re going to get lightheaded and pass out. If that’s prolonged, it leads to ischemic organ damage and organ failure and can be deadly.

2. A condition called methemoglobinemia. That’s a big word meaning that it oxidizes the iron of hemoglobin and reduces your oxygen carrying capacity. You’ll become cyanotic, you’ll get blue around the lips. Your extremities will turn white from lack of perfusion or lack of oxygen. But you rarely see that. Your blood pressure will drop to an unsafe level long before you get any accumulation of methemoglobinemia.

Nitric Oxide and Telomere Length

STEVEN BARTLETT: On this point of longevity, one of the points you mentioned was telomere length. I’ve heard about studies they’ve done in rats and other rodents around telomere length. It was discovered that individuals with shorter telomeres had a death rate nearly twice of those with longer telomeres. You’re telling me that there has been research done that shows how nitric oxide can increase telomere length?

DR NATHAN BRYAN: Absolutely. We understand at the DNA level, at the nuclear level, that nitric oxide co-localizes with estrogen receptor to allow for the cell to turn on transcription and translation of the telomerase enzyme. It’s not only affecting the genetic transcription of that protein, but it’s also regulating the function of the enzyme. Without nitric oxide, you have less telomerase enzyme, and that telomerase enzyme isn’t functional.

STEVEN BARTLETT: Okay, so nitric oxide has an impact on the telomerase.

DR NATHAN BRYAN: Telomerase enzyme. That’s right. What happens with each cellular division is those telomeres can get shorter. But as long as that telomerase enzyme is active, it prevents the shortening of the very ends of the chromosome.

STEVEN BARTLETT: And just for people that don’t understand – with every replication, as we age, we’re continually replicating our cells to restore and repair them. But in that replication process, harm has occurred sometimes.

DR NATHAN BRYAN: Different cell types have different replication rates. The epithelium of the gut is highly regenerative. We’re replacing these cells all the time because it’s the outside environment that you’re having to continue to replace those cells. Neurons are the exact opposite – aren’t regenerative by nature. It was once thought that you can’t regenerate neurons, but today we know we can. It affects different organ systems differently. But the data are clear: shorter telomeres, shorter lifespan.

Nitric Oxide and the Oral Microbiome

STEVEN BARTLETT: The other thing I wanted to talk to you about before we get into how to improve nitric oxide levels is nitric oxide’s relationship with the oral microbiome. I had a conversation on this podcast not too long ago about the oral microbiome. Is there a relationship there?

DR NATHAN BRYAN: No doubt. This is probably 20-year-old science. About 20 years ago, the microbiome project was completed. What that means is that the bacteria that live in and on our body were completely mapped out and these communities were identified. It started in the gut, the gastrointestinal tract. You can culture the skin flora. There are bacteria that live on our skin, in our colon, and in women, bacteria that reside in the vagina.

All of these different ecologies of bacteria that live in and on the body are there to help the human host. We call it symbiosis. We’re providing benefit to the bacteria and the bacteria are providing benefit to the human host. If we use antibiotics or antiseptics to kill the bacteria that live in and on our body, you get human disease. There’s no physician in the world that would recommend you or I take an antibiotic every day for the rest of our lives.

STEVEN BARTLETT: Yeah.

The Dangers of Disrupting the Microbiome

DR NATHAN BRYAN: 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 leaky gut syndrome, you get autoimmune disease, you get high blood pressure, you get yeast infections, you get overgrowth of candida, you get parasites. So the bacteria are really the police of the human kind of surveillance. 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 if you destroy that microbiome, then it leads to systemic disease.

STEVEN BARTLETT: We live in a culture where we’re constantly trying to kill bacteria. Right. We’re like, especially post pandemic, we’re using all kinds of hand washes and antiseptics. And obviously the big, I guess chemicals that we all typically use are things like mouthwashes.

DR NATHAN BRYAN: Yeah.

STEVEN BARTLETT: Which are, again, trying to just clean out all the bacteria from our mouths. Well, how would you caution someone on using these things? And even the antibacterial.

DR NATHAN BRYAN: Yeah. It’s bad news.

STEVEN BARTLETT: Really.

DR NATHAN BRYAN: Yeah.

STEVEN BARTLETT: We give it to our children because we want our kids to be clean and not to have kids need to be dirty.

