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Arginine and L-Arginine

Posted on 12. Nov, 2010 by .

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L-arginine was first isolated in 1886. In 1932, scientists learned that L-arginine is needed to create urea, a waste product that is necessary for toxic ammonia to be removed from the body. In 1939, researchers discovered that L-arginine is also needed to make creatine. Creatine breaks down into creatinine at a constant rate, and it is cleared from the body by the kidneys.

L-arginine is a chemical building block called “an amino acid.” It is obtained from the diet and is necessary for the body to make proteins. L-arginine is found in red meat, poultry, fish, and dairy products. It can also be made in a laboratory and used as medicine.

Arginine is considered a semi-essential amino acid because even though the body normally makes enough of it, supplementation is sometimes needed. For example, people with protein malnutrition, excessive ammonia production, excessive lysine intake, burns, infections, peritoneal dialysis, rapid growth, urea synthesis disorders, or sepsis may not have enough arginine. Symptoms of arginine deficiency include poor wound healing, hair loss, skin rash, constipation, and fatty liver.

Arginine changes into nitric oxide, which causes blood vessel relaxation (vasodilation). Early evidence suggests that arginine may help treat medical conditions that improve with vasodilation, such as chest pain, clogged arteries (called atherosclerosis), coronary artery disease, erectile dysfunction, heart failure, intermittent claudication/peripheral vascular disease, and blood vessel swelling that causes headaches (vascular headaches). Arginine also triggers the body to make protein and has been studied for wound healing, bodybuilding, enhancement of sperm production (spermatogenesis), and prevention of wasting in people with critical illnesses.

Arginine hydrochloride has a high chloride content and has been used to treat metabolic alkalosis. This use should be under the supervision of a qualified healthcare professional.

In general, most people do not need to take arginine supplements because the body usually produces enough.

Why Do People Use L-Arginine?

Heart disease

In the body, L-arginine is used to make nitric oxide, which reduces blood vessel stiffness, increases blood flow, and improves blood vessel function.

However, L-arginine should not be used following a heart attack. An study sponsored by the National Institutes of Health examining the use of L-arginine after a heart attack was terminated early after six patients died, a disproportionate number. There were no deaths in the patients who did not receive L-arginine.

The study researchers speculate that L-arginine may aggravate the effects of cardiac shock. The results were published in the Journal of the American Medical Association

Erectile Dysfunction

L-arginine has been used for erectile dysfunction. Like the drug sildenafil citrate (Viagra), L-arginine is thought to enhance the action of nitric oxide, which relaxes muscles surrounding blood vessels supplying the penis. As a result, blood vessels in the penis dilate, increasing blood flow, which helps maintain an erection. The difference in how they work is that Viagra blocks an enzyme called PDE5 which destroys nitric oxide and L-arginine is used to make nitric oxide.
In one study, 50 men with erectile dysfunction took either 5 grams of L-arginine per day or a placebo. After six weeks, more men in the L-arginine group had an improvement compared to those taking the placebo.

Unlike Viagra, L-arginine must be taken daily.

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Wound healing

L-arginine’s possible activity in wound repair may be due to its role in the formation of L-proline, an important amino acid that is essential for the synthesis of collagen.
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Other Conditions
L-arginine is also used for high blood pressure, migraines, sexual dysfunction in women, intermittent claudication, and interstitial cystitis.

Sources of L-Arginine

L-arginine is conditionally essential, which means that the body normally has enough. It’s produced in the kidney and to a lesser extent, in the liver.

Food sources of L-arginine include plant and animal proteins, such as dairy products, meat, poultry, fish, and nuts. The ratio of L-arginine to lysine is also important – soy and other plant proteins have more L-arginine than animal sources of protein.

Severe burns, infections, and injuries can deplete the body’s supply of arginine. Under these conditions, L-arginine becomes essential and it is necessary to ensure proper intake to meet the increased demands.

L-arginine is also essential for children with rare genetic disorders that impair the formation of L-arginine.
Side Effects of L-Arginine

L-arginine may lower blood pressure because it is involved in the formation of nitric oxide. It may also result in indigestion, nausea, and headache.

L-arginine should not be used following a heart attack. If you have a history of heart disease, consult your doctor before taking L-arginine.

Higher doses of arginine can increase stomach acid, so it may worsen heartburn, ulcers, or digestive upset cause by medications. Arginine appears to increase stomach acid by stimulating the production of gastrin, a hormone that increases stomach acid.

