L-Arginine is an amino acid involved in numerous areas of human biochemistry, including ammonia detoxification, hormone secretion, and the immune system. Arginine is also well known as a precursor to nitric oxide, a key component of endothelial-derived relaxing factor. The endothelium is the lining inside blood vessels and arginine supplements help make more nitric oxide. Therefore arginine, by making more nitric oxide, helps to relax and dilate blood vessels. Nitric oxide is a messenger molecule involved in a variety of endothelium-dependent effects in the cardiovascular system. Because of arginine's nitric oxide-stimulating effects, there have been claims that this amino acid is useful in hypertension, preeclampsia, intermittent claudication, and erectile dysfunction. Arginine has been studied for its role in athletic performance, burns and trauma, diabetes and syndrome X, male and female infertility, and interstitial cystitis. What does the research say about the benefit of arginine supplements for various medical conditions?
   Even though arginine supplements have been claimed to be useful for some of the conditions listed above, it would be premature to be overly excited. Much research needs to be done before we can be more confident about the health benefits of arginine supplements. However, thus far, arginine appears to have a role to play in conditions involving blood vessel dilation. Whether the dilation is short lived or continues for an adequate period is still being evaluated. Arginine does not appear to be helpful as a supplement taken by those who have suffered a heart attack. However, some research supports the use of arginine in heart failure (see below).
   As to arginine and erectile function, see below. If you have an interest in arginine as a sexual enhancer, instead consider Passion Rx which is significantly more effective. Passion Rx does not have this amino acid. Prostate Power Rx is also an effective sexual enhancer.

L Arginine supplement 750 mg, 60 Capsules
Passion Rx, highly effective sexual enhancer
L Arginine is a semi-essential amino acid synthesized by the body from ornithine. This amino acid supports protein synthesis as it is involved in the transport and storage of nitrogen. Among many functions, L Arginine is used by the body to produce creatine. Each arginine supplement capsule contains 750 mg elemental L Arginine.

Usage: Take 1 to 6 arginine supplement capsules daily, or as directed by your qualified health consultant.
Serving size 1 capsule
L Arginine hcl - 750 mg per capsule

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In recent years science has made breakthroughs in the understanding of sexual dysfunction. But, for hundreds of years, civilizations around the world have known about locally grown herbs that achieve wonderful results with far fewer side effects than prescription drugs. Now, renowned physician and herbal expert Dr. Ray Sahelian, M.D., author of Natural Sex Boosters, has discovered a combination of exotic herbs from the Amazon jungle, India, China, Malaysia, and Africa, that provides a natural solution for those seeking an alternative to synthetic drugs.
   The potent herbal extracts and nutrients in Passion Rx include acetylcarnitine, ashwagandha, catuaba, cnidium, horny goat weed, maca, mucuna pruriens, muira puama, passion flower, tribulus herb, tongkat ali and yohimbe. Passion Rx does not contain l arginine. Another version of Passion Rx is available without yohimbe. Passion Rx does not contain Citrulline.

L Arginine and erectile dysfunction studies
One of the more popular supplements for sexual dysfunction is L-arginine, also referred to as arginine. Arginine is a versatile amino acid in animal cells, serving as a precursor for the making not only of proteins but also of nitric oxide, urea, glutamate, and creatine. What makes l-arginine interesting is that it can be metabolized to nitric oxide (NO). NO is the most powerful chemical known to dilate and engorge blood vessels in the penis and clitoris. What does the research say about the role of arginine in erectile dysfunction?

A Low dose of l arginine supplement, at 500 mg three times a day, was not found to be effective for erectile dysfunction.

A double-blind, placebo-controlled study of 50 men with erectile dysfunction tested l arginine at a dose of 5 grams per day for six weeks. About a third of the participants who received l arginine showed improvement, and that improvement was greater than the 10% improvement seen in the placebo group.

The amino acid L arginine has been studied in combination with other nutrients as a treatment for sexual dysfunction in women. A small trial found some improvement with a combination treatment providing a daily dose of 2,500 mg of l arginine, as well as ginseng, ginkgo, and damiana. In a four-week, double-blind study, 77 women with decreased libido were given either the combination product or a placebo. Those taking the arginine blend showed statistically greater improvement, reporting increased sexual desire in 71% of participants given the treatment. In the placebo group, 42% reported an increased libido. Other improvements included relative satisfaction with sex life and heightened clitoral sensation. No significant side effects were seen in either group. However, we don't know if the arginine had anything to do with the results.

