Dr Rainer Boger

The Power of Nitric Oxide: Dr Rainer Boger

The Power of Nitric Oxide
- A message from Rainer Boger, M.D. -
Nitric oxide (NO) is one of the smallest molecules in the human body,
but like oxygen (O2), it plays an extraordinarily important role for
maintaining a healthy life. Nitric oxide keeps arteries wide, so that
oxygen can be easily delivered to all the organs where it is needed.
NO is produced, in many different cell types throughout the body,
from the amino acid precursor, L-arginine. The conversion of Larginine to NO makes it a very unique amino acid that is of essential
nutritional importance.
The site of NO production determines its biological effects:
 In the arteries, NO keeps blood flow high and keeps arteries
smooth and flexible.
 In the gut, NO enhances intestinal function and prevents obstipation.
 In the airway system, NO helps keep air flowing freely to the lungs.
 In the brain and nervous system, NO decreases pain sensation and contributes to good memory
formation.
By enhancing NO production, L-arginine is able to promote all of these effects. Thus, it is no wonder that
such a huge diversity of organ functions are positively affected by L-arginine supplementation. Some
people may call it a wonder, but I call it the science behind L-arginine.
Indeed, people with all different kinds of health concerns have reported improvements in their health
status while on regular L-arginine supplementation.
One true fact needs to be considered, though, when one contemplates about this broad variety of
health benefits: None of them can be achieved if L-arginine levels in blood are not successfully elevated
above “normal” for 24/7. Only combinations of L-arginine with L-citrulline have the biological potential
to achieve this goal, and only ProArgi9+ has been scientifically confirmed to do this.
This product’s success is also explained by some of its additional ingredients that support ProArgi9+’s
effects on stimulating NO:
 Resveratrol, the powerful antioxidant contained in red wine, supports the biological actions of
NO on cells by reducing toxic oxygen radicals that may not only destroy the NO molecule, but
also cause severe harm to the cell itself.
 Vitamin D3 has been known as a vitamin that is good for bone health; however, medical
research in the last few years has revealed that it is also an important regulator of glucose and
fat metabolism, of blood vessel function and cell growth.
Thus, the power of ProArgi9+ is in the quality and science coming with its ingredients

Message from Dr Rainer Boger, M.D.

A message from Rainer Boger, M.D. –

Beginning in the 1980’s, a series of exciting discoveries were made that greatly influenced the way we can improve our cardiovascular health. It all started in 1981 when Robert Furchgott, and his group from New York, discovered that the ability of arteries to dilate (become wider and more flexible) strictly depended on the presence of the innermost layer of cells, the so-called endothelial cells.

Lou Ignarro, along with his research group from Los Angeles, was able to prove that the volatile compound released from endothelial cells upon stimulation is nitric oxide, a gas produced from L-arginine. It was Ferid Murad, from Stanford University, who finally discovered the mechanism by which nitric oxide exerts its beneficial effects in the vascular wall.

With 22 years of basic and applied clinical research experience, I have made it my mission to use the discovery of these biological mechanisms to develop novel ways of enhancing cardiovascular health. As a clinical physician, I have treated patients who suffered from severe lack of blood flow to the legs, and it is this experience that has inspired me to research the benefits of L-arginine and its affect on tissue blood flow.

L-arginine is the precursor of nitric oxide, and people who are deficient in L-arginine have an increased risk of cardiovascular concerns. Based on our clinical studies, we believe that enhanced L-arginine in the blood will improve vascular function and vascular health. This knowledge makes L-arginine unique among the near 250 amino acids that have biological function.

When using L-arginine as a dietary supplement, there are a few caveats that need to be considered. Restoring nitric oxide formation with L-arginine needs to be maintained around the clock. L-arginine, however, has a short residence time in blood; in less than 1 hour, half is already spent. Only when L-arginine is combined with L-citrulline is it possible to provide prolonged elevations of L-arginine in the blood stream.

Furthermore, cardiovascular health is a refined balance in which the endothelial cells interact with oxidative factors, blood platelets and the coagulation system, and transcriptional regulation of cell growth and development. Thus, additional components can interact with L-arginine to promote cardiovascular health on a multifactorial level.

With its unique blend of l-arginine and other supportive ingredients, it is my experience that Synergy’s ProArgi-9+ provides an optimized way to enhance your cardiovascular system compared to other nutritional supplements on the market.

