Arginine information and its role in nitric oxide production, how effective is this dietary supplement as a treatment or prevention of medical diseases?
Found in food and and health benefit of supplements

Arginine, a semi-essential amino acid, is involved in numerous areas of human biochemistry, including ammonia detoxification, hormone secretion, and immune modulation. It is also well known as a precursor to nitric oxide (NO), a key component of endothelial-derived relaxing factor, an endogenous messenger molecule involved in a variety of endothelium-dependent physiological effects in the cardiovascular system. Because of its NO-stimulating effects, it may be utilized in therapeutic regimens for angina pectoris, congestive heart failure, hypertension, coronary heart disease, preeclampsia, intermittent claudication, and erectile dysfunction. In addition, arginine has been studied in the treatment of HIV/AIDS, athletic performance, burns and trauma, cancer, diabetes and syndrome X, gastrointestinal diseases, male and female infertility, interstitial cystitis, immunomodulation, and senile dementia.
    Even though the this amino acid has been postulated to be useful for some of the conditions listed above, much research needs to be done before we can be more confident about its potential.

Buy L Arginine 750 mg, 60 Capsules
L Arginine is a semi-essential amino acid synthesized by the body from ornithine, it supports protein synthesis as it is involved in the transport and storage of nitrogen. Among many functions,it is used by the body to produce creatine.  Each supplement tablet contains 750 mg elemental L Arginine. Usage: Take 1 to 6 tablets daily, or as directed by your qualified health consultant.

Serving Size 1 capsule
L Arginine  - 750 mg each pill

Is it better to take as a capsule or powder?
   It depends on how much you plan to take. If your dose is less than 2 grams, the capsule works. If you plan to take several grams, then the powder is more efficient. Most people prefer using it on an empty stomach.

Can it be combined with B vitamins?
   Probably, if the dosages are low.

Mechanism of action
The most likely explanation for the modest effectiveness of arginine is its conversion into nitric oxide. Nitric oxide is converted into cGMP, which becomes the secondary messenger that causes smooth muscle relaxation, resulting in more blood going into the genital organs, which leads to erections. However, nitric oxide is metabolized quite rapidly, which may explain why taking it does not lead to consistent or prolonged erections.

Anemia associated with kidney disease
L-arginine administration reverses anemia associated with renal disease.
Int J Hematol. 2007.
We administered 1.3 grams a day of L-arginine to 8 elderly patients with anemia associated with renal disease. All 8 patients responded to the treatment with increases in hemoglobin levels. Six of the patients showed improved renal function. There were no significant arginine side effects. Our data show that oral administration significantly improves erythropoietin production and reverses anemia without adverse effects in elderly patients who have anemia associated with renal disease and are in the predialysis state of chronic renal failure.

Benefit in the elderly
Year-long changes in protein metabolism in elderly men and women supplemented with a nutrition cocktail of beta-hydroxy-beta-methylbutyrate (HMB), L-arginine, and L-lysine.
JPEN J Parenter Enteral Nutr. 2009.
To determine whether supplementation of an amino acid cocktail daily for 1 year could improve the age-associated changes in protein turnover and lean body mass in elderly people. Elderly women and men were recruited for a double-blinded controlled study. Study participants were randomly assigned to either an isonitrogenous control-supplement or a treatment-supplement (HMB / Arg / Lys) consisting of beta-hydroxy-beta-methylbutyrate, L-arginine, and L-lysine for the 1-year study. In subjects taking the HMB / Arg / Lys supplement, lean tissue increased over the year of study while in the control group, lean tissue did not change. Compared with control, HMB /Arg / Lysine increased body cell mass by 1.6% and lean mass (DXA) by 1.2%. Consumption of a simple amino acid-related cocktail increased protein turnover and lean tissue in elderly individuals in a year-long study.