A study done at the University of Texas at Austin examined l arginine benefit, combined with yohimbine, on sexual arousal in postmenopausal women. Twenty-four women participated in three sessions in which sexual responses to erotic stimuli were measured following treatment with either arginine glutamate (6 grams) plus yohimbine (6 mg), yohimbine alone (6 mg), or a placebo. Sexual responses were measured at one hour after taking the supplements. Compared to placebo, the combined oral administration of arginine and yohimbine substantially increased vaginal pulse amplitude responses to the erotic film. It is well known that yohimbine, alone, has a significant effect on sexuality and whether arginine was a factor is not known.

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Mechanism of action
The most likely explanation for the mild effectiveness of l arginine is its conversion into nitric oxide. As discussed in Chapter 2 of Natural Sex Boosters book, nitric oxide is converted into cGMP, which becomes the secondary messenger that causes smooth muscle relaxation, resulting in blood vessel dilation, and more blood going into the genital organs, which leads to erections. However, nitric oxide is quickly metabolized and any potential l arginine benefit could be short lived.

L Arginine benefits
There is some supporting evidence that l arginine offers benefits in reducing angina and lowering blood pressure (see studies bottom of page). Research indicates supplemental l arginine reduces pulmonary resistance and blood pressure. Arginine supplementation improves renal function in patients with chronic heart failure. Polish researchers have found that arginine supplements increases exercise tolerance in stable coronary artery disease patients. Oral L-arginine improves endothelial function in older healthy individuals. However, I am not convinced yet that arginine is a worthwhile supplement for erectile function or sexual enhancement, at least when used in low dosages.  

Benefit of arginine for heart failure
L-arginine supplements may improve the physical fitness of heart failure patients by enhancing their endurance to exercise. Dr. Stephane Doutreleau and colleagues from Institut de Physiologie, Strasbourg, France, examined the potential benefits of 6 weeks of L-arginine supplements on endurance exercise in 10 patients with chronic stable heart failure. Patients who took L-arginine experienced a significant decrease in their average heart rate throughout exercise and the recovery period. There were no significant changes in blood pressure and respiratory parameters. The current study supports a prior study in which a group of heart failure patients were shown to benefit from a combination of exercise and L-arginine supplements. In that study, the combination appeared to help correct the abnormal functioning of blood vessels seen in chronic heart failure. International Journal of Sports Medicine July 2006.

L arginine not helpful in peripheral artery disease
L-arginine supplementation in peripheral arterial disease: no benefit and possible harm.
Circulation. 2007 July 10. Wilson AM, Harada R, Nair N, Balasubramanian N, Cooke JP. Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California.
L-arginine is the precursor of endothelium-derived nitric oxide, an endogenous vasodilator. L-arginine supplements improve vascular reactivity and functional capacity in peripheral arterial disease (PAD) in small, short-term studies. We aimed to determine the effects of long-term administration of L-arginine on vascular reactivity and functional capacity in patients with PAD. The Nitric Oxide in Peripheral Arterial Insufficiency (NO-PAIN) study was a randomized clinical trial of oral L-arginine (3 grams a day) versus placebo for 6 months in 133 subjects with intermittent claudication due to PAD in a single-center setting. In patients with peripheral artery disease, long-term administration of L-arginine does not increase nitric oxide synthesis or improve vascular reactivity.

Benefit of L arginine supplements in gestational hypertension
L-arginine supplementation in patients with gestational hypertension: a pilot study.
Hypertens Pregnancy. 2007. Mother-Infant Dept., Section of Gynaecology and Obstetrics, University of Modena and Reggio Emilia, Italy.
Patients with gestational hypertension and proteinuria and those without proteinuria were randomized in a double-blind design to receive either L arginine (20 grams / 500 mL intravenously daily, for 5 days followed by 4 grams /day orally for 2 weeks) or placebo. Compared with baseline, both systolic and diastolic blood pressue 6 days after treatment were significantly reduced in the l arginine group but not in the placebo group. The treatment with l arginine seems promising in prolonging pregnancy and reducing blood pressure, particularly in patients with gestational hypertension and without proteinuria.

