Your Oral Microbiome and Exercise Capacity

June 19, 2023

Your Oral Microbiome and Exercise Capacity

Did you know you have a distinct biome of bacteria, viruses, and fungi in your mouth? More specifically, on your tongue? There are some 10 billion bacteria in your mouth, gums, and tongue, that represent some 700 distinct species.

These bacteria do important work. Your oral bacteria are key to making nitric oxide. When you eat green, leafy vegetables you will concentrate the natural nitrates from those vegetables in your salivary glands within about 90 minutes. Your saliva has about a 10-fold concentration of nitrates over your serum. The bacteria on your tongue take those nitrates and reduce them into nitrite. When swallowed, those nitrites are converted to Nitric Oxide if the pH of the stomach is below 3. Guess what happens if you take any PPI for GERD or ulcer disease? You are correct. NO production goes to zero. And your risk of cardiovascular disease rises by some 30% over the next three years. Yes, PPIs are dangerous for your long-term health and are not approved by the FDA for long-term use.

If you take 20, young dental students and give them mouthwash twice a day for two weeks, you can completely wipe out their oral biome. With that, you also will successfully raise their blood pressure by 12 points. And if you measure the complexity of oral biomes in people, you can predict who has high blood pressure and who doesn't by the range of their oral biome. Folks with high blood pressure will universally have very simple oral biomes with just a few dominant bacteria. Folks with low blood pressure will have a wide variety of bacteria and four specific strains that are responsible for nitrate-to-nitrite conversion. Humans do not have the genes to do that.

Humans do have a pathway to convert arginine to NO. It's complicated and slow, degrading with aging. Taking arginine as a supplement has been disappointing and with two seminal studies has been shown to cause more harm than good. Don't take arginine. But what's an older person to do? We lose 12% of NO production per decade and find ourselves with little effective NO above age 50-60.

The stimulus to make NO naturally is sheer stress on the walls of our arteries. That is otherwise called exercise. Exercise has been shown to have all sorts of beneficial effects on overall health. NO is the mediator of those benefits. In fact, we can now measure the effect of sufficient NO on exercise. Peak exercise and capacity is based on NO production. This has big implications for all sports. As a general rule, younger people play competitive sports because they are more capable. That capability rests, in part, on their ability to make NO. It is NO that allows oxygen to penetrate further into tissue. It is NO that facilitates the biogenesis of new mitochondria, extending exercise capacity.

All of those effects flow from having a healthy oral biome. Those 10 billion cells on your tongue drive a huge amount of downstream benefit. And it can all be undone with chlorhexidine mouthwash, fluoride toothpaste and PPI antiacid drugs.

www.What will Work for me? Well, I've had a bottle of mouthwash I've used with relative infrequency. I threw 3/4s of it out. I'm flossing much more and water-piking more. I ordered the spinach salad for dinner last night at the restaurant. I refrained from boring the guests with NO information. And I now take NO lozenges twice a day. Those lozenges might just become as vital for your health as Vitamin D, K2, and B12. Stay tuned to NO information. The link to exercise capacity startled me. We all need to know this.

References: Nitric Oxide, Jr Bacteriology, Meth Debak, Nature, Med Sci Sports Med., 

Pop Quiz

1. How long does it take for orally ingested nitrates to get into our saliva?                       Answer: 90 minutes

2. How much does our saliva concentrate nitrates over blood?                          Answer; 10 fold

3. How much does chlorhexidine mouthwash reduce NO production?                         Answer: Just about 100%

4. What else reduces NO production inadvertently?                              Answer: Any PPI or other systemic acid reducer.

5. What is the correlation between NO blood level and exercise capacity?                      Answer: Strikingly positive. The more NO, the better the capacity.