The overlooked cause of high blood pressure

Dr. Frank Shallenberger, MD

August 9, 2021


If you have high blood pressure, there’s a 30% chance you don’t really have true hypertension. Many people simply have situational hypertension. That’s where your blood pressure goes up when you’re nervous.

But if you do have true hypertension, your doctor will likely tell you it’s because you eat too much salt, you’re not getting enough exercise, or it’s genetic.

However, it’s highly likely that none of those are causing your high blood pressure.

That’s because one of the primary causes of high blood pressure is a nutritional deficiency. And there are several deficiencies that can cause high blood pressure.

All you have to do is treat the deficiency and your blood pressure will come down.

Unfortunately, nutritional deficiencies are tough to find. But let me give you the most common types, show you how to know if you’re deficient, and tell you how to reverse the problem.

One of the Biggest Deficiencies

The first deficiency I check for is omega-3 fatty acids. Most people I check are seriously deficient. Oh, we eat plenty of fatty acids. But most of them are omega-6.

In fact, the typical ratio of omega-6 to omega-3 fatty acids is 20 to 1. The optimal ratio is under 6 to 1. So you can see how deficient most of us are in omega-3s.

So how can you change the ratio? First, cut back on your omega-6 intake. These are good fats, but only in moderation. We eat way too many.

Foods that contain lots of omega-6s include peanut oil, safflower oil, soybean oil, corn oil (and the processed foods that contain these oils), whole grains and flours (such as wheat and corn), grain-fed meat and poultry, and eggs from grain-fed chickens.

Second, you need to take two high-potency fish oil supplements. In one study, researchers gave 16 patients with hypertension and 16 patients with normal blood pressure either a four-gram dose of fish oil or a placebo for four months.

The fish oil group saw their systolic pressure lowered by an average of 6 mmHg, and the diastolic 5 mmHg.

The researchers noted that it took about two months to see these results. So don’t expect results overnight.

In fact, I’ve found (and other studies confirm) that it takes a fairly high dose of fish oil for at least three to four months to really make a difference in blood pressure.

If you’re not deficient in omega-3s, then fish oils probably will not lower your blood pressure. But they are still very helpful for your heart and brain. So they’re worth trying.

Fish oils are now available in a super concentrated, highly purified form, which is the only form you should use. Other forms often contain impurities, impart an unpleasant fish oil taste and smell, and require taking way too many capsules to get the proper dosage.

A good starting dose is to take a fish oil capsule that contains 1,000 mg of combined EPA/DHA twice a day. Do this for 2-3 months, and then double the dose for an additional 2-3 months if your blood pressure hasn’t normalized.

Diabetics, particularly those on insulin, should carefully monitor their blood sugars while on the higher doses. Occasionally these doses can interfere with optimal blood sugar control.

You can find high-quality fish oils in many health food stores and on the Internet.

39% of Hypertension Patients Are Deficient in This Nutrient

Another nutrient that’s commonly deficient is Coenzyme Q10. Conventional medicine says a normal CoQ10 level is between .75 and 1.5.

In my experience, people under 1.0 don’t function well and need to take CoQ10. Most people can start out with 100 mg. And if you’re below .75, you can push it to 200 mg.

In many human trials, an average daily dose of 120-225 mg of CoQ10 per day causes a reduction in average systolic blood pressure of 7%, and in average diastolic blood pressure of 9%.

But, like the fish oils, don’t give up too early. The trials all say it takes three to four months to see improvement.

After you’ve taken CoQ10 for a few months, re-test and see if the levels are up. If so, check your blood pressure and see if it’s come down.

One study in particular showed CoQ10’s ability to lower blood pressure. In this study, researchers conducted a 12-week randomized, double-blind, placebo-controlled trial in 46 men and 37 women with hypertension. They gave the participants 120 mg of CoQ10 for 12 weeks.

The average reduction in systolic blood pressure of the CoQ10 treated group was 25.9 mm Hg. That’s far better than you could ever get from any drug!

You can find CoQ10 at most health food stores and on the Internet.

Public Health Experts Estimate That Most People Are Deficient in This Nutrient

The third nutrient deficiency that’s common with almost everyone who has high blood pressure is magnesium. In fact, of all the deficiencies, magnesium deficiency is the #1 cause of high blood pressure.