L arginine and heart attack
Q. I came across a web site where it says not to take l arginine supplements following a heart attack (does that apply to recent and old one?) and that six people had died during an arginine study. I am 66 and have had a heart attack in 1989 and don’t take any drugs for it. I wanted to try an arginine supplement because of the benefits I have read about, especially erectile dysfunction, and better circulation, but am now afraid to do so.
   A. I have listed the arginine heart attack study below. It would seem prudent to not use l arginine supplements the first few months after a heart attack. However, at least one or two additional studies are needed to determine whether the results of this study regarding the influence of l arginine supplements and heart attack were coincidence or whether l arginine does have a negative impact on heart health in those who have had a recent heart attack.

L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial.
JAMA. 2006 Jan 4. Schulman SP, Becker LC, Kass DA, Champion HC, Terrin ML, Forman S, Ernst KV, Kelemen MD, Townsend SN, Capriotti A, Hare JM, Gerstenblith G. Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, USA.
To determine whether the addition of L-arginine to standard postinfarction therapy reduces vascular stiffness and improves ejection fraction over 6-month follow-up in patients following acute ST-segment elevation myocardial infarction. A total of 153 patients following a first ST-segment elevation myocardial infarction were enrolled; 77 patients were 60 years or older. Patients were randomly assigned to receive L-arginine (goal dose of 3 g 3 times a day) or matching placebo for 6 months. Baseline characteristics, vascular stiffness measurements, and left ventricular function were similar between participants randomized to receive placebo or L-arginine. There was no significant change from baseline to 6 months in the vascular stiffness measurements or left ventricular ejection fraction in either of the 2 groups, including those 60 years or older and the entire study group. However, 6 participants (8.6%) in the L-arginine group died during the 6-month study period vs none in the placebo group. Because of the safety concerns, the data and safety monitoring committee closed enrollment. L-arginine, when added to standard postinfarction therapies, does not improve vascular stiffness measurements or ejection fraction and may be associated with higher postinfarction mortality.

Dosage
L Arginine is available most often as 750 to 1,000 mg capsules and in powder form. The dosage of l arginine depends on the condition being treated. In some cases, an arginine dosage of more than 5 grams a day may be required.

History of L arginine amino acid
L arginine was first isolated in 1886. In 1932, L arginine was found to be required for the generation of urea, which is necessary for the removal of toxic ammonia from the body. In 1939 L arginine was also shown to be required for the synthesis of creatine, the muscle builder.

Arginine deficiency
Symptoms of arginine deficiency include poor wound healing, hair loss, skin rash, constipation, and fatty liver. Arginine is considered a semi-essential amino acid, because although it is normally synthesized in sufficient amounts by the body, arginine supplementation is sometimes required (for example, due to inborn errors of urea synthesis, protein malnutrition, excessive lysine intake, burns, peritoneal dialysis, and rapid growth).

L Arginine side effects
I have not come across any significant l arginine side effects up to now. It is possible that one side effect of high dosage l arginine is nausea. Other possible side effects on very high dosages are digestive disturbances. I have personally taken more than 10 grams at one time at least on three different occasions without any significant adverse effects. But, it is not clear whether l arginine has side effects if used in high dosages daily for many months or years.
   It is unlikely that dosages of arginine supplements less than 3 grams a day would lead to any untoward effects.

L Arginine and nitric oxide
Arginine is a precursor of nitric oxide, which causes blood vessel relaxation. Although there is some evidence that suggests that arginine supplements may be useful in the treatment of medical conditions that are improved by vasodilation, such as angina, atherosclerosis, coronary artery disease, erectile dysfunction, heart failure, intermittent claudication / peripheral vascular disease, and vascular headache, more proof is needed. The appropriate l arginine dosage and long term safety is not clear at this time. Arginine also stimulates protein synthesis and has been studied for wound healing, bodybuilding, enhancement of sperm production (spermatogenesis), and prevention of wasting in people with critical illness.