The Hygienic Hypothesis and Oral Health

DR NATHAN BRYAN: And again, you look at epidemiological data. Kids who grow up in a rural area, they’re out in the environment, they’re rolling in dirt. They get dirt on them and they have, you know, they’re inoculated with a lot of bacteria. Those kids are the healthiest people. And you look later in life, they have lower incidence of cardiovascular disease, diabetes, they have better immune function, less autoimmune disease. So there’s this whole 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, 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 thyroid toxicant. It kills your thyroid, and it’s a neurological toxin.

And so when you go back and look at the history of dentistry, over 100 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 embolus that occluded that coronary artery, and they basically biopsy 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 translocation of the pathogens. That’s why bleeding gums are a problem, because you’ve got bacteria in the mouth, 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 good reason, they go, well, let’s treat with an antiseptic. We have to kill all the bacteria in the mouth. So if you have bleeding gums, there’s no translocation of that in systemic circulation, and we can prevent heart attack or stroke. That was 100 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 fluoride? And they go, well, it’s been used for 100 years. 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.

Mouthwash and Blood Pressure

And so this field started probably in the 90s showing that 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 published on this probably in 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 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 saying, okay, let’s see 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 stopped for four days. We say, okay, don’t take mouthwash for four days, then come back, let’s remeasure your blood pressure and let’s do tongue scrapings and figure out what’s happening to these bacterial communities. And what we found was that if you eradicate the bacteria within seven days, your blood pressure goes up.

STEVEN BARTLETT: So if you use mouthwash within seven days, your blood pressure goes up.

DR NATHAN BRYAN: I think it occurs earlier. But what we looked at was 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.

STEVEN BARTLETT: Of mercury, which is, put that in context for me.

DR NATHAN BRYAN: It’s clinically hypertensive. So for every 1 millimeter increase in blood pressure, that increases your risk of cardiovascular disease by 1%. So within seven days we increased this kid’s risk of cardiovascular disease by 26% simply by giving him mouthwash.

STEVEN BARTLETT: And explain to me in layman’s terms the mechanism now what’s going on?

How Oral Bacteria Produce Nitric Oxide

DR NATHAN BRYAN: 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 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.

Humans do not have the functional enzyme to do this. We’re 100% dependent upon the bacteria then. Now, because nitrate is inert in humans, 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 bacteria now the nitrate is just being recirculated. But you’re urinating because 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 nitrite and nitric oxide being produced in the acid environment of the stomach is somehow regulating resistance arteries and dilation to normalize systemic blood pressure.

STEVEN BARTLETT: So if I don’t have a healthy oral microbiome, then you have an elevation in blood pressure. And much of the things you’re talking to me about today in terms of dietary changes won’t have any effect anyway because I need the bacteria to convert it into nitric oxide.

DR NATHAN BRYAN: As it relates, there are many benefits 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 for instance, a plant based diet, if you don’t have the right bacteria, you get zero benefits of that.

Oral Health and Cancer

STEVEN BARTLETT: Have you seen a link between oral health and cancer?

DR NATHAN BRYAN: Yes, absolutely.

STEVEN BARTLETT: What have you seen?

DR NATHAN BRYAN: 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 I made a controversial statement 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?

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 metastatic, meaning that it’s now everywhere. 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.

STEVEN BARTLETT: What percentage of cancer patients that you see that you then refer to a dentist, have an oral infection.

DR NATHAN BRYAN: People with primary tumors, solid tumors. So we categorize these in bloodborne cancers, something like lymphoma, leukemia, multiple myeloma, 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 liver. Without fail, 100% of them have dental infections.

STEVEN BARTLETT: But cause and effect is not possible to establish here. Right?

DR NATHAN BRYAN: 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 when I tell people, well, you need to go see a dentist. I mean, many people laugh and they go, 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 I always look at what’s held true throughout ages. And if you look at Ayurvedic medicine, if you look at traditional Chinese medicine, if you look at acupuncture and 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 the meridians, the acupuncture meridians.

You know, the analogy is they’re circuit breakers. So 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, 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 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.

STEVEN BARTLETT: Right.

The Importance of Oral Health and Nitric Oxide Production

DR NATHAN BRYAN: 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 best example is if you’ve got a root canal and 100% of root canal teeth are infected. And when you think, 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.

A tooth is a crystalline 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 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. 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 site of infection.

