# How Beetroot Supports Nitric Oxide

Published: 2026-06-15

How Beetroot Supports Nitric Oxide: The Science Explained | Matter

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# How Beetroot Supports Nitric Oxide

Beetroot is one of the few foods with a direct, measurable effect on nitric oxide production in the body. The mechanism is simple, the evidence is solid, and the dose required is specific. Here is what the published research actually says about it, and what to look for if you want the effect.

[NK
Medically reviewed by Dr. Nouman Kazmi, MBBS FCPS](https://getmatter.co/pages/matter-cardiologist-dr-syed-nouman-kazmi "View reviewer profile")
·
9 min read

~50%

NO production decline by age 60

5–8

mmol nitrate per effective dose

3–10

mmHg systolic drop in RCTs

1998

Nobel Prize for NO discovery

## Key Takeaways

* Beetroot is rich in dietary nitrate. Oral bacteria convert nitrate to nitrite, which the body converts to nitric oxide (NO).
* NO relaxes blood vessel walls, supporting blood flow and contributing to healthy blood pressure.
* The dietary nitrate pathway is independent of eNOS, the enzyme that produces NO from L-arginine and loses efficiency with age.
* An effective dose is roughly 5 to 8 mmol of nitrate, equivalent to about 250ml of beetroot juice or 150mg of a 50:1 standardised extract.
* Randomised controlled trials show systolic blood pressure drops of 3 to 10 mmHg from consistent dietary nitrate intake.
* Antibacterial mouthwash blocks the oral bacteria step and significantly reduces the BP effect. Worth knowing if you use it daily.

In This Article

1. [What nitric oxide actually does](#what-no-does)
2. [The dietary nitrate pathway, step by step](#nitrate-pathway)
3. [What the published research shows](#evidence)
4. [The dose that actually matters](#dose)
5. [Juice vs capsule extract vs raw powder](#format-choice)
6. [Who benefits most from supplementing](#who-benefits)
7. [Practical tips: timing, mouthwash, consistency](#practical)
8. [Frequently asked questions](#faq)

## What Nitric Oxide Actually Does

Nitric oxide (NO) is a small signalling molecule the body uses to control blood vessel diameter. When NO binds to vascular smooth muscle, those muscle cells relax, the vessel widens, and blood flow improves. The drop in resistance shows up as a drop in blood pressure. This is the mechanism behind everything from glyceryl trinitrate spray for angina to dietary nitrate for cardiovascular support.

NO's role in the cardiovascular system was recognised with the **1998 Nobel Prize in Physiology or Medicine**, awarded to Ignarro, Furchgott, and Murad for showing that NO acts as a signal in the cardiovascular system. Before that work, no one had ever proposed that a gas could be a biological messenger inside the body.

Beyond vasodilation, NO has several other cardiovascular effects. It inhibits platelet aggregation, which means blood is less likely to form unwanted clots. It modulates vascular inflammation. And it helps regulate the thickness and elasticity of the artery walls themselves over time. Low NO production is associated with stiffer arteries, higher resting blood pressure, and a steeper age-related decline in cardiovascular function.

The body produces NO through two main pathways. The first is the L-arginine pathway: an enzyme called **eNOS** (endothelial nitric oxide synthase) converts L-arginine directly into NO inside endothelial cells. This pathway is what most older cardiovascular textbooks describe. It is also the one that becomes less efficient with age.

The second pathway is the **dietary nitrate pathway**, and it is the one beetroot operates on. It does not depend on eNOS, which is why it works even when the L-arginine route has slowed down.

0%

**The drop in nitric oxide production from the L-arginine pathway between ages 25 and 60.** The dietary nitrate route, which beetroot drives, is independent of the enzyme that loses efficiency with age. That is what makes it a useful intervention later in life.

## The Dietary Nitrate Pathway, Step by Step

The route from beetroot to nitric oxide in your bloodstream takes four steps. None is complicated on its own, but the chain is what makes the system work.

### Step 1: nitrate enters from food

Beetroot is one of the most concentrated dietary sources of inorganic nitrate. Other strong sources include rocket, spinach, celery, and chard. The nitrate itself is not biologically active in this form. It is just a salt in the food matrix that the body absorbs.

