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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
Viagra or Cialis: Which gets you Harder?
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<blockquote data-quote="madman" data-source="post: 195798" data-attributes="member: 13851"><p>Of course, you can!</p><p></p><p>L-Arginine or L-Citrulline would amplify the effects as they serve as precursors of NO.</p><p></p><p>Let alone are considered vasodilators.</p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/alternative-treatment-for-ed.22759/#post-195039[/URL]</p><p></p><p><strong>Amino Acids </strong></p><p><strong></strong></p><p><strong><em>L-Arginine</em></strong></p><p><strong><em></em></strong></p><p><strong><em>L-Arginine is a semi-essential amino acid and serves as a precursor of NO. Nitric oxide synthase (NOS) catalyzes the oxidation of L-arginine, produces NO, and begins an enzymatic cascade that results in penile tumescence [43, 44]. </em></strong>There has been continued interest in L-arginine for the treatment of ED. Of note, it is the most studied ingredient found in online ED supplements and the most common amino acid included in men’s health supplements [45, 46].</p><p></p><p><em><strong>L-Arginine has the ability to increase systemic concentrations of NO when taken in supraphysiologic doses [47].</strong></em> The importance of dosing was first seen in the earliest trials evaluating its efficacy. In 1999, Klotz et al. found that 500 mg 3 times a day did not demonstrate significant benefits [48]. <strong><em>On the contrary, several studies showed that erectile function improved when taking larger doses: between 2.8 and 6 g/day [43, 44].</em></strong> The first systematic review and meta-analysis were published in 2019 by Rhim et al. where they evaluated the efficacy of L-arginine on ED, both as monotherapy and in conjunction with other over-the-counter supplements. They concluded that for the treatment of mild to moderate ED, L-arginine was more beneficial than placebo at doses of 1500 to 5000 mg with a low adverse event rate.<strong><em> Concomitant dosing of other supplements involved in a NO-producing pathway (e.g., yohimbine, pycnogenol, ornithine, and AMP) leads to more pronounced improvement in ED than L-arginine alone [49]. This review did not include the most recent studies describing the efficacy of taking PDE5i in combination with L-arginine.</em></strong></p><p><strong><em></em></strong></p><p><strong><em>Several RCTs have evaluated tadalafil in combination with L-arginine.</em></strong> <strong><em>The first was conducted in 2019 which found that that<u> L-arginine (5 g) taken in combination with tadalafil increased IIEF-5 scores significantly compared to either L-arginine or tadalafil separately (p ≤ 0.001)</u> [50•]. A second trial was published in 2020 which again found that <u>combination therapy with both tadalafil and arginine (2.5 g) once a day was superior to either monotherapy for patients with mild and severe ED </u>[51].</em></strong></p><p><strong><em></em></strong></p><p><strong><em><u>L-Arginine with sildenafil has also been evaluated</u>. The first study in 2001 found <u>the combination to be equally as effective as sildenafil alone</u>. However, this study was performed on post-radical prostatectomy patients and, regrettably, an improvement was measured by a buckling test, rather than an IIEF-5 score [52]. In 2020, <u>sildenafil was compared with sildenafil + L-arginine for patients with organic ED</u>. <u>They found that the combination resulted in a statistically significant improvement of ED grades based on IIEF-5 scores compared to sildenafil alone (p ≤ 0.0001)</u> [53]. <u>It appears that L-arginine can be successful in improving erectile function and may be a good option for patients in combination with PDE5i before progressing to invasive options</u>. It may also be beneficial for men seeking a more “natural” solution for their ED. A greater body of evidence will be necessary prior to adoption by the AUA guidelines as an adjunctive ED treatment. </em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 195798, member: 13851"] Of course, you can! L-Arginine or L-Citrulline would amplify the effects as they serve as precursors of NO. Let alone are considered vasodilators. [URL unfurl="true"]https://www.excelmale.com/forum/threads/alternative-treatment-for-ed.22759/#post-195039[/URL] [B]Amino Acids [I]L-Arginine L-Arginine is a semi-essential amino acid and serves as a precursor of NO. Nitric oxide synthase (NOS) catalyzes the oxidation of L-arginine, produces NO, and begins an enzymatic cascade that results in penile tumescence [43, 44]. [/I][/B]There has been continued interest in L-arginine for the treatment of ED. Of note, it is the most studied ingredient found in online ED supplements and the most common amino acid included in men’s health supplements [45, 46]. [I][B]L-Arginine has the ability to increase systemic concentrations of NO when taken in supraphysiologic doses [47].[/B][/I] The importance of dosing was first seen in the earliest trials evaluating its efficacy. In 1999, Klotz et al. found that 500 mg 3 times a day did not demonstrate significant benefits [48]. [B][I]On the contrary, several studies showed that erectile function improved when taking larger doses: between 2.8 and 6 g/day [43, 44].[/I][/B] The first systematic review and meta-analysis were published in 2019 by Rhim et al. where they evaluated the efficacy of L-arginine on ED, both as monotherapy and in conjunction with other over-the-counter supplements. They concluded that for the treatment of mild to moderate ED, L-arginine was more beneficial than placebo at doses of 1500 to 5000 mg with a low adverse event rate.[B][I] Concomitant dosing of other supplements involved in a NO-producing pathway (e.g., yohimbine, pycnogenol, ornithine, and AMP) leads to more pronounced improvement in ED than L-arginine alone [49]. This review did not include the most recent studies describing the efficacy of taking PDE5i in combination with L-arginine. Several RCTs have evaluated tadalafil in combination with L-arginine.[/I][/B] [B][I]The first was conducted in 2019 which found that that[U] L-arginine (5 g) taken in combination with tadalafil increased IIEF-5 scores significantly compared to either L-arginine or tadalafil separately (p ≤ 0.001)[/U] [50•]. A second trial was published in 2020 which again found that [U]combination therapy with both tadalafil and arginine (2.5 g) once a day was superior to either monotherapy for patients with mild and severe ED [/U][51]. [U]L-Arginine with sildenafil has also been evaluated[/U]. The first study in 2001 found [U]the combination to be equally as effective as sildenafil alone[/U]. However, this study was performed on post-radical prostatectomy patients and, regrettably, an improvement was measured by a buckling test, rather than an IIEF-5 score [52]. In 2020, [U]sildenafil was compared with sildenafil + L-arginine for patients with organic ED[/U]. [U]They found that the combination resulted in a statistically significant improvement of ED grades based on IIEF-5 scores compared to sildenafil alone (p ≤ 0.0001)[/U] [53]. [U]It appears that L-arginine can be successful in improving erectile function and may be a good option for patients in combination with PDE5i before progressing to invasive options[/U]. It may also be beneficial for men seeking a more “natural” solution for their ED. A greater body of evidence will be necessary prior to adoption by the AUA guidelines as an adjunctive ED treatment. [/I][/B] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
Viagra or Cialis: Which gets you Harder?
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