Cardiologist Links Beetroot Supplements to Severe Neurologic Symptoms
Dr. Melissa Walton-Shirley, a retired cardiologist, details her personal experience using beetroot supplements to manage resistant hypertension. While initial studies suggest beetroot can lower blood pressure by boosting nitric oxide, her case highlights potential risks. She developed severe neurologic symptoms, including ataxia and visual disturbances, which resolved after stopping the supplements. She attributes this to the trigeminovascular cascade triggered by increased cyclic guanosine monophosphate (cGMP). The article serves as a cautionary tale for patients and clinicians regarding over-the-counter nitrate sources.
Key points
- Dr. Walton-Shirley used beetroot chews to manage hypertension that was resistant to losartan and diltiazem, aiming to boost nitric oxide levels for vasodilation.
- She experienced severe neurologic symptoms, including ataxia, slurred speech, and visual field defects, which began after starting the supplements.
- The symptoms resolved within days of discontinuing the beetroot chews, suggesting a causal link.
- The proposed mechanism involves the trigeminovascular cascade, where increased cGMP from nitric oxide boosts can trigger migraine-like pathways.
- She emphasizes that any supplement, including beetroot, should be considered a potential medication with side effects, especially for patients with unexplained neurologic episodes.
Background
Beetroot supplements have gained popularity for their potential to lower blood pressure by increasing nitric oxide levels. Small trials have shown modest reductions in systolic blood pressure, and some studies suggest benefits for vascular health. However, the long-term safety and potential side effects, particularly in individuals with migraine or vascular conditions, are not well understood. This case report adds to the growing body of anecdotal evidence regarding the risks of nitrate supplementation.
Why it matters
This case highlights the importance of considering over-the-counter supplements as potential medications. Patients with hypertension or migraine may be at risk for adverse neurologic effects from nitrate-rich supplements like beetroot. Clinicians should be aware of these potential side effects and consider supplement use in the differential diagnosis of unexplained neurologic symptoms. The case also underscores the need for more rigorous studies on the safety and efficacy of beetroot supplements in diverse populations.
What to watch
Further research is needed to understand the long-term safety and efficacy of beetroot supplements, particularly in individuals with migraine or vascular conditions. Clinicians should monitor patients for neurologic symptoms when they start nitrate-rich supplements and consider discontinuing them if symptoms occur. Patients should be advised to consult their healthcare provider before starting any new supplement, especially if they have a history of migraine or hypertension.
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