### Step 2: oral bacteria convert nitrate to nitrite

This is the step that surprises people. After absorption, much of the nitrate is concentrated in your saliva and delivered back into your mouth. Specific bacteria living on the surface of your tongue, mainly in the *Veillonella*, *Actinomyces*, and *Rothia* genera, reduce nitrate to nitrite. Without these bacteria, the chain breaks. This is also why daily antibacterial mouthwash can significantly reduce beetroot's blood pressure effect: it kills the bacteria you need.

### Step 3: nitrite becomes nitric oxide

Once swallowed, nitrite is reduced further. In the acidic environment of the stomach, and in tissues that are low in oxygen (which is most of the cardiovascular system at any given moment), nitrite is converted into nitric oxide. The whole pathway is sometimes called the **entero-salivary nitrate cycle** for this reason.

### Step 4: NO acts on blood vessels

The NO produced by this pathway acts the same way as NO produced by the eNOS route. It binds to vascular smooth muscle, triggers relaxation, vessels widen, and resistance falls. The result is a measurable drop in blood pressure, typically peaking 1 to 3 hours after the original dose and sustained with consistent daily intake.

The reason this pathway matters more than people realise is its independence from age-related enzymatic decline. The L-arginine route depends on eNOS, which loses efficiency over the decades. The dietary nitrate route depends on bacteria living in your mouth, which do not. (For the broader category context, see our [guide to nitric oxide supplements](https://getmatter.co/blogs/heart-health/nitric-oxide-supplements-what-you-need-to-know).)

## What the Published Research Shows

Dietary nitrate is one of the better-studied food-based cardiovascular interventions. The evidence base is now around 20 years deep, spans multiple populations, and converges on a consistent finding: consistent daily intake at a meaningful dose produces a small but measurable drop in systolic blood pressure.

The landmark paper was **Webb et al. 2008**, published in the journal *Hypertension*. In that study, a single 500ml dose of beetroot juice produced a peak systolic drop of around 10 mmHg within 3 hours, sustained for up to 24 hours. The effect mapped cleanly onto plasma nitrite levels, which gave the mechanism strong support.

Several systematic reviews and meta-analyses have followed. **Siervo et al. 2013**, published in the *Journal of Nutrition*, pooled 16 trials and found an average systolic drop of 4.4 mmHg from inorganic nitrate or beetroot juice supplementation. **Bahadoran et al. 2017** in *Advances in Nutrition* reached a similar conclusion across a larger pool of studies.

**Kapil et al. 2015**, also in *Hypertension*, took the question further. They gave hypertensive adults daily beetroot juice for 4 weeks and tracked 24-hour blood pressure. The result was a sustained ~7 to 8 mmHg systolic drop, comparable to a single low-dose antihypertensive medication. This was the first trial to show that the acute effect translates into a sustained effect with consistent intake.

The effect size matters in context. A 5 mmHg systolic drop across a population is associated with a meaningful reduction in stroke and heart disease risk. Dietary nitrate alone will not bring severe hypertension under control, and these trials make no claim that it would. But as part of a broader approach to cardiovascular health, the effect is real and the evidence is solid.

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## The Dose That Actually Matters

Most of the trials that produced a measurable cardiovascular effect used a daily dose in the range of **5 to 8 mmol of dietary nitrate**. That is the threshold the research has converged on. Below it, effects tend to be marginal. Above it, additional intake produces little extra benefit in most populations.

In practical terms, here is roughly what 5 to 8 mmol of nitrate looks like across the common formats:

* **250ml of beetroot juice**: around 6 to 7 mmol of nitrate. This is the dose used in most of the original BP studies.
* **150mg of a 50:1 standardised beetroot extract**: equivalent to 7,500mg of whole-root powder, delivering a comparable amount of nitrate in a capsule.
* **200g of cooked beetroot**: roughly the same nitrate as a 250ml glass of juice, give or take a third depending on growing conditions.
* **Around 100g of fresh rocket**: high nitrate content per gram, though hard to eat that much in a sitting.
* **500mg of raw beetroot powder in a capsule**: well below the threshold. You would need 10 to 15 capsules to reach the dose the studies used.