To me, when you sit back and think about this, who does this and why do they do it? Well, it’s because it’s what we’ve always done. So then what happens is these anaerobic bacteria, they don’t need oxygen. They’re sitting there in an anaerobic low oxygen environment and they’re just eating away at your jawline. They’re just like us. They metabolize, they take stuff in, they excrete waste out. Those waste products accumulate, shut down voltage and they eat away at your jawline. So then you’ve got osteonecrosis osteomyelitis 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.

STEVEN BARTLETT: It’s really interesting. I was doing some research in preparation for this conversation around the subject of oral microbiome and cancer and the link there. One particular study that was done published in the New York Post, but done by a team of researchers 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%. I’m getting a cancer, which is pretty shocking. Literally, I feel like texting my assistant and asking to book an oral hygienist and to change my mouthwash.

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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?

Improving Oral Health and Microbiome

DR NATHAN BRYAN: Well, I think the most important thing we’ve learned is what you shouldn’t be doing.

STEVEN BARTLETT: Yeah.

DR NATHAN BRYAN: 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. Just this past weekend I was speaking at a dental conference in Salt Lake City and there were people there from the National Toxicology Program, which in the US is the organization tasked with assessing risk of exposure to environmental toxicants. 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.

What they report is that fluoride has no benefit and it’s all risk. It lowers IQ in kids by as much as 7 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, 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 pea sized amount of toothpaste on your toothbrush. A pea size, but everybody that I know fills the entire bristle of the toothbrush with toothpaste. So that’s about 10 or 15, sometimes 20 pea size amounts of toothpaste. And a pea size amount of toothpaste contains about half a milligram of fluoride. Now, if you’re using 10, 20 times more than that pea size, 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 buccal mucosa, the oral cavity, and it becomes systemic.

STEVEN BARTLETT: I’m not going to use it anymore.

DR NATHAN BRYAN: No, you shouldn’t.

STEVEN BARTLETT: What should I use instead?

DR NATHAN BRYAN: You have to use a non-fluorinated toothpaste.

STEVEN BARTLETT: And what about things like tongue scrapers?

DR NATHAN BRYAN: 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.

STEVEN BARTLETT: Why is this? My girlfriend’s been going on to me about tongue scraping for the last two years and I’ve kind of just ignored her. When she’s not in the bathroom, I’m not using her tongue scraper because it just looks strange. And 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?

DR NATHAN BRYAN: Well, if you’re going to plant a garden, do you plant a garden on untiled soil?

STEVEN BARTLETT: Listen, I know nothing about gardening. Asking the wrong guy. So maybe, yes.

DR NATHAN BRYAN: I grow my own food. You have to till the soil, right? You got to break up the soil so the seeds actually can be aerated. And you break up that biofilm. You take the back of the dorsal tongue, 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 kind of like tilling the soil and it’s increasing the diversity of the dorsal part of the tongue, the microbiome.

STEVEN BARTLETT: So my girlfriend was right in that regard.

DR NATHAN BRYAN: 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.

STEVEN BARTLETT: Interesting.

DR NATHAN BRYAN: 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 able to penetrate deep in the crypts of the tongue and more effectively kill the bacteria.

STEVEN BARTLETT: So you want to tongue scrape and then use a toothbrush without fluoride toothpaste?

DR NATHAN BRYAN: Absolutely. And no antiseptic mouth rinse.

STEVEN BARTLETT: Okay. And what about going to dental hygienists and things like that? Do you think that’s an advisable idea? Because once every quarter or so I’ll go and see a dental hygienist just to get everything sort of cleaned out.

DR NATHAN BRYAN: No, I think that’s a good proactive practice. Because you need to look at the health of the gum tissue and the gingival tissue and a routine clean and scraping the plaque off the teeth and making sure you have good mineralization of the enamel of the tooth is good. But never let them do a fluoride rinse.

STEVEN BARTLETT: Is there anything else on the subject of the microbiome and its relationship with nitric oxide that I need to be aware of before we move on?

Nitric Oxide, Exercise, and Hormones

DR NATHAN BRYAN: Yeah. There’s also data showing that if you use mouthwash, you lose the cardio protective 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 go and they try to eat well, 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.

STEVEN BARTLETT: What’s the mechanism now?

DR NATHAN BRYAN: Well, because you’re killing 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.