Benefit for sexual enhancement
There are many potent herbs that have sexual enhancement properties. Arginine is not on my top ten list of aphrodisiac supplements and I don't think a l arginine health benefit is significant erection enhancement. I prefer the sex enhancing herbs found in Passion Rx which are much more potent and effective.

Ornithine, arginine, amino acids, and human growth hormone release

Certain amino acids, such as l arginine and ornithine, can stimulate the release of growth hormone when infused intravenously or administered orally. Some individuals ingest amino acids before strength training workouts, thinking that this enhances exercise-induced growth hormone release, thereby promoting greater gains in muscle mass and strength. There is a wide range of response of growth hormone release to amino acid administration between different people. A number of factors are involved including training status, sex, age, medications, other supplements, and diet. Although IV arginine administration consistently leads to increased circulating growth hormone concentration, oral arginine doses that are great enough to induce significant growth hormone release are likely to cause stomach discomfort and diarrhea. During exercise, intensity is a major determinant of growth hormone release. Up to now, studies have not consistently found that pre-exercise oral amino acid supplementation enhances growth hormone release. In addition, no major studies have found that oral supplementation with amino acids such as arginine or ornithine before strength training increases muscle mass and strength to a greater extent than strength training alone. The use of specific amino acids to stimulate growth hormone release by athletes is probably not worthwhile.

Arginine metabolism by the kidneys
The kidney plays a major role in arginine metabolism in 3 principal ways: arginine synthesis, creatine synthesis, and arginine reabsorption. Arginine is made in the kidney from citrulline produced by the intestine. The renal enzymes of arginine synthesis, argininosuccinate synthetase and argininosuccinate lyase, occur in the cells of the proximal tubule. The rate of arginine synthesis depends on citrulline delivery and does not appear to be regulated by dietary arginine availability. Renal arginine synthesis in humans produces approximately 2 grams arginine per day, which may be compared to an intake, from a Western diet, of approximately 4 to 5 grams a day. Spontaneous, nonenzymatic breakdown of creatine and creatine phosphate to creatinine causes the excretion of 1 to 2 g creatinine a day and requires the replacement of an equivalent amount of creatine from the diet and by endogenous synthesis. The first enzyme of creatine biosynthesis, L-arginine:glycine amidinotransferase, occurs in the kidney and produces guanidinoacetate, which is released into the renal vein. The renal output of guanidinoacetate, however, is rather low, and we propose that the entire pathway of creatine synthesis may also occur in the liver. Renal arginine reabsorption salvages approximately 3 grams of arginine per day. At the apical membrane of proximal tubular cells, arginine shares a transporter with lysine, ornithine, and cystine. Defects in this heteromeric transporter cause cystinuria, which is also characterized by urinary loss of arginine, lysine, and ornithine.

L Arginine research update
L-Arginine supplement improves vascular function by overcoming deleterious effects of ADMA, a novel cardiovascular risk factor.
Altern Med Rev. 2005 Mar;10(1):14-23.
There is abundant evidence that the endothelium plays a crucial role in the maintenance of vascular tone and structure. One of the major endothelium-derived vasoactive mediators is nitric oxide (NO), an endogenous messenger molecule formed in healthy vascular endothelium from the amino acid precursor L-arginine. Endothelial dysfunction is caused by various cardiovascular risk factors, metabolic diseases, and systemic or local inflammation. One mechanism that explains the occurrence of endothelial dysfunction is the presence of elevated blood levels of asymmetric dimethylarginine (ADMA) -- an L arginine analogue that inhibits nitric oxide formation and thereby can impair vascular function. Supplementation with L-arginine has been shown to restore vascular function and to improve the clinical symptoms of various diseases associated with vascular dysfunction