The variability between beetroots is real. Nitrate content depends on the cultivar, the soil, the season, and how long the root has been stored. This is why standardised extracts (the ratio is printed on the label) tend to be more dose-reliable than raw powders. A reputable supplier batch-tests for nitrate content to keep doses consistent.

Onset of the BP effect is fairly fast. Peak plasma nitrite levels usually arrive within 1 to 3 hours, and the BP effect tracks alongside. Sustained effects on resting blood pressure typically take 2 to 4 weeks of consistent daily intake to show clearly. This is why the trials run for at least a month, not a few days.

## Juice vs Capsule Extract vs Raw Powder

The dose is what matters. The format you choose is mostly about practicality and what you will actually keep up with for the 6 to 12 weeks that the BP effect needs to settle in.

### Beetroot juice

The deepest evidence base. Almost all of the original BP studies used juice as the delivery vehicle, in roughly 250ml daily doses. The trade-offs are practical: around 20g of natural sugar per glass, refrigeration, the well-known pink urine, and a daily routine that most people stop maintaining after a few weeks. If you do not mind any of that, juice is a fine choice.

### Standardised capsule extract

A 50:1 or 30:1 extract at the right milligram count delivers a comparable nitrate dose in a capsule. The format is convenient, has no sugar, does not stain, and travels with you. The catch is that the quality varies enormously across brands. Look for a clear extract ratio on the label and a reputable supplier. (Our [UK buyer's guide to beetroot supplements](https://getmatter.co/pages/best-beetroot-supplement-uk) covers what to check.)

### Raw beetroot powder

Many cheaper supplements are raw beetroot powder at 200 to 500mg per capsule. This is well below the dose the research uses. To reach the threshold, you would need to take 10 or more capsules a day. Some powders are sold loose (a teaspoon stirred into water), and at higher serving sizes they can work, but the nitrate content is rarely standardised.

### Gummies

The newest format, mostly marketed as "energy" or "pre-workout" rather than for cardiovascular support. The actual beetroot content per gummy is usually 100 to 300mg of raw powder, far below the BP threshold. Often sugar-heavy. Not a serious option if you are taking it for cardiovascular reasons.

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## Who Benefits Most from Supplementing

Not everyone responds equally to dietary nitrate. The published trials suggest the effect is biggest in the people whose endogenous NO production has slowed down most, which lines up with what the biology would predict.

### Adults over 45 with declining NO production

The eNOS pathway, which converts L-arginine to NO directly, becomes less efficient over the decades. By 60, the contribution of this pathway has roughly halved. The dietary nitrate route does not depend on eNOS, which is why supplementing tends to show clearer effects in older adults than in younger ones with healthy endogenous production. This is the primary group the BP trials were run in.

### People with elevated or borderline blood pressure

The Kapil et al. trial recruited adults with hypertension and saw sustained ~7 to 8 mmHg systolic drops. Trials in healthy normotensive adults tend to show smaller effects, because there is less to bring down. If your readings are in the borderline (130 to 139 systolic) or Stage 1 range, you are in the population where the published evidence is strongest.

### Endurance athletes

Beyond cardiovascular support, dietary nitrate has been studied for endurance performance. Multiple trials show modest improvements in time-to-exhaustion and oxygen efficiency at submaximal workloads. The effect is smaller in highly trained athletes than in moderately trained ones, but it exists. This is a separate use case from the BP literature but operates on the same NO pathway.

### Who probably does not need it

Younger adults with healthy blood pressure and no specific cardiovascular concern are less likely to see a meaningful change. People whose hypertension is well controlled on medication should talk to their GP before adding any supplement, particularly if they are on glyceryl trinitrate or similar nitrates for angina, where the effects can stack.

For a broader look at where supplementation fits into a wider cardiovascular routine, see our guide on [how to lower blood pressure naturally](https://getmatter.co/blogs/heart-health/how-to-lower-blood-pressure-naturally).

## Practical Tips: Timing, Mouthwash, Consistency

If you are going to bother taking dietary nitrate for cardiovascular support, a few small details make the difference between an effect and no effect.