Sincerely,
Rainer Boger, M.D.
Medical Advisory Board Member

About Dr. Rainer Boger

About Dr. Rainer Böger

Dr. Böger is currently the Professor of Clinical Pharmacology and Director of the Institute of Clinical Pharmacology and Toxicology at Hamburg University Medical Center, Germany. He is also Director of the Clinical Trial Center North at Hamburg University.

Dr. Böger’s scientific work centers on the early diagnosis and prevention of cardiovascular related diseases. Dating back to the beginning of his medical career, Dr. Böger has been heavily involved in the research and treatment of cardiovascular related diseases. In 1991, while working closely with pharmaceutical drug companies to develop treatments that could combat and alleviate such diseases, he became highly interested in nitric oxide (NO) and its effects on the vascular system.

Dr. Böger has dedicated 21 years of academic research in basic science and clinical studies related to L-arginine and its influence on the body’s ability to produce NO. His major achievements are the discovery that ADMA (asymmetric dimethylarginine) is a risk marker of vascular disease and the utilization of L-arginine to prevent vascular dysfunction and disease.

Dr. Böger collaborates with renowned institutions like the Mayo Clinic and Stanford University Medical Center. He has documented his knowledge in more than 200 scientific articles, of which 130 exclusively cover the roles of ADMA and L-arginine in cardiovascular and metabolic diseases.

Dr. Böger’s extensive knowledge, expertise, and ongoing research clearly set him apart as one of the world’s leading L-arginine experts. It’s an honor to have Dr. Böger as part of the Synergy WorldWide team.

Synergy WorldWide Welcomes Dr Rainer Boger

Synergy Welcomes Dr. Rainer Böger

Synergy WorldWide is pleased to announce that Professor Rainer H. Böger, M.D., leading expert in L-arginine research, has joined Synergy’s Medical and Scientific Advisory Board.

Dr. Böger received his medical training at Hannover Medical School in Hannover, Germany. He received his postgraduate training in Internal Medicine and Pharmacology both in Hannover and at Stanford University School of Medicine in Stanford, CA.

Dr. Böger is currently the Professor of Clinical Pharmacology and Director of the Institute of Clinical Pharmacology and Toxicology at Hamburg University Medical Center, Germany. He is also Director of the Clinical Trial Center North at Hamburg University.

Dr. Böger’s scientific work centers on the early diagnosis and prevention of cardiovascular related diseases. Dating back to the beginning of his medical career, Dr. Böger has been heavily involved in the research and treatment of cardiovascular related diseases. In 1991, while working closely with pharmaceutical drug companies to develop treatments that could combat and alleviate such diseases, he became highly interested in nitric oxide (NO) and its effects on the vascular system.

Dr. Böger has dedicated 21 years of academic research in basic science and clinical studies related to L-arginine and its influence on the body’s ability to produce NO. His major achievements are the discovery that ADMA (asymmetric dimethylarginine) is a risk marker of vascular disease and the utilization of L-arginine to prevent vascular dysfunction and disease.

Dr. Böger collaborates with renowned institutions like the Mayo Clinic and Stanford University Medical Center. He has documented his knowledge in more than 200 scientific articles, of which 130 exclusively cover the roles of ADMA and L-arginine in cardiovascular and metabolic diseases.

Dr. Böger’s extensive knowledge, expertise, and ongoing research clearly set him apart as one of the world’s leading L-arginine experts. This new partnership will further assist Synergy WorldWide in its effort to remain at the forefront of heart health.

Dr. Böger, it’s an honor to have you join the Synergy team.

ADMA

ADMA
Asymmetric dimethylarginine (ADMA) proved to be a key factor in the question of why some people produce enough nitric oxide, while others do not. In 1992, Drs. Salvador Moncada and Patrick Vallance helped solve this puzzling question. They discovered that another amino acid, ADMA, plays a significant role in cardiovascular disease. They discovered that this modified amino acid can block the production of nitric oxide.

Biochemists had known for many years that ADMA was in urine, but Drs. Moncada and Vallance were the first ones to realize how significant this was. They observed that patients with kidney failure, who are known to have accelerated atherosclerosis, along with higher risk of heart attack and stroke, were not able to excrete ADMA, and therefore had high blood levels. They thought the possible reason for this was that this arginine-like molecule blocked the effect of L-arginine. This hypothesis proved to be correct.

Asymmetric dimethylarginine is identical to L-arginine, except that it has two extra methyl groups attached to it. Both ADMA and L-arginine are able to attach to the enzyme NO synthase (NOS). When L-arginine attaches, it converts to nitric oxide, however, when ADMA attaches, it can not be converted, thereby blocking the production of nitric oxide.

