Dietary nitrate is one of the best-evidenced natural tools for blood pressure. In a four-week randomised trial, around 400mg a day lowered systolic pressure by about 8 mmHg in hypertensive adults.1 So why do so many people try beetroot and feel nothing? Usually one of three things.
Reason 1: the dose wasn't there
The trials used roughly 6 to 8 mmol of nitrate a day, which is about 400 to 500mg, delivered as concentrated beetroot juice.1 A typical beetroot powder contains somewhere around 1 percent nitrate by weight, and a typical capsule holds about 720mg of powder. That is about 7mg of nitrate per capsule. To reach 400mg you would need somewhere around 50 to 60 capsules a day. Nobody takes that, so nobody gets the dose, and the label never said how much nitrate was in it anyway. This is why Core3 uses patented NO3-T® nitrate sources rather than beetroot powder: the trial dose arrives in one serving, and the milligrams are on the label.
Reason 2: mouthwash
The nitrate pathway runs through your mouth. Bacteria on your tongue convert nitrate to nitrite; you swallow it; stomach acid converts nitrite to nitric oxide. Antiseptic mouthwash kills those bacteria. In a crossover study, a single antibacterial mouthwash abolished the rise in nitrite after a nitrate load and with it the blood pressure effect.2 In another, a week of chlorhexidine mouthwash raised systolic pressure by around 2 to 3.5 mmHg in healthy volunteers.3 Antibacterial mouthwash also blunted the blood-pressure effect of a nitrate-rich diet in treated hypertensive adults.4 A cohort study found that people who used mouthwash twice a day or more were more likely to develop hypertension over the following years.5 You still get the vitamins from the greens. You just don't get the nitric oxide. If you use antiseptic mouthwash and eat beets, you are pouring the beets down the sink.
You still get the vitamins from the greens. You just don't get the nitric oxide.
Reason 3: antacids and acid blockers
The second half of the pathway needs an acidic stomach. Nitrite converts to nitric oxide efficiently at a low pH; raise the pH and the conversion stalls. In a randomised trial, a proton pump inhibitor abolished the blood-pressure-lowering effect of orally ingested nitrite in healthy volunteers.6 Antacids work the same way, more briefly. This is not an argument to stop a medication you have been prescribed. Reflux and the drugs that treat it are a conversation for you and your physician. It is an argument to have that conversation, knowing that acid blockers and the nitrate pathway don't get along, so the two of you can decide what to do about it.
What to do
- Get the dose. Look for the nitrate figure in milligrams on the label; if it isn't there, assume it is low.
- Swap antiseptic mouthwash for brushing, flossing and a non-antibacterial rinse. Give your tongue its bacteria back.
- If you take antacids or a PPI, ask your physician about it with the nitrate pathway in mind.
- Keep eating the greens and beets. They were never the problem; the delivery was.