L-arginine may also alter potassium levels, especially in people with liver disease. People with kidney disease and those who take ACE inhibitors or potassium sparing diuretics should not use supplemental L-arginine unless they are under professional supervision. It may also alter the levels of other chemicals and electrolytes in the body, such as chloride, sodium, and phosphate.

Arginine may increase blood sugar levels, so it shouldn’t be used by people with diabetes unless under a doctor’s supervision.

Pregnant and nursing women and children should not use supplemental L-arginine, as it’s safety has not been established.

People with genital herpes should not take L-arginine because it may aggravate their symptoms.
Possible Drug Interactions

L-arginine may counteract the benefits of lysine to treat herpes

NSAIDS (non-steroidal anti-inflammatories) or other drugs that are hard on the stomach should not be combined with L-arginine.

Drugs that alter potassium levels in the body, such as ACE inhibitors and potassium sparing diuretics.

Possibly effective for…

* Improving recovery after surgery. Taking L-arginine with ribonucleic acid (RNA) and eicosapentaenoic acid (EPA) before surgery or afterwards seems to help reduce the recovery time, reduce the number of infections, and improve wound healing after surgery.
* Congestive heart failure. Taking L-arginine along with usual treatment seems to help eliminate extra fluids that are a problem in congestive heart failure. But taking L-arginine doesn’t always improve exercise tolerance or quality of life. L-arginine should not be used instead of the usual treatments ordered by a healthcare provider.
* Chest pain associated with coronary artery disease (angina pectoris). Taking L-arginine seems to decrease symptoms and improve exercise tolerance and quality of life in people with angina. But L-arginine doesn’t seem to improve the disease itself.
* Bladder inflammation. Taking L-arginine seems to improve symptoms, but it may take up to three months of treatment to see improvement.
* Wasting and weight loss in people with HIV/AIDS, when used with hydroxymethylbutyrate (HMB) and glutamine. This combination seems to increase body weight, particularly lean body mass, and improve the immune system.
* Preventing loss of effect of nitroglycerin in people with angina pectoris.
* Problems with erections of the penis (erectile dysfunction).
* Improving kidney function in kidney transplant patients taking cyclosporine.
* Preventing inflammation of the digestive tract in premature infants.
* Cramping pain and weakness in the legs associated with blocked arteries (intermittent claudication).

Possibly ineffective for…

* Heart attack. Taking L-arginine does not seem to help prevent a heart attack. It also doesn’t seem to be beneficial for treating a heart attack after it has occurred. In fact, there is concern that L-arginine might be harmful for people after a recent heart attack. Don’t take L-arginine if you have had a recent heart attack.
* Pre-eclampsia, an increase in blood pressure during pregnancy. Taking L-arginine doesn’t seem to lower diastolic blood pressure (the second number) in women with pre-eclampsia in their 28th to 36th week of pregnancy.

Insufficient evidence to rate effectiveness for…

* Migraine headache. Taking L-arginine by mouth along with the painkiller ibuprofen seems to be effective for treating migraine headache. This combination sometimes starts to work within 30 minutes. But it’s hard to know how much of the pain relief is due to L-arginine, since ibuprofen can relieve migraine pain on its own.
* Decreased mental function in the elderly (senile dementia). Limited research suggests that L-arginine might improve senile dementia.
* Improving healing of diabetic foot ulcers. There is interest in using L-arginine for preventing diabetic foot ulcers. Applying L-arginine to the feet seems to improve circulation in people with diabetes, which might be helpful in preventing ulcers. But if there is already an ulcer on the foot, injecting L-arginine under the skin near the ulcer doesn’t seem to shorten healing time by much or lower the chance of needing an amputation in the future.
* High blood pressure. There is some evidence that taking L-arginine can slightly lower blood pressure in healthy people and in people with type 2 diabetes who have mild high blood pressure.
* Male infertility.
* Prevention of the common cold.
* Improving athletic performance.
* Breast cancer when used in combination with chemotherapy.
* Wound healing.
* Female sexual problems.
* Sickle cell disease.
* Improving the immune system in people with head and neck cancer.

Are there safety concerns?

L-arginine is POSSIBLY SAFE for most people when taken appropriately by mouth short-term. It can cause some side effects such as abdominal pain, bloating, diarrhea, gout, blood abnormalities, allergies, airway inflammation, worsening of asthma, and low blood pressure.
Special Precautions & Warnings:
Pregnancy and breast-feeding: L-arginine is POSSIBLY SAFE when used appropriately short-term in pregnancy. Not enough is known about using L-arginine long-term in pregnancy or during breast-feeding. Stay on the safe side and avoid use.

