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Expert Pearls

Erectile Dysfunction - acetyl-L-carnitine - 43770

Acetyl-L-carnitine 2 gm/d and proprionyl-l-carnitine 2 gms/d. [Urology, 2005;66(5):1080-5. 43770 (5/2006)] Summary Interview

Erectile Dysfunction - arginine - 44952

Arginine 1.7 g/d (dipeptide arginyl aspartate) and Pycnogenol® 80-120 mg/d. [Sex Marital Ther. 2003 May-Jun;29(3):207-13. 44952 (7/2006)] Summary Interview

Erectile Dysfunction - cardiovascular disease, nitric oxide - 50099

Exercise 30 minutes of moderate to vigorous intensity daily; 500-1,000 mg of EPA/DHA daily; increased intake of antioxidants (i.e. green tea, dark chocolate, berries, fruits and vegetables, red wine); 500-1,000 mg of vitamin C, and/or 2 capsules of pycnogenol (usual capsules contain 40-60 mg per capsule); folic acid (400 ug per day); avoid excessive alcohol, and decrease fat and sugar intakes; along with pelvic floor exercise can achieve results equal to or better than the phosphodiesterase 5 inhibitors (Cialis, Levitra and Viagra). L-arginine at 5 gms/d has improved ED in some studies. 2-3 gm of L-citrulline will most likely have a similar effect since it is the intracellular source of arginine and about half of the arginine dose is required for similar blood levels. Vegetables are a natural source of nitric oxide. Dr. Meldrum's book about ED (with Joseph C. Gambone, DO, MPH , Marge Morris, M Ed, RD, CDE and Claudia Meldrum) is "Survival of the Firmest" and website http://www.erectile-function.com/. Am J Cardiol, 2011 Aug 15;108(4):599-606. Epub 2011 May 31. 50099 (5/2012)] Interview PubMed

Erectile Dysfunction - diet, lifestyle - 50637

Erectile function can be enhanced significantly by diet, supplements and lifestyle factors that increase nitric oxide which increase blood flow into the penis by relaxing and dilating the penile artery, and, by the strengthening of pelvic floor muscles with pelvic floor exercises (PFE) which keep the blood trapped in the penis longer to maintain an erection. Beneficial lifestyle factors include; weight control, exercise, reduced intake of fat and sugar, increased intake of fruits and vegetables, moderate alcohol, and limiting barbequing and grilling/broiling of foods. Supplements that can help increase nitric oxide include folic acid, omega-3 fatty acids (fish oil) and pycnogenol. Instructions on PFE and Dr. Meldrum’s book, “Survival of the Firmest” are available at www.erectile-function.com. [J Sex Med. 2014 May;11(5):1208-20. 50637 (1/2015)] Interview PubMed

Erectile Dysfunction - korean red ginseng - 45682

Korean Red Ginseng 1000 - 3000 mg/d before breakfast. [Asian J Androl, 2007; 9(2): 241-4. 45682 (11/2007)] Summary

Erectile Dysfunction - periodontal disease - 50171

Vasculogenic erectile dysfunction (VED) can be affected by chronic periodontitis do to inflammatory cytokines released that can negatively affect endothelial dysfunction of the small vessels in the penis. Diets that are rich in protein, whole grains, fiber, vitamins, minerals and PUFAs have positive effects on periodontal health and can improve endothelial function and reduce vulnerability to VED. [J Periodonto, 2011 Dec;82(12):1665-9. 50171 (4/2013)] Interview PubMed

Erectile Dysfunction - propionyl-l-carnitine - 45315

Carnitine - propionyl-l-carnitine (PLC) 1 gm b.i.d. independently from Sildenafil 50 mg b.i.w. and meals in diabetic patients with erectile dysfunction reduced oxidative stress and improved endothelial dysfunction markers in type 2 diabetic patients with erectile dysfunction and had more sustained improvement in symptoms of E.D. than Sildenafil alone. [Eur Urol, 2007 Apr 25; [Epub ahead of print]. 45315 (7/2007)] Summary Interview

Erectile Dysfunction - sunlight, vitamin d -

Vitamin D 6000 IU/d with 25 hydroxy vitamin D3 levels between 60-80 ng/ml. [Dermatoendocrinol. 2012 Apr 1;4(2):128-36. 50259 (1/2014)] Interview PubMed

Erectile Dysfunction - yohimbine - 26601 / 26602

Erectile DysfunctionYohimbine 5-10 mg t.i.d.. [Arch Sexual Behavior, 1997;26(1):49-62. 26601 / 26602 (1997)] Summary Interview

Erectile Dysfunction - yohimbine - 39233

Yohimbine 5.4 mg -10.8 mg t.i.d. or 5.4 mg 1-2 tablets 15-30 minutes before sex. [Intern J Impotence Res,2002;14:25-31. 39233 (2002)] Summary Interview
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