STEVEN BARTLETT: That’s crazy. And is there a link between our hormone levels, things like my testosterone levels, and the nitric oxide?

DR NATHAN BRYAN: Yeah. So this is a two way street. So in men, testosterone activates nitric oxide production.

STEVEN BARTLETT: Okay.

DR NATHAN BRYAN: In women, estrogen activates and stimulates nitric oxide production.

STEVEN BARTLETT: Okay.

DR NATHAN BRYAN: 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.

STEVEN BARTLETT: Got you. So taking testosterone or estrogen therapies helps to increase my nitric oxide levels as.

DR NATHAN BRYAN: As long as the enzyme is functional and coupled. Which means that we have to understand the enzymology and the biochemistry of that reaction to where when it’s exposed to testosterone, the cell can actually make nitric oxide in response.

STEVEN BARTLETT: And there’s a two way relationship as well with exercise then? Because I’ve read in your book that 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. You’re going to do a worse workout as well, presumably.

DR NATHAN BRYAN: Well, think about, there are other agonists too, like vitamin D. Most Americans are deficient in vitamin D. People with low testosterone have erectile dysfunction. Why is that? Because they’re not stimulating nitric oxide production and they’re not dilating the blood vessels. They develop ED.

So all of this, no matter what it is, whether it’s related to vitamin D deficiency, which is an activator and stimulator 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.

STEVEN BARTLETT: When I think about the role that food plays in my nitric oxide production, what should I be eating to increase my nitric oxide levels or to keep them at a healthy level?

The Dangers of Sugar and Its Impact on Nitric Oxide Production

DR NATHAN BRYAN: I think the same answer is for that too. It’s not so much what we should be eating, it’s what we should not be eating. Okay, so 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 applies, 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 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. And in biochemistry and enzymology, enzymes have to be able to undergo conformational changes. Right? So it transfers electrons from one donor to an acceptor and that’s how biochemistry is done. But if sugar is stuck to that enzyme, it locks it in some conformation and it can’t do its job, it can’t make nitric oxide. So sugar is an absolute poison and it kills many enzymes and binds to.

STEVEN BARTLETT: Everything and it lowers nitric oxide production.

DR NATHAN BRYAN: Absolutely. That’s why diabetics have a 10 time higher incidence of heart attack, stroke, all cause mortality. That’s why they develop 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 is stuck to the enzyme. The sugar destroys the oral microbiome and completely changes the ecology of the bacteria and completely shuts down nitric oxide production.

Nitric Oxide’s Role in Wound Healing

STEVEN BARTLETT: Just a bit of a tangent there. You mentioned that’s why they have open wounds that don’t.

DR NATHAN BRYAN: Yeah, diabetic ulcers.

STEVEN BARTLETT: Okay, so nitric oxide’s playing a role, a healing role in wounds and scars.

DR NATHAN BRYAN: Absolutely.

STEVEN BARTLETT: 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 they, they like, they passed out and 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. I’m wondering, I’m like, if I apply.

DR NATHAN BRYAN: The nitric oxide serum, it’ll stimulate blood flow to that, it’ll improve cellular turnover and heal that wound and basically remediate the scar.

STEVEN BARTLETT: And how do I do that? Is it?

DR NATHAN BRYAN: Yeah, you see, you take one pump from each side, so one pump from this side, turn it around one, pump from the other.

STEVEN BARTLETT: Yeah.

DR NATHAN BRYAN: 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, 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 infectious bacteria.

Dietary Recommendations

STEVEN BARTLETT: Okay, well we shall see if that works. So back on this point of food then. So sugar’s bad?

DR NATHAN BRYAN: Sugar’s bad. Yeah. You got to eliminate and I think the benefits of it, like a straight ketogenic diet or a straight, you know, vegan vegetarian diet is just the elimination of sugar and carbs. Yeah, right. But I think to answer your question, what should we be eating? I think you’ve got to eat a balanced diet in moderation. You know, Americans are overfed. All you got to do is walk around and see the epidemic of obesity. Good high quality protein, good quality fats and little or no carbs. And it’s really that simple.

The Truth About Beetroot

STEVEN BARTLETT: And why did you write a book about beetroots?