Children: L-arginine is POSSIBLY SAFE when used by mouth in premature infants in appropriate doses. When used in high doses, L-arginine is POSSIBLY UNSAFE. Doses that are too high can cause serious side effects including death in children.

Allergies or asthma: L-arginine can cause an allergic response or make swelling in the airways worse. If you decide to take L-arginine, use it with caution.

Herpes: There is a concern that L-arginine might make herpes worse. There is some evidence that L-arginine is needed for the herpes virus to multiply.

Low blood pressure: L-arginine might lower blood pressure. This could be a problem if you already have low blood pressure.

Recent heart attack: There is a concern that L-arginine might increase the risk of death after a heart attack, especially in older people. If you have had a heart attack recently, don’t take L-arginine.

Surgery: L-arginine might affect blood pressure. There is a concern that it might interfere with blood pressure control during and after surgery. Stop taking L-arginine at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

Do not take this combination.

Medications for high blood pressure (Antihypertensive drugs)
L-arginine seems to decrease blood pressure. Taking L-arginine along with medications for high blood pressure might cause your blood pressure to go too low.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.

Medications that increase blood flow to the heart (Nitrates)
L-arginine increases blood flow. Taking L-arginine with medications that increase blood flow to the heart might increase the chance of dizziness and lightheadedness.

Some of these medications that increase blood flow to the heart include nitroglycerin (Nitro-Bid, Nitro-Dur, Nitrostat), and isosorbide (Imdur, Isordil, Sorbitrate).

Moderate
Be cautious with this combination. Talk with your health provider.

Sildenafil (Viagra)
Sildenafil (Viagra) can lower blood pressure. L-arginine can also lower blood pressure. Taking sildenafil (Viagra) and L-arginine together might cause the blood pressure to go too low. Blood pressure that is too low can cause dizziness and other side effects.

Are there interactions with herbs and supplements?

Xylitol
L-arginine can cause an organ in the body called the pancreas to release a hormone called glucagon. Glucagon comes to the rescue when blood sugar levels are too low. Glucagon makes the liver convert stored sugar to useable sugar that is released into the bloodstream. Using L-arginine along with xylitol can keep L-arginine from stimulating the pancreas to release glucagon.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The following doses have been studied in scientific research:

BY MOUTH:

* For congestive heart failure: doses range from 6-20 grams per day, as three divided doses.
* For chest pain associated with coronary artery disease (angina pectoris): 3-6 grams three times per day for up to one month.
* For preventing the loss of the effectiveness of nitroglycerin in relieving pain in people with chest pain due to coronary artery disease (angina pectoris): 700 mg four times daily.
* For organic erectile dysfunction (ED): 5 grams per day. Taking lower doses might not be effective.
* For preventing inflammation of the digestive tract in premature infants: 261 mg/kg added to oral feedings daily for the first 28 days of life.

Other names

2-Amino-5-guanidinopentanoic Acid, Arg, Arginine, Arginine Ethyl Ester, Arginine Ethyl Ester Dihydrochloride, Arginine Ethyl Ester HCl, Arginine HCl, Arginine Hydrochloride, Di-Arginine Malate, Di-Arginine Orotate, Di-L-Arginine-L-Malate, Dl-Arginine, L-Arginine Ethyl Ester Dichloride, L-Arginine HCl, L-Arginine Hydrochloride, L-Arginine L-Pyroglutamate, L-Arginine Pyroglutamate, R-Gene 10.

references and thank you
http://www.mayoclinic.com/health/l-arginine/NS_patient-arginine
http://altmedicine.about.com/cs/herbsvitaminsad/a/Arginine.htm
http://www.nlm.nih.gov/medlineplus/druginfo/natural/875.html
# McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
# Ehren I, Lundberg JO, Adolfsson J, Wiklund NP. Effects of L-arginine treatment on symptoms and bladder nitric oxide levels in patients with interstitial cystitis. Urology 1998;52:1026-9.
# Bode-Boger SM, Boger RH, Galland A, et al. L-arginine-induced vasodilation in healthy humans: pharmacokinetic-pharmacodynamic relationship. Br J Clin Pharmacol 1998;46:489-97.
# Sandrini G, Franchini S, Lanfranchi S, et al. Effectiveness of ibuprofen-arginine in the treatment of acute migraine attacks. Int J Clin Pharmacol Res 1998;18:145-50.
# Lerman A, Burnett JC Jr, Higano ST, et al. Long-term L-arginine improves small-vessel coronary endothelial function in humans. Circulation 1998;97:2123-8

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