For decades we’ve been told to monitor our cholesterol, blood pressure and blood sugar. Yet there is another molecule that may be just as important for healthy ageing, cardiovascular health and energy production: nitric oxide.
Nitric oxide (NO) is often called the body’s “master signalling molecule” because it helps regulate blood flow, oxygen delivery, mitochondrial function, brain health, immune function and even sexual performance.
The challenge is that nitric oxide itself is difficult to measure. It exists for only a few seconds before being converted into other compounds. This is why saliva nitric oxide test strips have become a practical way to assess how effectively your body is producing nitric oxide through the nitrate-nitrite-NO pathway.
What Does The Research Show?
Researchers have attempted to determine what constitutes healthy nitric oxide status by measuring blood nitrite levels and endothelial function.
One landmark study found that healthy individuals with the best vascular function had plasma nitrite levels around 350 nmol/L, while people with increasing cardiovascular risk factors showed progressively lower levels.
As nitric oxide levels declined, blood vessel function declined alongside them.
This suggests that maintaining nitric oxide activity equivalent to approximately 350 nmol/L plasma nitrite may represent a practical target for optimal cardiovascular health.
How Do Saliva Test Strips Help?
Saliva nitric oxide strips do not directly measure blood nitric oxide.
Instead, they measure salivary nitrite, which reflects how effectively your oral bacteria are converting dietary nitrates into nitric oxide precursors.
This pathway accounts for a significant proportion of the body’s nitric oxide production and becomes increasingly important with age.
Typical saliva strip ranges include:
- 10–20 mg/L: Low nitric oxide production
- 20–110 mg/L: Moderate nitric oxide production
- 110–220 mg/L: Good nitric oxide production
- 220–435 mg/L: Excellent nitric oxide production
- 435–870 mg/L: Very high nitric oxide production
The Sweet Spot: Aim For Around 350 mg/L
While many people assume higher is always better, the research does not currently show that extremely high nitric oxide levels provide greater benefits than already healthy levels.
The goal should not be to chase the darkest colour possible every day.
Instead, the aim should be to consistently maintain readings around 220–435 mg/L, with a practical target close to 350 mg/L.
This range appears to reflect robust nitric oxide production, healthy oral bacteria and sufficient dietary nitrate intake.
Think of it like blood pressure or cholesterol. The objective isn’t to achieve the highest number possible. The objective is to maintain an optimal level consistently over time.
Why Nitric Oxide Matters As We Age
Nitric oxide production declines naturally with age.
Research suggests that by the age of 40, nitric oxide production may be approximately 50% lower than it was in youth.
As levels decline, we may experience:
- Reduced circulation
- Higher blood pressure
- Lower energy levels
- Poor exercise performance
- Reduced cognitive function
- Increased cardiovascular risk
- Reduced sexual performance
- Slower recovery
For many people, these changes are accepted as a normal part of ageing. However, declining nitric oxide may be one of the major drivers behind them.
Factors That Lower Nitric Oxide
Several common lifestyle factors can significantly reduce nitric oxide production:
- Antibacterial mouthwash
- Poor oral health
- Smoking
- Chronic stress
- Lack of exercise
- Poor sleep
- Heavy alcohol consumption
- Low vegetable intake
- Ageing
Even a single episode of heavy drinking may impair nitric oxide signalling and endothelial function for 24–48 hours.
How To Optimise Nitric Oxide
Eat Nitrate-Rich Foods Every Day
The richest dietary sources include:
- Arugula (rocket)
- Beetroot
- Spinach
- Lettuce
- Celery
The challenge is that most people do not consistently consume enough nitrate-rich vegetables every day to support optimal nitric oxide production.
Protect Your Oral Microbiome
The bacteria living on your tongue play a critical role in nitric oxide production.
Avoid unnecessary use of strong antibacterial mouthwashes and maintain good oral hygiene.
Recent research has even identified oral bacterial proteins inside approximately 70% of coronary artery plaques, further highlighting the important relationship between oral health and cardiovascular health
Exercise Regularly
Physical activity is one of the most powerful stimulators of nitric oxide production.
Both aerobic exercise and resistance training increase nitric oxide synthesis within blood vessels.
Prioritise Sleep
Poor sleep is associated with impaired endothelial function and reduced nitric oxide production.
Aim for consistent, high-quality sleep each night.
Where Does Ultimate 4 Fit In?
Ultimate 4 was specifically developed to help address one of the most common problems associated with ageing: declining nitric oxide production.
Rather than relying on a single ingredient, Ultimate 4 combines multiple pathways involved in nitric oxide production and cardiovascular health.
Each serve provides:
- Nitrate-rich arugula extract
- Nitrate-rich beetroot extract
- L-citrulline to support nitric oxide synthesis
- Vitamin C to help preserve nitric oxide bioavailability
- Taurine for vascular function
- Magnesium to support cardiovascular health
- Additional ingredients selected to support healthy ageing
The goal is simple: provide the body with the building blocks required to support healthy nitric oxide production every day.
Many users notice that after taking Ultimate 4 consistently, their nitric oxide test strip readings move from the low or moderate ranges into the optimal range of approximately 220–435 mg/L.
Don’t Guess. Test.
One of the unique features of Ultimate 4 is that you can purchase nitric oxide test strips.
This allows you to see how your body responds rather than relying on assumptions.
By testing regularly you can:
- Track your nitric oxide levels
- Monitor the impact of your diet
- Assess the effects of mouthwash and alcohol
- Observe the impact of exercise and sleep
- Determine whether your nitric oxide status is improving
The ability to measure your results provides immediate feedback and helps turn nitric oxide optimisation into something practical and measurable.
The Takeaway
Current research suggests that healthy vascular function is associated with blood nitrite levels around 350 nmol/L.
While saliva strips do not directly measure blood nitric oxide, maintaining saliva nitrite readings around 220–435 mg/L, with a target close to 350 mg/L, appears to represent a practical and achievable goal for many adults.
The combination of nitrate-rich nutrition, regular exercise, quality sleep, good oral health and targeted supplementation can help support healthy nitric oxide production throughout life.
If your readings are consistently below 110 mg/L, it may be time to take action.
And if you’re looking for a simple way to support nitric oxide production while measuring your progress, Ultimate 4 provides both the ingredients and the testing tools to help you optimise one of the most important molecules for healthy ageing.
References
- Kleinbongard P, et al. Plasma nitrite reflects constitutive nitric oxide synthase activity in mammals. Free Radical Biology & Medicine. 2003.
- Ghasemi A, et al. Reference values for serum nitric oxide metabolites in healthy adults. Clinical Biochemistry. 2008.
- Lundberg JO, Weitzberg E, Gladwin MT. The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics. Nature Reviews Drug Discovery. 2008.
- Kapil V, et al. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients. Hypertension. 2015.
- Bryan NS. Functional Nitric Oxide Nutrition to Combat Cardiovascular Disease. Nutrients. 2018.
- Proteomics analysis reveals oral bacterial proteins in coronary calcified atheromas: Tampere Sudden Death Study. Atherosclerosis. 2025.