We’ve known about magnesium’s role in the prevention and treatment of hypertension for over three decades now. But since magnesium is inexpensive and not patentable, don’t wait for your doctor or the pharmaceutical industry to tell you about it.

Another reason your doctor won’t tell you about it is that magnesium deficiency is hard to test for. Blood tests are not an accurate assessment of the levels of magnesium in the cells. So it’s tough to know what the optimum level is for each person. We all need different amounts.

How can you know if you’re deficient in magnesium? It’s easy. If your body isn’t functioning right, you probably have a magnesium deficiency. That’s how important this nutrient is.

In other words, if someone has high blood pressure, I put them on magnesium right away. I don’t waste their money on tests. And there’s no reason not to take it.

The only side effect of taking too much is loose stools. Then you just cut back on the dose and everything’s fine. So start taking 1,000 mg of magnesium a day and see what happens.

One final note on magnesium: If you’re currently taking a blood pressure medication, feel free to add magnesium to your regimen.

In one clinical study, researchers gave magnesium to 18 patients who were taking diuretics for hypertension. The study lasted for six months. Both systolic and diastolic pressures decreased significantly, by a mean of 12/8 mmHg. That’s a very substantial reduction in blood pressure.

The majority of patients who take drugs for their blood pressure usually require two and even three medications in order to have an optimal effect. This study showed that you can use only one drug with magnesium and have the same (or better) results than multiple drugs. And you definitely will reduce the number of side effects you experience.

The Nutrient No One Considers

Another deficiency that’s quite predominant in hypertension is that of the amino acid l-arginine. Even though it’s an important nutrient for treating the disease, it’s often overlooked — even among alternative doctors.

L-arginine is the precursor for the enzyme that forms a substance called nitric oxide. By taking supplemental l-arginine, you can raise your levels of nitric oxide.

Researchers have determined that nitric oxide causes blood vessels to dilate; the dilatation is significant enough that it leads to decreased blood pressure.

Other studies show that combining l-arginine with blood pressure medications results in a much more effective treatment than just the drugs alone.

In one controlled study, researchers followed six healthy subjects to assess the effects of an arginine-enriched diet on blood pressure. They randomly gave the subjects either a placebo capsule or one containing l-arginine. Not surprisingly, those who received the l-arginine were the only ones to have a decrease in their blood pressure.

You may have heard the rumor that l-arginine can result in cold sores. But I can assure you that this is an extremely uncommon occurrence. I’ve used a lot of l-arginine over the years in hundreds of patients and have never seen it cause one case.

Good starting doses of this extremely safe amino acid are from 2,000-3,000 mg. Take this dose two to three times per day. Note that since l-arginine and the drug Viagra both increase nitric oxide levels, don’t use it with Viagra unless under the guidance of a physician.

If you follow all this advice — lose weight, reduce stress, get good sleep, detoxify heavy metals, exercise regularly, and correct any nutrient deficiencies — it’s highly unlikely you’ll still have high blood pressure.

If you do, then (and only then) should you consider very low doses of a prescription drug. In all my years of practice, using this sound strategy, I’ve rarely seen a newly diagnosed case where the patient needed drugs. That’s how effective this advice is — and it will work for you!


Burke, B.E., et al. “Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension.” South Med J., 94(11):1112-1117, 2001.

Calver, A., et al. “Dilator actions of arginine in human peripheral vasculature.” Clin Sci., 81(5):695-700, 1991.

Dyckner, T., et al. “Effect of magnesium on blood pressure.” British Medical Journal, 286(6381):1847-1849, 1983.

Folkers, K., et al. “Evidence for a deficiency of coenzyme Q10 in human heart disease.” Int J Vit Res., 40:380, 1970.

Morgan, K.J., et al. “Magnesium and calcium dietary intakes of the U.S. population.” Journal of the American College of Nutrition. 4(2):195-206, 1985.

Pezza, V., et al. “Study of supplemental oral l-arginine in hypertensives treated with enalapril + hydrochlorothiazinde.” Am J Hypertens., 11:1267–70, 1998.

Prisco, D., et al. “Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients.” Thromb Res., 91(3):105-112, 1998.

Siani, A., et al. “Blood pressure and metabolic changes during dietary L-arginine supplementation in humans.” Am J Hypertens., 13:547-551, 2000.

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