Nitric oxide pathway and metabolism
Nitric oxide released by the inner layer of cells (endothelium) in the arteries relaxes these blood vessels, keeps them flexible, and improves blood flow. Nitric oxide (nitrogen monoxide) plays an important role in a wide range of bodily  processes. It dilates blood vessels, may reduce blood coagulation, helps dilate bronchi in the lungs, and relaxes the gastrointestinal system. Nitric oxide is formed from the enzyme nitric oxide synthase. Impaired nitric oxide bioactivity is associated with endothelial dysfunction and cardiovascular disease. As to the l arginine nitric oxide relationship, it is not fully clear at this time how effective a supplement would be in terms of sustained nitric oxide production and maintenance.

Diabetes, blood sugar
I heard that L-Arginine was not good for a diabetic to take. Is this true.
   We have no reason to believe that reasonable amounts of arginine would be harmful to a patient with diabetes. In fact, one study shows potential benefits.

Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients.
Am J Physiol Endocrinol Metab. 2006.
Because chronic L-arginine supplementation improves insulin sensitivity and endothelial function in nonobese type 2 diabetic patients, the aim of this study was to evaluate the effects of a long-term oral therapy on adipose fat mass (FM) and muscle free-fat mass (FFM) distribution, daily glucose levels, insulin sensitivity, endothelial function, oxidative stress, and adipokine release in obese type 2 diabetic patients with insulin resistance who were treated with a combined period of hypocaloric diet and exercise training. Thirty-three type 2 diabetic patients participated in a hypocaloric diet plus an exercise training program for 21 days. Furthermore, they were divided into two groups in randomized order: the first group was also treated with L-arginine (8 g/day), and the second group was treated with placebo. Although in the placebo group body weight, waist circumference, daily glucose profiles, fructosamine, insulin, and homeostasis model assessment index significantly decreased, L-arginine supplementation further decreased FM and waist circumference, preserving FFM, and improved mean daily glucose profiles and fructosamine. Moreover, change in area under the curve of cGMP, superoxide dismutase (index of antioxidant capacity), and adiponectin levels increased, whereas basal endothelin-1 levels and leptin-to-adiponectin ratio decreased. Long-term oral L-arginine treatment resulted in an additive effect compared with a diet and exercise training program alone on glucose metabolism and insulin sensitivity. Furthermore, it improved endothelial function, oxidative stress, and adipokine release in obese type 2 diabetic patients with insulin resistance.

Dialysis
I am a renal dietitian in CA. I have a lot of experience in alternative nutrition and especially with arginine supplementation for cardiovascular disease. I was wondering if you or another MD might have some experience with supplementation and dialysis patients?
   Not at this time.

Erectile dysfunction treatment
One of the more popular supplements for sexual dysfunction is L-arginine serving as a precursor for the making not only of proteins but also of nitric oxide, urea, glutamate, and creatine. What makes it special is that it can be metabolized to nitric oxide (NO). NO is the most powerful chemical known to dilate and engorge blood vessels in the penis and clitoris. However the benefits of NO production may be shortlived. We doubt this nutrient is of benefit in those with impotence, at least in the short term. There are better sexual herbs, such as tongkat ali supplement that are much more potent and effective.

Low doses at 500 mg three times a day have not been found to be effective.

Arginine has been studied in combination with other nutrients as a treatment for sexual dysfunction in women. A small trial found some improvement with a combination treatment providing a daily dose of 2,500 mg, as well as ginseng, ginkgo, and damiana. In a four-week, double-blind study, 77 women with decreased libido were given either the combination product or a placebo. Those taking the nutraceutical blend showed statistically greater improvement, reporting increased sexual desire in 71% of participants given the treatment. In the placebo group, 42% reported an increased libido. Other improvements included relative satisfaction with sex life and heightened clitoral sensation. No significant side effects were seen in either group. However, we don't know if the arginine had anything to do with the results.