Plasma l arginine concentrations are reduced in cancer patients: evidence for arginine deficiency?
American Journal of Clinical Nutrition, Vol. 81, No. 5, 1142-1146, May 2005
Preliminary evidence suggests that arginine availability in cancer is reduced. However, no valid data are available on plasma arginine concentrations in cancer patients. We aimed to determine whether there is evidence for disturbed arginine metabolism in cancer. We measured plasma arginine concentrations postabsorptively in patients with various types of tumors, hypothesizing that arginine concentrations would be lower than those in age- and sex-matched control subjects. Patients with localized tumors with a range of metabolic implications were studied: breast cancer (no weight loss), colonic cancer (sometimes weight loss), and pancreatic cancer (usually weight loss). Plasma arginine concentrations were lower in patients with cancer irrespective of tumor type, weight loss, tumor stage, or body mass index. Malignant tumors associated with various degrees of metabolic derangements are all associated with decreased plasma arginine concentrations, even without weight loss. This suggests that decreased arginine availability is a specific feature of the presence of cancer. These disturbances in arginine metabolism could contribute to the cascade of metabolic events leading to cancer cachexia.

Oral L arginine supplement improves hemodynamic responses to stress and reduces plasma homocysteine in hypercholesterolemic men.
J Nutr. 2005 Feb;135(2):212-7.
When administered intravenously, the benefit of l arginine supplement is that it substantially reduces blood pressure (BP) and peripheral vascular resistance in healthy adults and in patients with vascular disease. Oral l-arginine has been shown to improve endothelial function; however, it is not clear whether oral administration has significant effects on systemic hemodynamics. We tested whether oral l-arginine (12 grams per d for 3 weeks) affected hemodynamics, glucose, insulin, or C-reactive protein in 16 middle-age men with high cholesterol. After each treatment, hemodynamic variables were measured at rest and during 2 standardized stressor tasks (a simulated public-speaking task and the cold pressor). Regardless of treatment, the stressor tasks increased BP and heart rate (P </= 0.02). Relative to placebo, l arginine changed cardiac output, diastolic BP (-1.9 mm Hg), pre-ejection period (+3.4 ms), and plasma homocysteine. The change in plasma l-arginine was inversely correlated with the change in plasma homocysteine. Contrary to the results of previous studies of l arginine administered intravenously, oral administration did not affect total peripheral resistance or plasma insulin. Oral l-arginine also did not affect plasma glucose, C-reactive protein, or lipids. This pattern of findings is consistent with the hypothesis that oral l-arginine reduces BP. This study is the first to describe a hemodynamic mechanism for the hypotensive effect of oral l arginine and the first to show substantial reductions in homocysteine with oral administration.

Effect of oral L arginine on oxidant stress, endothelial dysfunction, and systemic arterial pressure in young cardiac transplant recipients.
Am J Cardiol. 2004 Sep 15;94(6):828-31. Department of Pediatrics, University of Virginia, Charlottesville, VA
Oral L-arginine therapy reverses endothelial dysfunction and attenuates high blood pressure in hypertensive cardiac transplant recipients. L-arginine corrects derangements in the vascular endothelial nitric oxide (NO)-dependent signaling pathway. Our data support the concept that cardiac transplant recipients use excess endogenous nitric oxide from L-arginine supplementation to buffer increased vascular oxidant stress.

Effect of oral L arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension, positive exercise tests, and normal coronary arteries.
Am J Cardiol. 2004 Apr 1;93(7):933-5.
Thirteen hypertensive patients with microvascular angina were studied before and after receiving oral L-arginine (4 weeks, 2 g, 3 times daily). L-arginine significantly improved angina class, systolic blood pressure at rest, and quality of life. Maximal forearm blood flow, plasma L-arginine, L-arginine : asymmetric dimethyl arginine ratio, and cyclic guanylate monophosphate increased significantly after treatment. In medically treated hypertensive patients with micro-vascular angina, oral L-arginine may represent a useful therapeutic option.

The influence of two different doses of L arginine oral supplementation on nitric oxide NO concentration and total antioxidant status (TAS) in atherosclerotic patients.
Med Sci Monit. 2004 Jan;10(1):CR29-32.
The purpose of this study was to assess the effect of two different doses in 28-day L arginine oral supplementation on nitric oxide (NO) concentration and total antioxidant status (TAS) in patients with atherosclerotic peripheral arterial disease. 32 patients were divided into 2 groups receiving L-arginine at 3i2 g/day (group A) or 3i4 g/day (group B).  Group A showed substantially higher NO levels after 14 and 28 days of therapy. In group B, the NO level increase was substantial after 28 days. Noticeably higher total antioxidant statuses were noted in both groups: group A showed this only after 28 days of treatment, while group B exhibited substantial increase in TAS after 7, 14 and 28 days of L-arginine supplementation. Oral supplementation of L arginine for 28 days leads to substantial increases in nitric oxide and TAS levels in the blood of patients with atherosclerotic peripheral arterial disease at Fontaine's stages II and III. The TAS concentration rise points to an antioxidative effect of L arginine oral supplementation.