After the findings of Drs. Moncada and Vallance, research teams around the world wanted to find out if ADMA was the reason for low levels of nitric oxide in people who were at risk for, or already had, cardiovascular disease.

Drs. Rainer Boger and Stephanie Bode-Boger from the University of Hannover in Germany found this to be true in patients with peripheral arterial disease (PAD). Their findings showed that the worse the PAD, the higher the blood level of ADMA. Not long after that, Dr. Imaizumi and coworkers in Japan had similar findings with regards to brain arteries. Dr. Imaizumi’s team used ultrasound to observe blood vessels in the neck of 120 Japanese patients. They found that the thickest amount of plaque was found in the people with the highest level of ADMA. Dr. Azuma’s group in Tokyo found blood level of ADMA to be an independent marker for vessel thickening in women.

Dr. John Cooke of Stanford Medical School collaborated with many different scientists from around the world and found that high levels of blood asymmetric dimethylarginine were present in people with all types of cardiovascular disease risk factors, including high cholesterol, high triglycerides, high blood pressure, high blood sugar, insulin resistance, high homocysteine, and tobacco use.

Triglycerides are a common type of fat found in your blood and in fatty foods. They are one of our main sources of energy and our body’s most common type of fat. Our body uses whatever calories it needs from the food we eat for quick energy. Any additional calories are converted into triglycerides and stored in fat cells for later use. Regardless of what type of food from which you get your calories, if you consume excess calories, it will be stored as fat. If you consume excess calories on a regular basis, you may have high triglyceride levels.

At normal levels, triglycerides are important for optimal health. Research has not clearly shown whether high triglyceride levels directly increase your risk for heart disease, however, it is part of a group of conditions known as metabolic syndrome. The other factors of metabolic syndrome are high blood pressure, high blood sugar, excess fat in your abdominal area, and low HDL (good) cholesterol levels. Metabolic syndrome definitely increases your risk for heart disease, diabetes, and stroke.

A study performed in collaboration between Dr. Cooke of Stanford, and Dr. Pia Lundman and coworkers at the Karolinska Institute in Stockholm, found a strong correlation between triglyceride and ADMA levels in the blood. Along with these findings, Dr. Ali Fard at Columbia University found that after eating a high-fat or high-carbohydrate meal, ADMA levels in the blood increased. He found that the level of fat in the blood was the highest about two hours after the meal and this increased level remained for about four to six hours. This causes poor endothelial function and is possibly one of the main reasons people with heart disease often complain of angina (chest pain) after this type of meal.

Another study between Dr. John Cooke and Dr. Gerald Reaven, also of Stanford, found that when someone was insulin resistant, they also had high levels of asymmetric dimethylarginine. This correlation between asymmetric dimethylarginine levels and insulin resistance is stronger than with any other marker.

Dr. John Cooke further collaborated with Dr. Rene Malinow at Oregon Health Sciences and found that homocysteine will increase the level of ADMA in people with vascular disease. They gave these patients methionine (which converts to homocysteine in the body), and measured the function of their endothelium both before the methionine and after. After receiving methionine, their homocysteine levels rose, along with ADMA, and their endothelial function decreased. They were able to determine that the homocysteine was directly responsible for the increase in ADMA. However, they found that people with a healthy endothelium were resistant to methionine, and their ADMA levels did not increase, nor did their endothelial function deteriorate. They came to the conclusion that if you have a healthy endothelium, you have some natural resistance to some of these damaging factors.

Dr. John Cooke concluded that asymmetric dimethylarginine levels are high in people with cardiovascular disease risk factors or who already have heart disease. He believes that ADMA is a common pathway by which all risk factors manifest their negative effects on the blood vessel wall. An accumulation of ADMA occurs in people with risk factors and this blocks the production of nitric oxide. This in turn causes poor blood flow and the progression of atherosclerosis.

There are two ways of getting rid of ADMA in the body, excretion in the urine, or being broken down by the enzyme dimethylarginine dimethylaminohydrolase (DDAH). At Stanford, they found that ADMA levels were balanced by the breakdown action of DDAH. If DDAH was reduced or impaired, then ADMA levels gradually increase. All of the major cardiovascular disease risk factors contribute to the diminished ability of DDAH to breakdown ADMA. This is because of the effects of oxygen radicals. They found that DDAH is extremely sensitive to these free radicals. Therefore, increasing antioxidant activity is vital in reducing oxygen radicals, which in turn helps DDAH to reduce levels of asymmetric dimethylarginine. This causes an increase in the production of nitric oxide and improves the health and function of the endothelium.