A study done at the University of Texas at Austin examined the effects of arginine, combined with yohimbe, on sexual arousal in postmenopausal women. Twenty-four women participated in three sessions in which sexual responses to erotic stimuli were measured following treatment with either arginine glutamate (6 g) plus yohimbine (6 mg), yohimbine alone (6 mg), or a placebo, using a randomized, double-blind design. Sexual responses were measured at one hour after taking the supplements. Compared to the placebo, the combined oral administration substantially increased vaginal pulse amplitude responses to the erotic film. It is well known that yohimbine, alone, has a significant effect on sexuality and whether arginine was a factor is not known.

Epstein Barr virus
Can a supplement with L-Arginine and some Lysine raise Epstein Barr IgG levels? In my opinion the amino acid stimulates growth hormone, which, in research, can worsen the titers of the EBV virus. More research should be done on taking L-Arginine (or growth hormone), with contraindications for those with viruses. My Epstein Barr IgG level was 160: now it is 2000.
   We have not seen research regarding their influence on Epstein Barr IgG levels, so we don't know.

Heart health
Is l-arginine a better daily supplement for heart health than taking a 81 mg aspirin each day? The reason I as is because I also take garlic capsules and am concerned about possible bleeding side effects when garlic and aspirin are combined.
   In order to answer this question more accurately, a doctor has to review the whole medical history, do a medical exam, review lab results and evaluate a person's dietary history. Without knowing all this additional information it is not easy to make recommendations. For cardiac health, see heart disease info.

Herpes simplex
I am trying to take a vitamin and mineral supplement, and I get pain in my penis then herpes outbreaks. this amino acid is found in many foods, but only chicken and supplements with arginine seem to cause this problem. Will L-Lysine counteract this problem of pain and outbreaks, without negating the positive effect .
   We are not impressed with the effectiveness of lysine for herpes prevention or treatment and don't think arginine in food causes an outbreak.

Pre-eclampsia
Dietary supplementation with L-arginine or placebo in women with pre-eclampsia.
Staff AC.. Departments of Obstetrics and Gynecology, Ulleval University Hospital, Kirkeveien Oslo, Norway.
A randomized double-blind study was designed to compare the effect of L-arginine and placebo in pre-eclamptic women with gestational length ranging from 28+0 to 36+0 weeks. The women received orally 12 g of L-arginine or placebo daily for up to 5 days. Oral supplementation did not reduce mean diastolic blood pressure after 2 days of treatment compared with placebo in pre-eclamptic patients with gestational length varying from 28 to 36 weeks.

Thyroid gland
Can u take l-argine while on thyroxine or thyroid hormone medication?
    This amino acid is quite safe in dosages up to several grams, but it is not easy to predict any one person's reaction when combining supplements and medications.

L arginine side effects
No major arginine side effects have yet been reported with the short term use of this supplement. The benefits and risks of long term use are not fully known.  It is possible that one side effect of high dosage is nausea. Other possible adverse effects on very high dosages are digestive disturbances. It is not clear how safe it is if used in high dosages daily for many months or years.

I ordered l-arginine from a website called Blessed Nutritions. Most of the articles I have read say nothing but positives. I received my product today and i have consumed 30 grams throughout the day. The only side effects i have noticed from taking that much is diarrhea. I am an 18 year old male and i was interested at the idea that consuming enough arginine daily could stimulate the pituitary gland to release HGH.
   Long term human studies are not available to determine the safety in high doses. We don't see the need at your age to take it for hgh release. Exercise and deep sleep are your best options. It's possible high dose over prolonged periods may cause side effects that would make you regret taking it, but we can't be sure of this at this time.