Treatment of erectile dysfunction with pycnogenol and L arginine.
J Sex Marital Ther. 2003 May-Jun;29(3):207-13.
We investigated the possibility of overcoming erectile dysfunction by increasing the amounts of endogenous itric oxide. For this purpose, we orally administered Pycnogenol, because it is known to increase production of nitric oxide by nitric oxide syntase together with L arginine as substrate for this enzyme. The study included 40 men, aged 25-45 years, without confirmed organic erectile dysfunction. Throughout the 3-month trial period, patients received 3 ampoules Sargenor a day, a drinkable solution of the dipeptide arginyl aspartate (equivalent to 1.7 g L arginine per day). During the second month, patients were additionally supplemented with 40 mg Pycnogenol two times per day; during the third month, the daily dosage was increased to three 40-mg Pycnogenol tablets. After 1 month of treatment with L arginine, a statistically nonsignificant number of 2 patients experienced a normal erection. Treatment with a combination of L arginine and Pycnogenol for the following month increased the number of men with restored sexual ability to 80%. Finally, after the third month of treatment, 92% of the men experienced a normal erection. We conclude that oral administration of L-arginine in combination with Pycnogenol causes a significant improvement in sexual function in men with erectile dysfunction without any side effects. 

Dietary supplementation with L-arginine or placebo in women with pre-eclampsia.
Staff AC.. Departments of Obstetrics and Gynecology, Ulleval University Hospital, Kirkeveien 166, Oslo, Norway.
To investigate the effect of dietary intake of the L-arginine on the diastolic blood pressure in women with pre-eclampsia. A study was designed to compare the effect of L-arginine and placebo in pre-eclamptic women. The women received orally 12 grams of L arginine or placebo daily for up to 5 days. The primary end-point was to identify a difference in diastolic blood pressure alteration between the two groups after 2 days of intervention. There was no statistically significant alteration in diastolic blood pressure in the L arginine group compared with the placebo group after 2 days of treatment. Oral L arginine supplementation did not reduce mean diastolic blood pressure after 2 days of treatment compared with placebo in pre-eclamptic patients with gestational length varying from 28 to 36 weeks.

Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients.
Hum Reprod. 1999 Jul;14(7):1690-7.
The objective of the present study was prospectively and randomly to evaluate the role of L-arginine in improving uterine and follicular Doppler flow and in improving ovarian response to gonadotrophin in poor responder women. A total of 34 patients undergoing assisted reproduction was divided in two groups according to different ovarian stimulation protocols: (i) flare-up gonadotrophin-releasing hormone analogue (GnRHa) plus elevated pure follicle stimulating hormone (pFSH); and (ii) flare-up GnRHa plus elevated pFSH plus oral L-arginine. The plasma and follicular fluid concentrations of arginine, citrulline, nitrite/nitrate (NO2-/NO3-), and insulin-like growth factor-1 (IGF-1) were assayed.  In the L-arginine treated group a lower cancellation rate, an increased number of oocytes collected, and embryos transferred were observed. In the same group, increased plasma and follicular fluid concentrations of arginine, citrulline, NO2-/NO3-, and IGF-1 was observed. Significant Doppler flow improvement was obtained in the L arginine supplemented group. Three pregnancies were registered in these patients. No pregnancies were observed in the other group. It was concluded that oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate.