DR NATHAN BRYAN: Beets, yeah. The beets hit the really the airwaves back in 2012 in the London Olympic Games. 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 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 misinterpreted that as gastric bleeds or urinary bleeds. And then when I started looking at the products on the market, most of the beet products, the desiccated beet powders provided zero nitric oxide benefit. They didn’t contain any nitrate, no nitrite. They were just, we called them dead beets. They’re, they’re 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 beats ability to improve nitric oxide production in the body, then the non scientists 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 placebo controlled clinical trials and we would take some of these commercial beet products that you can go to your local nutrition store or pharmacy, buy off the shelf, and we would use those as placebos in our clinical trials because it’s the perfect placebo.

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.

STEVEN BARTLETT: Trying to find the page in your book, but there was a page in your book where you describe beetroot as the most underappreciated food in the history of eating.

DR NATHAN BRYAN: Yeah. That may be in the beat. The odds thought it was in this book. But if you go back to historical times and you look at 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 benefits of that. But unfortunately, today, the beets that are grown, at least in America, really are nutrient depleted, just like most of the food.

STEVEN BARTLETT: So would you recommend people eat beetroots?

DR NATHAN BRYAN: No, because as we 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.

The Problem with Antacids

STEVEN BARTLETT: There’s a graph in front of me here which I printed off, which shows the rise in antacid medications.

DR NATHAN BRYAN: Oh yeah. From 2004 to. So a 20 year period, we’re seeing, what is that, almost a quadrupling of the use of antacids. And this is globally or is this in the US?

STEVEN BARTLETT: That’s worldwide, I believe.

DR NATHAN BRYAN: Yeah, worldwide. Now this is the problem. I mean, these antacids.

STEVEN BARTLETT: What is an antacid?

DR NATHAN BRYAN: So it’s a medication that’s given orally to suppress stomach acid production. Yeah, 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 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 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.

STEVEN BARTLETT: These are the brands like Gaviscon.

DR NATHAN BRYAN: Now these are like the Prilosec, the Prevacids, the Nexium. The prescription medications are Omeprazole, Pentoprazole, These today in the U.S. 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.

STEVEN BARTLETT: What about Tums over the counter?

DR NATHAN BRYAN: 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 pyloric cells of the stomach.

STEVEN BARTLETT: So what is the difference between. Have you heard of Gaviscon before?

DR NATHAN BRYAN: Yes.

STEVEN BARTLETT: Yeah. What’s the difference between like a Gaviscon?

DR NATHAN BRYAN: Well, there’s certain classes of antacids. 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. Gaviscon. I’m trying to think what class that falls under. I don’t think it’s widely used here in the U.S. I mean, the main drugs used here are probably Nexium, Prevacid. Those are the over the counter. And then the main prescription medications are the omeprazole and the pentoprazole.

STEVEN BARTLETT: Gaviscon is a commonly used antacid brand. And the active ingredients are aluminum hydroxide and magnesium carbonate.

DR NATHAN BRYAN: Oh, so Gaviscon. So, number one, it’s got aluminum in it, which should absolutely be avoided. But, yeah, that just looks like a buffer. It’s got a hydroxide, aluminum hydroxide, which is a strong base, so it’s neutralizing the stomach acid production, but it’s a neutralizing agent. But anything that contains aluminum you should.

Nasal Breathing and Nitric Oxide

STEVEN BARTLETT: Absolutely avoid, as I mentioned her a few times today. But my girlfriend’s a breath practitioner. She runs a business called balibreathwork.com ad and one of the things she’s talked to me a lot about is mouth breathing. And I know there’s 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 link?

DR NATHAN BRYAN: 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 bronchioles, 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.

STEVEN BARTLETT: 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.

DR NATHAN BRYAN: Oh, yeah. Again, going over the past 20 years. Yeah, no, I think there’s a lot of people. I mean, obviously your girlfriend. There’s Patrick McKeown in the UK.

STEVEN BARTLETT: Came into Dragon’s Den. I. And I made him an offer. In Dragon’s Den. Yeah.

DR NATHAN BRYAN: No, I think the benefits of that are pretty well and mechanistically, we understand the benefits of it. So the mouth breathers are not only bypassing this natural nitric oxide production pathway, but. But when you mouth breathe, it completely changes the microbiome. 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.

STEVEN BARTLETT: Interesting, interesting.

