A monthly collection of research, patient wisdom, and real-world experience from people living with lung diseases

In This Issue

  • •Improving blood pressure, cardiovascular function, and oxygenation: Two inexpensive supplements that have helped me.

  • •The centuries-old mushroom used to support lung health.

  • •Pushing Past Comfortable: How short bursts of effort strengthen heart, lungs, and mindset.

Before We Begin

This newsletter is for educational purposes only. It is not medical advice, diagnosis, or treatment. Most physicians must follow strict guidelines based on approved diagnostics and medications. Approaches involving exercise, nutrition, or non-pharmaceutical methods may fall outside their scope of practice.

Here, we share patient experiences, research insights, and strategies individuals have tried with varying success. These are not recommendations, but ideas to discuss with your care team.

SECTION 1

Nitric Oxide: Why the Answer Is “NO!” — And Why It Matters

Nitric oxide (NO) is essential for vascular, metabolic, and immune function. Levels decline with age as enzyme function decreases, precursors diminish, microbiome shifts occur, and oxidative stress rises. This decline contributes to hypertension, vascular disease, and reduced exercise tolerance.

For those with interstitial lung diseases like pulmonary fibrosis, NO’s role becomes even more important. Scarred lung tissue reduces the number of functioning capillaries, making oxygen transfer less efficient. NO widens blood vessels (vasodilation), improving oxygen and nutrient delivery. It also supports angiogenesis, the creation of new capillary networks.

Over the last year, I’ve refined my personal approach to improving nitric oxide levels. Many fellow patients have experimented with similar methods, often reporting improved fitness and oxygenation.

My Personal Supplement Protocol

L-Citrulline

  • Dose: 3–6 g/day (or ~8 g/day as citrulline malate).

  • Why this form: Raises plasma L-arginine more effectively than L-arginine supplements.

  • Supporting research:

    • 3 g/day improved endothelial function in middle-aged men (Br J Clin Pharmacol, 2008).

    • 6 g/day improved exercise tolerance in heart failure (Am J Physiol, 2010).

  • Safety: Generally well tolerated.

Beet Root Powder

  • Dose: 5 g in water about an hour before bedtime.

  • Why bedtime: Supports overnight blood flow and oxygenation.

This combination helps maintain steady NO levels without spikes and drops.

Benefits I’ve Personally Experienced

  • Higher daily and nighttime SpO₂

  • Six-minute walk test improvements

  • Reduced resting oxygen needs (3 L → 2 L)

  • Higher FVC on pulmonary function tests

  • Blood pressure improved to 118/75

  • ~10% lower walking heart rate

  • Better exercise tolerance and strength

  • Morning brisk walk without supplemental oxygen (73 steps/min, HR ~82)

  • Sleeping SpO₂ around 98%

  • Sleeping HR around 49 BPM

Important Precautions

  • Blood pressure: NO can lower it — monitor closely.

  • PDE5 inhibitors (Viagra, Cialis): Can cause dangerous drops in BP.

  • Oral hygiene: Avoid antiseptic mouthwashes (chlorhexidine, high-alcohol Listerine) — they kill nitrate-converting oral bacteria.

Why Nitric Oxide Matters in Pulmonary Fibrosis

Research suggests NO may:

  1. Improve pulmonary vascular flow and reduce pulmonary hypertension risk

  3. Enhance oxygen uptake efficiency

  • Mitigate endothelial dysfunction that contributes to fibrosis symptoms

SECTION 2

Cordyceps: A Traditional Lung Support Used for Centuries

I’ve taken cordyceps mushrooms (Cordyceps sinensis and Cordyceps militaris) for over four years. I first encountered it in an expensive herbal protocol costing nearly $1,000/month. Since then, I’ve purchased high-quality cordyceps directly for about $10/month.

It isn’t a cure, but I believe it contributes meaningfully to my overall improvement when combined with exercise, nutrition, and other practices.

Here’s what research suggests about how cordyceps may support lung health.

How Cordyceps May Support Lung Function

1. Anti-Inflammatory

  • Reduces cytokines like TNF-α and IL-1β.

  • Cordycepin inhibits NF-κB, a major inflammation regulator.

2. Anti-Fibrotic & Anti-Remodeling

  • Reduces collagen buildup and airway thickening (COPD models).

  • Reverses epithelial-mesenchymal transition — a key fibrosis process.

3. Antioxidant Protection

  • Activates Nrf2, the master antioxidant regulator.

  • Protects lung cells from oxidative injury and apoptosis.

4. Improved Mucus Hydration

  • Stimulates anion transport in airway cells.

  • May improve mucociliary clearance.

5. Immune Modulation

  • Influences T-cell activity and MAPK signaling.

  • Improves Th1/Th2 balance and reduces allergic inflammation.

  • May act via the gut–lung axis.

6. Improved Cell Survival

  • Reduces apoptosis.

  • May activate AMPK/mTOR pathways that support autophagy and cell repair.

Putting It All Together

Cordyceps appears to work through multiple pathways:

Anti-inflammatory, antioxidant, antifibrotic, immune-modulating, and mucus-supporting. Cordycepin is highly active, but polysaccharides and nucleosides also contribute.

Limitations

  • Much of the evidence comes from preclinical studies.

  • Human dosing and standardization are still unclear.

  • Possible interactions and long-term safety in lung disease require more research.

SECTION 3

Pushing Past Comfortable: The Power of Short, Hard Efforts

“You’re never too old to challenge yourself. Strength grows in the moments we choose not to quit.”

As we age, we gravitate naturally toward comfort. But brief, controlled bursts of effort provide benefits that gentle daily movement alone cannot. They improve oxygen use, strengthen the heart, build resilience, and help maintain functional fitness.

Source: Harvard Health Publishing, 2022.

How to Add Short Intervals to Your Routine

You don’t need to run or strain your joints — simply add 3–4 short, 30-second bursts to activities you already do.

Examples

Treadmill:

Walk normally → raise incline for 30 seconds → recover 1–2 minutes. (Or increase speed for 30 seconds) Repeat

Elliptical:

Regular resistance → faster pace for 30 seconds → recover. Repeat

Stationary Bike:

Comfortable pedaling → 30-second speed burst → easy recovery. Repeat

If you use supplemental oxygen, ensure your flow rate supports exertion, not just resting levels.

Source: American College of Sports Medicine, 2021.

Why These Short Bursts Matter

Research shows HIIT-style intervals can improve:

  • +VO₂ max and cardiorespiratory fitness Mayo Clinic Proceedings, 2017

  • +Blood pressure and vascular function Journal of Hypertension, 2019

  • +Blood sugar control Diabetes Care, 2018

  • Muscle strength and endurance European Review of Aging and Physical Activity, 2020

The Bottom Line

Short, controlled high-effort intervals keep your heart, lungs, and metabolism strong — especially as you age. They’re brief, accessible, and highly effective when practiced consistently and paired with proper oxygen support.