Oral L-arginine improves endothelial function in healthy individuals older than 70 years.
Bode-Boger SM. University Hospital, Otto-von-Guericke University, Magdeburg, Germany.
Ageing is associated with progressive endothelial dysfunction in normal humans. Flow-mediated dilation (FMD) of the brachial artery is impaired in elderly individuals with cardiovascular disease and vascular nitric oxide (NO) bioavailability is reduced. We investigated whether oral L arginine, the substrate for NO synthesis, can improve impaired FMD in healthy very old people. Twelve healthy old subjects took L arginine (8 grams orally. two times daily) or placebo for 14 days each, separated by a wash-out period of 14 days. L-Arginine significantly improved FMD, whereas placebo had no effect. After L-arginine supplement use, plasma levels of L-arginine increased significantly, but placebo had no effect. We conclude that in healthy very old age endothelial function is impaired and may be improved by oral L-arginine supplementation.

Practical recommendations for immune-enhancing diets.
J Nutr. 2004 Oct;134(10 Suppl):2868S-2872S; discussion 2895S.
Immune-enhancing diets contain nutrients that have putative benefits, including arginine, (n-3) fats, glutamine, nucleotides, and structured lipids. Although under most circumstances the systemic inflammatory response is beneficial to the host, improving the eventual outcome of injury, infection, or inflammation, excessive proinflammation (leading to cardiac, hepatic, and mitochondrial dysfunction) or excessive counterinflammation (leading to immune depression) can worsen outcome. In critically ill septic patients, the synthesis of arginine can be exceeded by its catabolism to nitric oxide and urea, rendering arginine conditionally essential. In patients with sepsis, increased production of nitric oxide increases serum nitrite and nitrate levels, whereas levels in patients with trauma and trauma with sepsis are lower than in controls. In septic patients, arginine supplements might further increase nitric oxide levels and be potentially harmful through excessive proinflammation. However, administration of increased amounts of arginine might improve immune function in surgical and trauma patients by increasing nitric oxide production in macrophages. Thus, the effects of arginine and (n-3)-fat supplementation might be expected to be complementary- arginine might improve cytokine and nitric oxide production in patients with immunodepression, whereas (n-3) fats might be beneficial when there is excessive proinflammation, particularly when supplemental arginine is supplied, by reducing cytokine-induced eicosanoid production.

Arginine supplement emails
Q. Should a l arginine supplement be taken with meals or on an empty stomach?
   A. L Arginine supplements are probably more effective when taken on an empty stomach.

Q. Can I take l arginine regularly for many months?
   A. As with most nutrients, I recommend taking breaks from use. In the case of arginine, it appears to be safe to take for extended periods as long as the dose is less than 2 grams a day.

Q. Is l arginine better to take as a capsule or powder?
   A. It depends on how much you plan to take. If your dose is 1 to 5 g, the capsule works. If you plan to take more than 5 grams of arginine, then the powder is more efficient.

Q. What are some foods high in arginine?
   A. All foods that have protein contain arginine.

Q. Dear Dr. Sahelian, I appreciate the sound advice and education that you provide. I have one question and I understand that by responding you are NOT in any manner obviating the need for me to get direct advice from my own physician. More than 25 years ago I had bypass surgery. I have NOT had a recent heart attack. However, I do have aortic stenosis. I have been taking 500 mg of L-arginine twice per day. Is the L Arginine harmful, maybe helpful or irrelevant? Thank you and keep up the good work.
   A. Thus far I am not impressed with the research regarding l arginine benefit in heart disease when used in dosages below 2 grams a day. Whether higher amounts of l arginine provide heart health benefits is not clear as of January 2008.

Q. Can you comment on the arginine benefits by ProArgi9? There is a website that makes these claims: ProArgi9 is the ONLY arginine product declared FDA SAFE! The following patented legal claims on ProArgi9 have been approved by the FDA and FTC:
* Reduces risk of heart disease
* Increases muscle mass
* Reduces adipose tissue body fat
* Stimulation of the release of the most important anti-aging hormone in the body, growth hormone
* Improves immune system
* Reduces healing time of injuries (particularly bone)
* Natural alternative to Viagra
   A. The FDA and the FTC do not allow such claims to be made about the health benefit of arginine. The statements on the website you mention regarding ProArgi9 are not correct and actually violate FDA and FTC rules.

Q. Is l arginine for a woman appropriate? What is the correct arginine dosage? Also, is l arginine a vitamin?
   A. I can't think of a medical reason why a woman would need to take a l arginine supplement. L arginine is not a vitamin but an amino acid.

