Q. I have been consulting a nutritionist who trained as a pharmacist. She has been very helpful.
I emailed her a list of my husband’s medications and asked which ones could cause erectile dysfunction. She said it could be enalapril with hydrochlorothiazide.
She recommended L-arginine, an amino acid that increases nitric oxide and boosts blood flow. The instructions are to take 500 mg twice a day, preferably on an empty stomach. Can you tell me more?
A. L-arginine is a natural compound that is found throughout our bodies and in foods such as nuts, seeds, whole grains, seafood and chocolate. It is an amino acid that is a building block for proteins, and as you have said, it is important for nitric oxide production.
Nitric oxide relaxes blood vessels and improves circulation. Drugs for erectile dysfunction (ED), such as Cialis and Viagra, work through the release of nitric oxide.
As a dietary supplement, L-arginine has a mixed record of success for ED. In one controlled trial, it worked no better than placebo (Urologia Internationalis, 1999); in another, it only helped men whose own nitric oxide production was subpar (BJU International, Feb., 1999).
Combining L-arginine with other compounds such as Pycnogenol (Journal of Sex & Marital Therapy, May-June, 2003), adenosine monophosphate (Andrology, March, 2013) or even drugs such as Cialis or Viagra (Journal of Sexual Medicine, Jan., 2013) produced better results.
Side effects are uncommon but may include digestive distress, asthma or allergic reactions. In some people, L-arginine could trigger a cold sore or other herpes simplex outbreak. Whether it would serve as an antidote to the blood pressure pill your husband takes is unknown. It may be worthwhile discussing this problem with his physician. It is possible that a different medication to control his blood pressure would not affect him in the same way. It might also be useful for his doctor to examine him for signs of other conditions, such as heart disease or diabetes, that sometimes trigger erectile dysfunction.
