L Arginine L citrine these guys are touted as huge nitric oxide boosters so do they actually help improve erections I'm Dr Reena Malik urologist and pelvic Sur and in today's video we're going to review the science behind both L arine and El citrine and which one you should consider taking for erectile dysfunction so let's talk about individual ingredients I'm going to start with L Arginine L arginine is important because it is converted in the body to that chemical we talked about nitric oxide which is the ignition for erections so when you take the LR genine it increases the availability of nitric oxide as well as the cgmp which leads to improved erectile function it then causes the blood vessels to open wider and increase blood flow and interestingly nitric oxide production is decreased and people who have injuries of those blood vessel cells or the vascular endothelium lining and this is often caused by things like diabetes heart disease or atherosclerosis and we find that people who have low levels of L Arginine or L citrine which we're going to talk about later have actually higher rates of erectile dysfunction so L Arginine has actually been pretty extensively studied there's been a metaanalysis of 10 randomized control trials looking at L Arginine and they looked at a daily dose ranging from anywhere from 2.8 to 8 gram in men who have mild to moderate Ed and they saw that it improved erectile function compared to Placebo in a more recent randomized double blind Placebo controlled trial they wanted to specify what happens if you have mild to moderate versus severe Ed so these guys took high doses of lrene for 3 months compared to Placebo and they took six G divided up over the course of the day three times a day with meals so they had 51 men who got the treatment versus 4 7 in the placebo group so at 90 days they saw again significant improvements in what we call the iie now this is going to come up in a lot of the studies the iie is the most commonly used questionnaire to assess erectile function now it's been validated which means that the score on this survey correlates with men's erectile function and so this is sort of the gold stand use most commonly across all these research studies so it saw improvements in these scores but it also saw improvements in Peak systolic velocity which is a measure of how quickly blood flows into the penis in fact 24% of men who had no Ed after they start started taking the supplement and those were usually men who had mild to moderate Ed adverse effects were pretty low meaning side effects so headache itching and insomnia and sometimes they had GI issues so when reviewing this data it seems that you need at least 5 G A Day 6 G is is probably the best if you have abnormal nitric oxide metabolism meaning that you have cardiovascular disease diabetes those sorts of things you may see the most benefit in terms of taking something like this now a couple cautions if you have allergies or asthma it actually can exacerbate your symptoms so you want to avoid using this or use it carefully it can also cause liver dysfunction and low blood pressure and might interact with other medications that you use for high blood pressure now the big issue with L argine is that it has poor bioavailability meaning that you got to take it at least three times a day for it to work because your body breaks it down pretty quickly however this brings us to our next supplement which is L citrine so L citruline is more bioavailable and it's converted into Arginine in the kidneys in fact oral citruline is better than oral Arginine at increasing blood levels of arginine itself and it results in a more more sustained release of L Arginine and avoids the enzymes that are in the intestines and the liver and there may be some data that El citrine encourages penal muscles to release what's called vegf or vascular endothel growth factor which improves blood vessel function and may restore healthy blood vessel function in the penis there's not as much robust data on El cetrine but in 2011 they recruited 24 adults with again mild to moderate what they called reduction of P fale rigidity they could penetrate but it wasn't satisfactory so these are not guys who are having trouble getting an erection they just have a weak erection and they assess their erectile hardness after taking 1 and2 gram of el citrine divided into two doses for a month and they were actually their own control so for the first month they would take a placebo and then they would take El citrine and they found that in the men who took El citrine they saw an improvement about half of them in their erectile hardness score from 3 to 4 however 2% in the placebo group saw the same change so it seems like Elsa Chine could work again for men who have mild erectile dysfunction now the good news is Eline again is relatively safe and has few side effects hope you guys enjoyed this episode if you did make sure to subscribe and share this Channel with your friends and as always you're going to take care of yourself because you're worth it