The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis

[madman]

The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis

Hye Chang Rhim, BA, Min Seo Kim, BA, Young-Jin Park, MD, Woo Suk Choi, MD, Hyoung Keun Park, MD, Hyeong Gon Kim, MD, Aram Kim, MD, and Sung Hyun Paick, MD, PhD







ABSTRACT

Introduction: The efficacy and safety of arginine supplements in erectile dysfunction (ED) remain debatable.

Aim: To assess the potential role of arginine supplements on ED as alternatives to phosphodiesterase inhibitors.

Methods: Studies published up to April 2018 that evaluated the efficacy of arginine supplements were identified from multiple databases (Google Scholar, PubMed, Medline, Embase, Kiss, DBpia, and Cochrane databases). Studies comparing arginine supplements with placebo or no treatment; focusing only on patients with mild to moderate severity of ED; and presenting outcomes such as improvement rate, International Index of Erectile Function (IIEF) score, and adverse effects were included. Subgroup analysis for arginine alone and arginine in combination with other substances was further conducted to increase interpretability.

Main Outcome Measure: The strength of the association between arginine supplements and ED was assessed using relative odds ratios and weighted mean differences with 95% CI.

Results: In total, 10 randomized controlled trials met the inclusion criteria, reporting the outcomes of 540 patients with ED. The analysis demonstrated that arginine supplements with dosage ranging from 1,500 to 5,000 mg significantly improved ED compared with placebo or no treatment (odds ratios, 3.37 [1.29, 8.77], P ¼ .01, I2 ¼ 44). Arginine supplements also caused significant improvements in the IIEF subdomain scores of overall satisfaction, intercourse satisfaction, orgasmic function, and erectile function, whereas the IIEF sexual desire score remain unchanged. The adverse effect rate in the arginine-treated group was 8.3%, and that in the placebo group was 2.3%, none of which were severe.

Clinical Implications: Arginine supplements can be recommended to patients with mild to moderate ED.

Strength & Limitations: The strength of this study is that it is the first meta-analysis to assess the potential role of arginine supplements in ED compared with placebo or no treatment. A limitation is that the treatment dosage and duration varied among studies, which may have contributed to study heterogeneity.

Conclusion: The results of our systematic review and meta-analysis provide evidence on the effectiveness of arginine supplements for mild to moderate ED.















CONCLUSIONS

The results of our systematic review and meta-analysis provide evidence on the effectiveness and safety of arginine for mild to moderate ED. Arginine and supplements combined with arginine may play an important role in patients who are reluctant to take drugs or are experiencing adverse effects and economic burden.

 

[torrential]

Thanks for posting this. L-Citrulline and L-Citrulline Malate can be a better way to boost arginine levels without the side effects of direct arginine supplementation. They note the effectiveness of Citrulline in the study:

As the only physiological substance for NOS, it was logical to try arginine as a treatment of ED, and citrulline has the potential advantage over arginine because it escapes intestinal or hepatic metabolism and can be converted rapidly to arginine in the kidneys. Thus oral citrulline supplementation has been shown to increase the plasma arginine concentration and to amplify NO-dependent signaling in a dose-dependent manner. We grouped citrulline and arginine in the same category because the rationale behind citrulline supplementation is to increase plasma arginine, the actual substrate for NOS.

 

[madman]

Thanks for posting this. L-Citrulline and L-Citrulline Malate can be a better way to boost arginine levels without the side effects of direct arginine supplementation. They note the effectiveness of Citrulline in the study:

As the only physiological substance for NOS, it was logical to try arginine as a treatment of ED, and citrulline has the potential advantage over arginine because it escapes intestinal or hepatic metabolism and can be converted rapidly to arginine in the kidneys. Thus oral citrulline supplementation has been shown to increase the plasma arginine concentration and to amplify NO-dependent signaling in a dose-dependent manner. We grouped citrulline and arginine in the same category because the rationale behind citrulline supplementation is to increase plasma arginine, the actual substrate for NOS.