What has worked to get PDE5 inhibitors to work effectively again?

[righteous99]

I have been using Cialis/Levitra over the past decade, and I have observed that the efficacy of these medications seems to decrease over time. There seems to be a lot of feedback that others have experienced the same.
I have added citrulline and also Maca to boost the effectiveness, but haven't seen much improvement.
I am a 46-year-old male, and assuming good cardiovascular fitness and hormone levels within normal limits, what measures have helped others boost the strength of these drugs?
I have heard several theories on why their strength fades over time: issues with Iron, issues with NAD+, tolerance to these drugs over time, along with the notion that perhaps we become accustomed to harder than normal erections.
Has anyone else experienced this, and what has worked to get a similar effect to when I first starting using these drugs?

 

[DorianGray]

I found not taking a PDE5 for a few days resets the effectiveness for me. Try adding some Arginine to your stack also.

 

[righteous99]

I found not taking a PDE5 for a few days resets the effectiveness for me. Try adding some Arginine to your stack also.

How much arginine do you recommend daily? I currently take 1500 mg of L-Citrulline in the morning.

 

[Guided_by_Voices]

I have been using Cialis/Levitra over the past decade, and I have observed that the efficacy of these medications seems to decrease over time. There seems to be a lot of feedback that others have experienced the same.
I have added citrulline and also Maca to boost the effectiveness, but haven't seen much improvement.
I am a 46-year-old male, and assuming good cardiovascular fitness and hormone levels within normal limits, what measures have helped others boost the strength of these drugs?
I have heard several theories on why their strength fades over time: issues with Iron, issues with NAD+, tolerance to these drugs over time, along with the notion that perhaps we become accustomed to harder than normal erections.
Has anyone else experienced this, and what has worked to get a similar effect to when I first starting using these drugs?

These drugs work by inhibiting the enzyme that breaks down Nitric Oxide, but if your NO is declining there will be less of it to work with. You can try Beetroot powder (warning: high in oxalates) or NO lozenges (I use the ones from N1o1, no affiliation). supporting your own production (no mouthwash, HIIT, low A1C, low fasting insulin) will also help.

 

[DorianGray]

How much arginine do you recommend daily? I currently take 1500 mg of L-Citrulline in the morning.

2-3 grams daily, taken at night.