Q. Does l arginine supplement reduce blood pressure? Can l arginine be taken the same time as Pycnogenol?
   A. I don't think l arginine stays in the bloodstream long enough to have a long term influence on blood pressure. I don't see any reason why l arginine can't be used together with Pycnogenol.

Q. What's the symptom of l arginine overdose?
   A. I don't know. I have personally taken 12 grams at one time without any problems.

Q. I came across a web site that said: Arginine Ornithine Lysine is an obvious choice to promote health and wellbeing at all stages of adult life. What's the scoop?
   A. I have not come across any studies that indicate arginine ornithine lysine together help promote health.

Q. Does l arginine cause a tumor or treat a tumor either by oral arginine supplement or arginine cream?
   A. I don't see any clinical reason why l arginine would cause or prevent a tumor. As to arginine cream, I can't imagine enough being absorbed to have a clinical effect.

Q. Do you recommend l arginine for body building?
   A. I'm much more impressed with creatine monhydrate and protein powders than l arginine for body building.

Q.  I have followed your career since my wife and I heard you at a book review at the La Quinta Hotel several years ago. I would like to call your attention to a problem I had recently with taking l arginine in quantity (6 grams per day) over several months, I came down with rosacea, which cleared up when I stopped taking it and with standard treatment by a dermatologist. I have read stories by body builders of their faces getting "rough" when taking large doses of l arginine and wonder if they have undiagnosed rosacea. Keep up the good work.
   A. Thanks, this is the first we have heard of any potential reaction to arginine leading to rosacea.

Q. I recently happened across a company, Stategic Science, Inc., promoting the topical application of arginine cream (and their transdermal delivery system) to restore hair growth - essentially by "improving blood flow to the hair follicles in the scalp." With poor circulation in the scalp so frequently cited as a common cause of thinning hair and hair loss, and arginine cream propounded to improve circulation and blood flow for so many other conditions, this company's claim (to a layman) seems to be at least plausible. Also, I read recently that "Kevis" is actually the number one selling hair loss treatment in the world, followed closely by (Rogaine) minoxidil in north America. From what I've read, the active ingredient in Kevis is "hyaluronic acid," which purports to restore depleted collagen around hair follicles, while Minoxidil dilates blood vessels. Since Kevis and Rogaine were originally patented and sold by UpJohn, it certainly begs the question in my mind if "business strategy" may be the reason why we hear so little about hyaluronic acid as an alternative restorative hair treatment to Minoxidil in the U.S.A. As an alternative to the Minoxidil / Finasteride approach, I was wondering if topical arginine, perhaps in conjunction with hyaluronic acid, would be (or has been) worth considering. You and your staff seem to be on the cutting edge of research along these lines.
   A. Since we have not seen studies with arginine cream and hair growth, and the same for hyaluronic acid, we can't say whether these two nutrients in the form of a cream would be effective to restore hair loss.

Q. I read in one of your books that you once ingested 12 grams of arginine and experienced no ill effects. What then were the positive effects gained? I am curious about that since the arginine dosage is quite high. I am guessing that the body does not need that much of one amino acid via supplementation, like vitamin C.
   A. I did not notice much of an effect from 12 grams of arginine, positive or negative.

Q. Can I take L Arginine with Passion Rx?
   A. We really can't say since each person responds differently and we have no idea of your health condition. As a rule, Passion Rx is potent by itself and there is little need to take any other supplements the same day. L arginine is quite benign, and we can't foresee any additional side effects if arginine is added.

Q. This question is in regards to arginine nitric oxide relationship. If I take an arginine supplement, how long does it take to convert into nitric oxide and how long does the nitric oxide stay in the body?
   A. These are excellent questions and at this time I don't know the precise answers to your questions but will search for research that explores the supplement arginine nitric oxide connection. Nitiric oxide stays in the blood stream for brief periods.

Q. Do arginine supplements improve erection?
   A. I am not impressed with this amino acid for erection enhancement. Perhaps some people may benefit from it if taken in very high doses, but my experience has not been overly promising.

Various misspellings of l arginine include arganine and argenine
This page was last updated in June 2008