### Take it consistently

The Kapil trial saw the sustained 7 to 8 mmHg drop with daily intake for 4 weeks. Skipping days erodes the effect. The mechanism relies on a steady supply of nitrate keeping plasma nitrite levels topped up. Pick a time that fits your routine and stick with it.

### Mind your mouthwash

The conversion of nitrate to nitrite happens via specific bacteria living in your mouth. Antibacterial mouthwash that kills these bacteria, taken daily, can reduce the BP effect by a measurable amount. The Govoni et al. work and subsequent studies showed that even short courses of chlorhexidine mouthwash blunt the response. If you use mouthwash for dental reasons, use it on a different time window from your beetroot dose, ideally several hours apart.

### Timing of the dose

The acute BP-lowering effect peaks 1 to 3 hours after intake. There is no strong evidence that morning or evening matters more for the sustained effect, so pick whichever time you will remember. Some people pair it with breakfast because it aligns with cardiovascular load through the day. Others take it before exercise because the same NO mechanism contributes to the endurance effect.

### Pair it with the other levers

Dietary nitrate is one input. The other established levers (salt reduction, weight management, regular activity, alcohol moderation, and consistent monitoring) move the needle far more in combination than any single one does on its own. The Cochrane meta-analyses suggest stacked lifestyle changes plus dietary nitrate can produce a cumulative 15 to 25 mmHg systolic drop in mild-to-moderate hypertension.

### Track to see if it is working

The effect is too small to feel. The only way to know if it is moving the needle for you is to measure consistently and look at the trend over 6 to 8 weeks. Our guide on [how to measure blood pressure correctly at home](https://getmatter.co/blogs/heart-health/how-to-measure-blood-pressure-correctly-at-home) covers the technique.

## Frequently Asked Questions

How long does it take for beetroot to raise nitric oxide?

Plasma nitrite (the intermediate step) rises within 1 to 3 hours of a dose, and the acute blood-pressure-lowering effect tracks alongside. The sustained effect on resting blood pressure builds over 2 to 4 weeks of consistent daily intake. The Kapil et al. 2015 trial showed the full sustained drop at 4 weeks, which is why most protocols suggest committing to at least that long before judging whether it is working.

Does beetroot lower blood pressure?

The published evidence supports a modest but consistent effect. Meta-analyses of randomised trials (Siervo et al. 2013, Bahadoran et al. 2017) report average systolic drops of around 4 to 5 mmHg from inorganic nitrate or beetroot juice supplementation, with effects up to 10 mmHg in some trials in hypertensive populations. Beetroot is not a replacement for medication, but as part of a broader cardiovascular routine it supports healthy blood pressure.

Why does mouthwash affect beetroot's effect on blood pressure?

The dietary nitrate to nitric oxide conversion requires specific bacteria living on the tongue (mainly Veillonella, Actinomyces, and Rothia species) to reduce nitrate to nitrite as an intermediate step. Antibacterial mouthwash kills these bacteria. Studies (Govoni et al. and others) have shown that daily chlorhexidine mouthwash significantly reduces the BP effect of dietary nitrate. If you use mouthwash for dental reasons, space it from your beetroot dose by several hours.

Can I get enough nitric oxide from food alone?

Possibly, if you regularly eat large portions of nitrate-rich vegetables. A daily plate of rocket, spinach, beetroot, celery, and similar leafy greens can plausibly hit the 5 to 8 mmol nitrate threshold. In practice most people do not eat that volume of nitrate-rich vegetables consistently. Supplementing with juice or a standardised extract is the practical way to hit the dose the published research uses.

Is dietary nitrate the same as the nitrates in cured meats?

The nitrate ion is the same molecule, but the context matters. Cured meats contain nitrates and nitrites used as preservatives, and they form nitrosamines (which have a carcinogenic association) when combined with the amines in processed meat. Vegetable-sourced nitrates are co-ingested with antioxidants and polyphenols that block nitrosamine formation. The cardiovascular benefit comes from the vegetable context, not the cured meat one. The two are not interchangeable in terms of overall health effect.

Why does beetroot turn urine pink?

