Garlic, Greens, and Beets for Sustained Nitric Oxide Production

The researchers who identified Nitric Oxide (NO) as a small molecule made by the endotherlial lining of arteries to promote blood flow and resist atherosclerosis won the Nobel Prize in Medicine in 1998. Despite that, NO rarely comes up in clinical care as it is hard to measure and no pharmaceutical agent is directly indicated to produce more NO. There are many supplements that claim to support NO production but many have no research.

A new supplement that combines dietary nitrates (like greens and beets) with a garlic extract was recently studied and shown to have a sustained increase in NO production, at least in the saliva. 

Why might this work? The conversion of dietary inorganic nitrate (NO3-) to NO plays an important role in NO biology. Inorganic NO3- supplementation is a proven method for controlling mild hypertension. Recent reports have suggested that another gaseous transmitter, hydrogen sulfide (H2S), influences NO biosynthesis and metabolism.

Data from a recent study are presented from an open-label clinical trial examining the effect of an encapsulated formulation (Vascanox® HP) that combines dietary sources of inorganic NO3- and S-allylcysteine (SAC), a source of H2S from garlic, on NO bioavailability and blood pressure in subjects experiencing elevated blood pressure or mild hypertension.


An open-label clinical trial was conducted among patients with hypertension. Participants took Vascanox® for four weeks. Blood pressure was measured at baseline, two weeks, and four weeks. Salivary nitrite (NO2-), a surrogate of NO bioavailability, and NO3- were assessed prior to and two, six, and 24 hours after dosing on the first day of the study and prior to and two hours after dosing at subsequent study visits using saliva NO test strips. 


Twelve participants completed the clinical trial. Vascanox® HP decreased systolic blood pressure by ~11 mmHg (p < 0.001) at two weeks and persisted beyond four weeks with daily supplementation. It also decreased the diastolic blood pressure of hypertensive subjects but not normotensive ones. The magnitude of the decrease was 11 mmHg (p < 0.01) at four weeks of study.

Measurements of salivary concentrations of NO2- revealed high peak levels (743 uM) at two hours post-administration and a slow decay to elevated levels (348 uM) at 24 hours. NO2- salivary concentrations, a surrogate biomarker of NO bioavailability, remained above baseline for the duration of the study.


Vascanox® HP was shown to be a safe, effective, quick-acting, and long-lasting dietary supplement for controlling mild hypertension.

Vascanox® HP is the first commercial dietary supplement that, inspired by recent advances in the field of NO biology, combines dietary sources of NO and H2S, that has been tested clinically

The collective effect of Vascanox® HP is an impressive reduction in SBP and DBP in mildly hypertensive individuals.

I have begun using this combination preparation in my clinic for those with salivary testing or blood testing (ADMA) evidence of reduced NO production. I also use it in those with blood pressure not at goal looking to avoid more medications. 

Dr. Joel Kahn

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