Nitric Oxide: The Molecule That Opens Your Blood Vessels

In 1998 the Nobel Prize in Medicine went to three researchers for a discovery that sounded implausible when they made it: that a gas functions as a signaling molecule in the cardiovascular system. The gas was nitric oxide, and it turned out to be one of the most important regulators of blood flow in the body.

How it works

Every blood vessel is lined with a single layer of cells called the endothelium. Wrapped around that lining is a layer of smooth muscle that sets the diameter of the vessel.

When endothelial cells produce nitric oxide, it diffuses the very short distance into that muscle layer and tells it to relax. The vessel widens and more blood flows through. Because nitric oxide breaks down within seconds, this is not a systemic switch. It is local, continuous, and constantly adjusted, which is exactly what you want from a system that has to route blood to whichever tissue currently needs it.

One of the main triggers for nitric oxide production is blood flow itself. Moving blood exerts shear stress on the endothelium, and the endothelium responds by making more nitric oxide. Flow encourages flow. It also means the reverse is true, and sedentary tissue with sluggish circulation loses part of the signal that would have opened it up.

Why it declines

Endothelial function falls with age in essentially everyone. It falls faster with elevated blood sugar, high blood pressure, smoking, and inactivity. Impaired nitric oxide signaling is one of the earliest measurable changes in vascular disease, appearing long before anything shows up on a scan.

The feet feel this first. They are the farthest point from the heart, they sit at the end of the longest vessels, and gravity is working against return flow the entire time you are upright. Whatever margin the rest of your circulation has, the feet have less of it.

The vessels inside your nerves

Nerves have their own blood supply, a network of tiny vessels called the vasa nervorum that runs within and along the nerve. These are small vessels serving tissue with high energy demand and very little tolerance for interruption. When microcirculation is compromised, nerve tissue is among the first to show it.

This is why circulation is central to how we think about nerve symptoms rather than a side note.

What can influence it

Movement is the most reliable lever anyone has. Walking increases shear stress across the whole vascular tree and is the closest thing to a direct request for more nitric oxide.

Diet contributes as well. Dietary nitrate from leafy greens and beets is converted by bacteria in your mouth to nitrite and then, in the body, to nitric oxide. This is a real and measurable pathway, which is also why using antibacterial mouthwash heavily can blunt it.

In the office, near-infrared therapy targets this same pathway locally, applied directly to the feet and legs where the circulation problem is.

If your feet are cold, discolored, or slow to heal, that is a circulation conversation worth having. Call (725) 255-7333. Henderson, southwest Las Vegas, and North Las Vegas.