This is called beeturia. It happens in roughly 10 to 15 percent of people and is caused by betalain pigments (the same compounds that give beetroot its colour) passing through the kidneys. It is harmless and unrelated to the nitric oxide pathway. If it happens to you, it can be a useful confirmation that the active compounds are reaching your system.

Should I take beetroot in the morning or evening?

There is no strong published evidence that timing significantly changes the sustained BP effect. The acute effect peaks 1 to 3 hours after intake either way. Pick the time you will most reliably remember. If you are using it for endurance-exercise reasons, taking it 2 to 3 hours before training is the protocol most studies have used. For cardiovascular support, consistency matters more than timing.

Is beetroot safe to take with blood pressure medication?

For most BP medications, yes, and many adults take both together without issue. The important exception: if you are on glyceryl trinitrate (GTN) or similar prescribed nitrates for angina, dietary nitrate can stack with the medication and produce additional blood pressure drops. Talk to your GP before combining them. People with kidney stones should also be aware that beetroot is high in oxalates.

## Continue Learning

[📊

UK Buyer's Guide

Best Beetroot Supplement UK: An Honest Buyer's Guide](https://getmatter.co/pages/best-beetroot-supplement-uk)
[💋

Foundational

Nitric Oxide Explained: A Simple Guide](https://getmatter.co/blogs/heart-health/nitric-oxide-explained-a-simple-guide-to-circulation-and-vascular-health)
[🌿

Mechanism

What Does Nitric Oxide Do for You?](https://getmatter.co/blogs/heart-health/what-does-nitric-oxide-do)
[📚

Category Overview

Nitric Oxide Supplements: What You Need to Know](https://getmatter.co/blogs/heart-health/nitric-oxide-supplements-what-you-need-to-know)
[⚠

Drinks for Circulation

Best Drink for Blood Circulation](https://getmatter.co/blogs/heart-health/best-drink-for-blood-circulation)

---

**Medically reviewed by Dr Nouman Kazmi**
Cardiovascular Specialist & Interventional Cardiologist, UK. Dr Kazmi reviews all clinical content on the Matter Heart Health Resource Centre for accuracy and compliance with current UK guidelines.

[View Dr Kazmi's profile →](https://getmatter.co/pages/matter-cardiologist-dr-syed-nouman-kazmi)

---

## References

1. Webb AJ, Patel N, Loukogeorgakis S, et al. Acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite. *Hypertension*. 2008;51(3):784–790.
2. Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. *J Nutr*. 2013;143(6):818–826.
3. Kapil V, Khambata RS, Robertson A, Caulfield MJ, Ahluwalia A. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. *Hypertension*. 2015;65(2):320–327.
4. Bahadoran Z, Mirmiran P, Kabir A, Azizi F, Ghasemi A. The nitrate-independent blood pressure-lowering effect of beetroot juice: a systematic review and meta-analysis. *Adv Nutr*. 2017;8(6):830–838.
5. Hobbs DA, Goulding MG, Nguyen A, et al. Acute ingestion of beetroot bread increases endothelium-independent vasodilation and lowers diastolic blood pressure in healthy men. *J Nutr*. 2013;143(9):1399–1405.
6. Lundberg JO, Weitzberg E, Gladwin MT. The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics. *Nat Rev Drug Discov*. 2008;7(2):156–167.
7. Govoni M, Jansson EÅ, Weitzberg E, Lundberg JO. The increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash. *Nitric Oxide*. 2008;19(4):333–337.
8. The Nobel Prize in Physiology or Medicine 1998. Robert F. Furchgott, Louis J. Ignarro, Ferid Murad. Available at: [nobelprize.org](https://www.nobelprize.org/prizes/medicine/1998/)
9. NICE. Hypertension in adults: diagnosis and management (NG136). Available at: [nice.org.uk/guidance/ng136](https://www.nice.org.uk/guidance/ng136)
10. British Heart Foundation. Foods that can help control blood pressure. Available at: [bhf.org.uk](https://www.bhf.org.uk/)

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Source: https://getmatter.co/blogs/heart-health/how-beetroot-supports-nitric-oxide