I was reading information about the health benefits (blood pressure, cholesterol, sexual issues), and it says that you should be careful to purchase the right kind of  in order to avoid bad side effect. Can you please respond to the information in this quote. "Since the precursor to the neurotransmitter nitric oxide is L-arginine, a formula containing it can be effective as an alternative to Viagra, but the formula must be carefully designed not to increase or stimulate the production of free radicals and/or peroxynitrite. Do not rush out and buy plain L-arginine, because without the correct synergists and co-factors or an improperly prepared itcan cause reactivation of the herpes virus as well as the stimulation of peroxynitrate. Formulas containing free forms of both L-arginine and lysine are to be avoided. When shopping for an L-arginine nitric oxide formula, make sure the research behind the formula is valid and safe."
   It does not appear that the website you quote has reliable information. They say arginine can be an alternative to Viagra," which is not a true statement.

I have been taking for 3 months in progressively increasing doses with a current dose of 12 g (6g twice a day) daily and I am a little confused by the ascending reddening in my lower legs. I am a Caucasian-Hispanic male, 69 years old, with syndrome X (diabetes, hypertension, and dyslipedemia).
   We have not heard of a rash in the legs as a side effect of arginine therapy but it may be possible. It is advisable to have a doctor take a look at it.

Dosage
This supplement comes in capsules of 500 mg, 750 mg and 1,000 mg. You can also find it in powder. As with most nutrients, we recommend taking breaks from use. It appears to be safe to take for extended periods as long as the dose is less than 3 or 4 grams a day.

I have been getting Life Choice, L-Arginine free form, 1000 mgs., 90 vcaps, from my health food store for some time, but now they can not get it anymore. Is there any way I can order it directly from you?
    We only carry the 750 mg capsules and the powder form.

Blood test
A recent serum amino blood test of mine indicates that I have no detectable arginine level. I have the results for about 35 amino acids. Would these results interest you in your research? Also, I would really appreciate any documentation (or links or pointers to articles) that describe in more detail such a condition.
   Except in rare cases of amino acid abnormalities which are often detected in infancy or early childhood, we have not found blood tests of amino acids to be helpful in diagnosis or treatment in adults.

Cream applied on skin
Topical L-arginine cream improves blood flow and temperature in the feet of diabetics, but it is not yet clear if this leads to fewer foot ulcers or better healing of ulcers.

Arginine rich foods in the diet
These include nuts, fish and chocolate, however practically speaking, trying to lower intake in one's diet or trying to increase intake through food may not make much difference in the treatment of a medical condition.

Various forms and types
There are so many forms. In one magazine i came across ads for the following products: L-Arginine Alpha Keto Glutarate, L/DL-Malate, Base or Mono HCl. Which form is better?
   There are few human studies available with the various forms that it is very difficult to make any recommendations regarding the use of these supplements and to know which product is best to use. L Arginine pyroglutamate is the salt of pyroglutamic acid also known as arginine pidolate. It may have some cognition-enhancing property due to the pyroglutamate part.

Combining with citrulline
I received info about a Source Naturals product that has arginine and citrulline. It said: "L-Arginine is well known for its heart function and circulation support, along with muscle metabolism and energy. Now in combination with L-Citrulline, it forms a powerful supplement to support the generation of nitric oxide in supporting performance in many areas of life. " What do you think of the combination?
   It's hard to say when no studies are available with this combination.

I have been reading that L-arginine is good for cardio health, production of nitric oxide, circulation, etc. But I have also read articles about concerns: "I would add citrulline malate is a precursor to arginine in our bodies. Taking arginine directly will have a good effect, but it also leads to the creation of free radicals because it is added to the system and not created. Hence the body thinks that something is awry and tries to compensate. With citrulline malate, the body sees this is as normal, uses its natural hormonal system to create arginine in response to citrulline. Excess citrulline malate then also does something really cool; it scavenges free radicals and also removes ammonia from your system (ammonia being a by product of muscle building). If you do supp directly with arginine, it is probably a good idea to take some strong antioxidants to deal with the free radicals. I think alpha lipoic acid is the best."
   The statement you have sent us appears to be one's person's opinion and we have not seen actual research that validates this viewpoint.

Interactions with other supplements
Can l arginine and glutamine amino acids be taken together?
   We don't see any obvious side effects that would occur if glutamine was taken with it in low dosages.