Sound Bites
Hypertension, Cannabinoids, Smoke, masks,
For all the new readers... thank you for joining us. For the ongoing subscribers; much appreciation. A newsletter is different then a blog. It allows me to express myself directly to those most deeply connected to my purpose and mission. When I write these newsletters; I am thinking about the people I know and care about most intimately. So thank you.
Thanks for all that attended the last webinar on Osteoporosis. I am working on announcing my next webinar.
For now, let's get into some sound bites.
Blood Pressure Creeping Up?
Everybody knows what foods to watch if your blood pressure is creeping up ( ie. those are the high sodium foods). Or do you? Sodium rich foods are easy to spot. They include restaurant-prepared foods, red meats, snack foods (ie, chips, baked goods). People have also heard of increasing potassium rich foods and magnesium rich foods. I go into this on one of my recent blog posts.
Yet, when confronting hypertension people overlook the importance of supporting Nitric Oxide.
Nitric Oxide is a vasodilating molecule released within the endothelial layers of the arteries. It opens arteries instead of constricting them. If arteries are open there is less resistance for the heart to pump against. Hence, lower blood pressure.
Nitric Oxide is synthesized by the amino acid L-arginine and is dependent on several cofactors including:
nicotinamide adenine dinucleotide phosphate (NADPH)
flavin mononucleotide
flavin adenine dinucleotide
tetrahydrobiopterin (BH4)
and calmodulin.
Also Nitric Oxide Synthesis is dependent on several enzymes including
endothelial nitric oxide synthase (eNos)
neuronal nitric oxide synthase (expressed in normal cells) (nNOS)
inducible nitric oxide synthase (expressed during infection/inflammation) (iNOS)
Nitric Oxide diffuses into the endothelial tissue and activates guanylate cyclase in vascular smooth muscle cells to synthesize cyclic guanosine-3',5-monophosphate (cGMP) which causes many of its biological effects.
In disease states there appears to be a disruption in this system leading to reduced Nitric Oxide synthesis; for example:
Insulin resistance appears to be associated with deficiency in nitric-oxide cofactor Biopterin (BH4)
Chronic cigarette smoking contributes to depletion of BH4 resulting in decreased nitric oxide synthesis
In hypercholesterolemia, BH4 seems to be impaired.
We should also note there are genetic predispositions to poor Nitric Oxide Synthase function.
So low Nitric Oxide synthase can lead to stiffer and less pliable arteries.
In these disease states we see overproduction of endogenous inhibitors of NOS such as asymmetric and symmetric dimethylarginine (ADMA/SDMA) . SEE image below.
ADMA inhibits L-arginine production of nitric oxide. Normally ADMA is processed by enzymes dimethylarginine dimethylaminohydrolase (DDAH I and II) and converted to Citrulline thereby having no negative impact on L-arginine . Yet when ADMA/SDMA builds up ( likely due to faulty DDAH function) it may inhibit L-arginine production of nitric oxide.
Now back to hypertension, there is evidence that in essential hypertension there is faulty eNOS release and also an elevation of ADMA.
So we can see why overlooking this mechanism may be a hole in the strategy.
What to do?
First you can get your ADMA/SDMA measured so you can see if this may be part of your hypertension picture.
Aso you can start by incorporating Citrulline-rich foods
Why citrulline Rich Foods?
Citrulline -containing containing the form L-citrulline provide support for nitric oxide (NO). L-citrulline is a naturally occurring amino acid that is readily converted by the body to arginine in the production of NO.
L-citrulline reduces ADMA-mediated reductions in NO. The mechanism may be by reducing ADMA levels and also by supporting Nitric Oxide formation . (Schwedhelm.2008) .
L- citrulline, however, is rarely found in foods. One of the richest food sources being found in watermelon in both the fruit and the rind. The amount of citrulline watermelon contains varies.
One study state that 1.5 kg or 3.3 lbs. of fresh watermelon has ~3 grams of l- citrulline (minimum effective dose) and 5.0 kg or 11 lbs. of fresh watermelon has ~10 kg of l-citrulline (maximum effective dose).
Citrulline Rich Foods to consider
Watermelon (1.6 - 3.5 g/kg)
Watermelon juice (10 oz.) has about the therapeutic level so L-citrulline
Pumpkin
Squash
Cucumber (has of 0.146 mg citrulline/g)
Bitter melon
Melons in general including cantaloupe
Source: Hartman JL, Wehner TC, Ma G, Perkins-Veazie P. Citrulline and Arginine Content of Taxa of Cucurbitaceae. Horticulturae. 2019; 5(1):22. https://doi.org/10.3390/horticulturae5010022
There are also Citrulline containing supplements like CitraNoX by Ortho Molecular Products or Nitric Oxide Caps Ultra by Pure Encapsulations
It also makes sense to look at L-arginine rich foods to support this pathway. But since L-arginine can sometimes trigger herpes simplex virus ; I am always encouraging starting with L-citrulline first.
How would I approach this? In the early days of hypertension when its mild such as 130-140 systolic , then it might be work checking ADMA/SDMA levels and if high starting support of Nitric Oxide Pathways. When things have moved above 140 Systolic, then often a combination of conventional and alternative interventions may be needed.
References:
Vallance P, Chan Endothelial function and nitric oxide: clinical . Heart. 2001;85:342-350.
New podcast with Jake Felice, ND on the Endocannabinoid System (ECS)
Dr. Felice describes the Endocannabinoid System as follow " It operates by retrograde transmission. In nerves are firing erratically , the ECS gets them to stop, slow down, and buffer"
When I was in medical school we didn't even mention the ECS once. Largely because we were coming of the "War on Drugs" era and Cannabis was seen as nothing but bad. A medication that acted on the ECS was not even available so most people opted for other therapies such as SSRI's, NSAIDS, and Opioids.
However over the last several years , medical Cannabis has emerged as a therapy for cancer support, Chronic Pain, IBD, PTSD, MS, and Migraines to mention a few.
I had the great pleasure of having Dr. Felice on my podcast. you can listen below.
<iframe src="https://podcasters.spotify.com/pod/show/adam-rinde/embed/episodes/The-Endocannabinoid-System-with-Dr--Jake-Felice-evnj80/a-a5cghdh" height="102px" width="400px" frameborder="0" scrolling="no"></iframe>
BeHealthistic about Dysbiosis
I recently appeared on the BeHealthlistic podcast speaking about Dysbiosis and gut imbalances including Small Intestinal Bacterial Overgrowth.
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This was one of my favorite interviews thus far. My good friend and colleague interviewed me. I had some lighting issues about otherwise the content came out great. Enjoy.
How clean is the air?
I don't know about you but the months August and September are etched in my brain for Smoke Season. It is time to get prepared. Purple Air is a great website to bookmark to check air quality https://www.purpleair.com/map?opt=1/mAQI/a10/cC0#4.87/49.72/-120.07
Before you ditch your covid masks entirely; now might be time to actually get a N95 quality mask to cope with smoke season. My dear friend told me about this one EnvoMask.
I think it's important to get ready to have supportive treatments around to deal with lung smoke such as a Nebulizer (I like OMRON for this) and to learn about nebulized glutathione for exposures to smoke. Nebulized glutathione is available by prescription at compound pharmacies.
Picture of the week
This was a picture captured as the most detailed representation of a human cell to date.
It was captured with using nuclear magnetic resonance and cryoelectric microscopy. I found it on Astrovia1's instagram page
When we look in the center we see the nucleus , microtubules, mitochondria, the endoplasmic reticulum and more.
Its is just so fascinating to see this after years of relying on textbook images to visualize it.
The human body is just so spectacular .