Mouth Taping and Airway Considerations

DR NATHAN BRYAN: So you have to. I mean, I’m a big fan 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 sometimes surgery. But the worst thing you can do is tape your mouth and your airway be constricted and you suffocate. So before you do mouth taping, you need to get some imaging done from your dentist to make sure that your airway is open to where if you’re forced to breathe through your nose, you can actually have oxygen exchange.

STEVEN BARTLETT: 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 for Nitric Oxide Production

DR NATHAN BRYAN: Humming. You know, there are certain frequencies, we’ve done this in 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 oral cavity and sinuses is probably much different than mine.

STEVEN BARTLETT: Give me an example. Show me.

DR NATHAN BRYAN: 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 gas phase analyzer here, I could hum and I could detect nitric oxide coming out of my exhale breath.

STEVEN BARTLETT: The frequency of the…

DR NATHAN BRYAN: Because of the frequency and activating the nitric oxide synthase enzyme. But if you take older patients, and we’ve demonstrated this as published years ago, and other groups have demonstrated this, older patients, 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.

Improving Nitric Oxide Levels

STEVEN BARTLETT: Is there anything else that I should be aware of if I’m trying to improve my nitric…

DR NATHAN BRYAN: Oxide levels, I think it’s doing the things that disrupt it. Get rid of fluoride, get rid of mouthwash, stop using antacids, stop eating sugar, anything that leads to an elevation in blood sugar, a balanced diet in moderation, moderate physical exercise, 20, 30 minutes of sunlight a day.

STEVEN BARTLETT: Sunlight?

DR NATHAN BRYAN: Sunlight. There’s certain at both ends of the visible spectrum. Both the UV spectrum and the full spectrum infrared. So those frequencies and vibrations again stimulate nitric oxide release. The UV has enough energy to where it’ll knock nitric oxide bound to a cysteine thio and protein. And then the UV spectrum will release nitric oxide down to metals.

STEVEN BARTLETT: So you mean go out in the sunshine but also those red light beds and stuff?

DR NATHAN BRYAN: Yeah, I have a red light bed, I have an infrared sauna that uses red lights in it. And I use it every day.

STEVEN BARTLETT: For nitric oxide production.

DR NATHAN BRYAN: Yeah, and there’s other benefits of light. You know, it can stimulate mitochondrial biogenesis, it improves energy production, it can lower blood pressure. 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 ourselves with these cancer causing chemicals in sunscreen. Makes no sense.

The Future of Medicine and Nitric Oxide

STEVEN BARTLETT: What is the most important thing we haven’t talked about that we should have talked about today, Dr. Nathan?

DR NATHAN BRYAN: You know, I think the future. Well, I don’t think 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 healthcare 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 were 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.

STEVEN BARTLETT: Well, it’s a good thing we have 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 the word nitric oxide. And maybe I’d heard it in passing, but maybe I was confusing it with that nose 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 really, really important molecule in 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?

Personal Balance and Life Priorities

DR NATHAN BRYAN: Happily or unhappily mated? You know, one of my biggest challenges in life is maintaining balance, right? Because I’ve been so focused on discovery and research and leaving a lasting legacy and making innovations and doing things in the scientific and medical community that many people said couldn’t be done. And so my problem is there’s always a deficiency. You know, I’ve got young kids, I spend a lot of time away and, 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 my spiritual, my mental, physical and spiritual health. I’m trying to do better at that now, but you know, there’s always sacrifice, right? And we just have to pick our sacrifices. And so I’ve got to choose to do better.

STEVEN BARTLETT: Yeah, everything has a trade off. 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.” 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. But if they want to find out more, if they want to understand the products that you sell in anything else, where do they go?

Resources and Where to Find More Information

DR NATHAN BRYAN: Well, I mean, obviously I’m here to educate and inform on 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 in this 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 nathansbook.com or you can get it anywhere books are sold. Amazon, Barnes and Noble. I’ve got a YouTube channel, Dr. Nathan S. Bryan Nitric Oxide, where we provide education information, latest scientific information on nitric oxide. You can find me on social media, Instagram: Dr. Nathan S. Bryan. And then for those who want to follow our product journey and bringing forth safe and effective product technology, that’s n101.com. So it’s the letter n, the number one letter o number one dot com. But you know, we make products that release nitric oxide.

STEVEN BARTLETT: Dr. Nathan Bryan, 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 going to inspire 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.

DR NATHAN BRYAN: Thank you so much. Pleasure being with you.

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