I have great respect for those doctors and researchers that have earned a Noble prize in Medicine for their groundbreaking insights and discoveries. I am indebted to some of these pioneers for the great impact their work has had on my own work as a physician. So it was a thrill and an honor to attend a lecture by Dr. Bryan, one of the scientists who assisted the recipients of the1998 Noble prize in medicine, the Drs Ignarro, Murrad and Furchgott. Together, they discovered that the cells produce a very useful substance that lines the blood vessels. This substance is nitric oxide (NO).

Many of you may be quite familiar with the effects of NO. If you suffer from heart disease, or have gone to the ER because of chest pain, it is very likely they sprayed Nitroglycerine under your tongue or rubbed Nitroglycerine paste on your chest to reduce the chest pain. Nitroglycerine causes the blood vessels in the coronary arteries to release nitric oxide. This allows more oxygen to the heart. Nitric oxide is made by the body and permeates tissues in less than a second, causing arteries to relax and expand so as to reduce blood pressure. Nitric oxide signals immune cells to kill harmful bacteria and cancer cells and helps brain cells to communicate with each other. Nitric oxide reduces the inflammation of arthritis; it protects bones from osteoporosis, helps heal chronic wounds, improves both male and female sexual functions, helps make anti-depressants more effective, and reduces sun damage to the skin.

If the body does not make enough nitric oxide, you can experience fatigue, reduced sexual performance, fibromyalgia, cardiovascular disease, high blood pressure and even memory loss. Unfortunately, after age 40, the body’s production of nitric oxide declines. The Journal of Behavioral Research has shown the importance of NO for learning and memory. A Finnish study has shown that decreased NO levels can affect sleep. In The Clinical Journal of Pain, arthritic patients with decreased NO levels, were prone to experiencing oxidative stress in the joints.

So how do you increase your NO levels? If you are under 40, you can take L-arginine but as you age, this becomes less effective. If you are over 40, you are going to have to work a little harder at it. Here are a few suggestions. Start with at least 90 minutes of rigorous exercise every week. Drink beet juice – it’s high in NO. If possible, take an infra red sauna. Take nitroglycerine (a prescription medication). Or take nitric oxide tablets (which are not prescription). With these tablets, I have been able to help several of my patients with resistant high blood pressure and I been able to provide hypertension patients with a more natural alternative. It has even worked in nausea and constipation.

As for me, the way I increase my NO, is to play a lot of hard tennis. I tell my wife, I’m not just playing tennis – I’m increasing my NO. She’s all for that.