Arginine

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Latest Edit: Iva Lloyd, ND 2021-08-24 (EDT)

See Also Amino Acids


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Arginine is considered a semi-essential amino acid. It is essential for children and for those with rare genetic conditions which prevent its synthesis. Some conditions of stress increase one's need for arginine such as trauma, sepsis, and burns; arginine becomes essential under these conditions.[1]. . Arginine has antiatherogenic, antioxidant, and immunomodulatory action.[1]

Food Sources

  • Best Sources: meat (especially lamb), peanuts, soybeans, hazelnuts, shrimp, eggs, and milk products
  • Other Significant Sources: almonds, cashews, Brazil nuts, filberts, pecans, sesame and sunflower seeds, walnuts, raisins, coconut, chicken, brown rice, barley, buckwheat, corn, and oats

Uses

The following is a list of the primary uses for arginine [2].

  • Cardiovascular Disease (CVD): Arginine functions to dilate blood vessels by increasing the production of an important vasodilator called nitric oxide (NO). Many clinical trials have shown improvements in blood flow through the arteries, increased quality of life, and increased ability to exercise with supplementation with arginine for the treatment of angina. Other studies have shown positive results when treating hypertension and congestive heart failure.[3]
  • Erectile Dysfunction: The pathogenesis of erectile dysfunction (ED) is complex and multifactorial. One factor which may contribute to ED is an issue with penile endothelial arginine. A number of studies have shown benefit with arginine in terms of decreased time to get an erection and increased duration of erection.
  • Male Infertility: Some trials have shown benefit in terms of increased sperm count and motility leading to more successful pregnancies.
  • Athletic Performance: In some individuals, Arginine has an anabolic effect, specifically it increases growth hormone and tissue growth. In this way, it can increase lean muscle mass and decrease body fat, thus increasing one's athletic performance.
  • Other Conditions: diabetes, burn injuries, compromised immune function in cancer patients, gastritis, ulcers, GERD, interstitial cystitis, and catabolic conditions
  • Detoxification of Ammonia: More specifically, it is involved in detoxification of ammonia which is formed during nitrogen catabolism of amino acids; it's a precursor for many compounds such as nitric oxide and creatine; it is a glycogenic amino acid meaning it can be converted to glucose and glycogen for energy; it stimulates the release of growth hormone (GH), prolactin, insulin, and glucagon at high doses [1]. The arginine available for these processes comes mostly from food but can also be synthesized by the body from glutamine and proline. [2]

Excess Symptoms

Arginine excess can occur due to a diet high in arginine foods or due to supplementation. An excess of arginine can contribute to or cause the following symptoms and/or conditions:

Deficiency Symptoms

Arginine deficiency is rare and is usually part of a larger picture of overall protein malnutrition or decreased health status, elevated physical stress, excessive ammonia production, or enzyme deficiency. Signs and symptoms may include [4]:

Prescribing Considerations

  • L-arginine is available in tablet, capsule, and powder form as L-arginine hydrochloride and free base L-arginine. It is also available in medical foods as an aid in the enhancement of immune function.[1]
  • An RDA has not been established for Arginine. To determine what your specific requirements are talk to your naturopathic doctor or other trained medical professional.

Safety

  • General Adverse Effects: mild gastrointestinal distress, headache; excessive doses may cause diarrhea; rapid IV infusion may cause flushing.
  • Adults: Dosages of 1-6g/day are generally well tolerated by adults. Adverse effects only occur in about 1-10% of patients. More severe reactions occur after IV administration.
  • Adverse effects in specific populations: gastritis, reflux esophagitis, or peptic ulcer disease (arginine supplementation may cause exacerbations); hepatic disease and kidney problems (hyperphosphatemia can be induced)
  • Precautions: renal or liver disease; diabetes type II (regular monitoring of blood glucose levels is appropriate)
  • Contraindications: herpes infections or history of herpes (can potentially cause an outbreak or replication of the virus); post-acute myocardial infarction (except under medical supervision); hepatic or renal failure (except under medical supervision); hypersensitivity to arginine.

Drug Interactions

The following are the drug interactions associated with arginine:[4]

Supportive or Beneficial:
  • Cyclosporine - Arginine may reduce drug-induced adverse effects such as vascular dysfunction and nephrotoxicity. Close supervision.
  • Sildenafil and Related Phosphodiesterase-5 Inhibitors - Nitric oxide (NO) enables therapeutic action of drug, which may be enhanced by arginine intake (arginine is a precursor to NO).
  • Theophylline/Aminophylline - Preliminary evidence indicates that theophylline or aminophylline could theoretically create a beneficially additive or synergistic effect by reducing arginase activity and increasing arginine's availability to be converted to NO.

References

  1. 1.0 1.1 1.2 1.3 Hendler Sheldon S., Rorvik David (Editors) (2008) PDR for Nutritional Supplements, Medical Economics Company Inc.
  2. 2.0 2.1 Hoffer Abram, Prousky Jonathan (2008) Principles and Practices of Naturopathic Clinical Nutrition, CCNM Press
  3. Miller Alan (2006) The Effects of a Sustained-Release L-Arginine Formulation on Blood Pressure and Vascular Compliance in 29 Healthy Individuals. Alternative Medicine Review;11(1):23-29.
  4. 4.0 4.1 Stargrove Mitchell Bebell, Treasure Jonathan, McKee Dwight L (2008) Herb, Nutrient, and Drug Interactions, Clinical Implications and Therapeutic Strategies. Mosby