Why ADMA and SDMA should be included in OATS test.

Written by Lee Stevenson, sorry I am a lousy editor.

This is not medical advice I am writing this for educational purposes. If you are ill you should find a qualified and experienced naturopath.

Why I believe Asymmetric protein-arginine dimethylation and symmetric protein-arginine. (ADMA and SMDA) should be part of a standard OATS test. Also nitric oxide levels should be measured.

ADMA and SMDA inhibit nitric oxide synthase which prevents the body from being able to produce nitric oxide. High levels of ADMA can be caused by stress, trauma, sepsis, infection, toxins, many medications especially fluoroquinolones, microbial dysbiosis in the gut, systemic inflammation, and many other things. It is also caused by high reactive oxygen species levels. The most common cause of high oxidative stress is inhibited mitochondrial ATP production which increases NADPH oxidase activity. High angiotension 2 levels can cause high ADMA levels. This can be caused by stress or eating bad fats such as trans fats. Low COX2 levels can cause high ADMA and SMDA levels.

Leaky gut, gut inflammation and gut dysbiosis causes systemic inflammation and oxidative stress so that increases ADMA and SMDA levels.

ADMA and SMDA inhibit nitric oxide production. These are the diseases that can result when nitric oxide levels are low.





Cardiovascular disease espcecially damage to the heart.

High LDL levels

Vericose veins and narrowing of arteries which inhibits blood flow especially to the legs.

Liver cirrhosis




formation of fibroid tissue throughout the body.

Renal failure especially kidney failure.

Rhematoid arthritis

inflammatory bowel

dysmenorrhea (severe menstrual cramps)

sleep apnea


adrenal dysfunction

Nocturia (frequent urination through the night)

Frequent infections

Parkinson’s disease

Many will recommend L-arginine when nitric oxide levels are low. This is not good when someone has high ADMA or high SDMA levels because it will increase them farther causing inhibition of NOS even more. Citruline, nitrate or nitrate would be a safer way to increase nitric oxide levels until the cause of the high ADMA and SDMA are addressed.

Things that contain antioxidants help to reduce ADMA and SDMA. PQQ, CoQ10, things that contain procyanidins such as pine bark extract or grape seed extract are very effective at reducing ADMA and SDMA levels.

Berberine found in coptis and bayberry can increase AMPK which helps. Melatonin, is also a very potent antioxidant and anti-inflammatory. NAC increases glutathione which helps to reduce ADMA and SDMA.

Sophora root is one of the most potent supplements for lowering ADMA and SDMA.

Calcium and magnesium help but the amounts taken in should be balanced so one does not over power the other.

L-carnitine and taurine can reduce the damage to the heart.

Glycine can help by preventing ACE2 overload.

Biotin, selenium, vitamin C, potassium chloride, and zinc help to decrease ADMA and SDMA.

Increasing heme oxygenase will reduce ADMA and SDMA. Sea algae, and spirulina in creases heme oxygenase.

Folate, niacin, thiamine, and riboflavin improve mitochondrial function which would help reude ADMA and SDMA. Those should be taken with food.

P5P (pyridoxal 5-phosphate) should not be taken in high dose. Doses of 100 mg grams or higher actually increases ADMA and SDMA because high dose starts having the opposite effect.

If copper levels are low VEGF levels become low and this can cause high ADMA and SDMA levels.

FXR activation decreases ADMA and SDMA. Most lactobacillus spp increases FXR expression. Betulinic acid is an FXR activator. birch bark, self heal, rosemary, chaga mushroom are high in betulinic acid. Phenylalanine, tyrosine, and leucine also activate FXR receptor. Oleanic acid found in olive oil, garlic, rose leaves, four O’clock flowers, holy basil, pomegranate, citrus extract, grapes, olives, apples, activates FXR. FXR activation also helps to clear phenols and salicylates from the body.

Not sure how but the lactic acid producing Lactobacillus and Bifidobacterium increases nitric oxide production.

If you have gut dysbiosis this needs addressed in order to restore nitric oxide levels and reduce ADMA and SDMA.

Any infection would need dealt with. Stress cannot be avoided we need to learn to handle stress better. Learn techniques to relax.

GMOs and processed foods are very damaging to the body it is best to eat organics when possible.