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It goes without saying that the average American diet is deficient in a number of crucial vitamins and minerals necessary for optimum health.
It is invariably too high in processed foods, carbs and sweets, while lacking in lean proteins, leafy vegetables, and fresh fruits. Even some of your patients who are diligent about eating a healthy diet may still be deficient in certain key nutrients, particularly if they have certain health issues. For patients whose nutritional needs cannot be met just from food sources, vitamins and supplements often provide a viable means to provide adequate nutrition.
L-arginine and L-citrulline are two amino acids that work in conjunction to help build protein, which is required for a number of basic body functions, from digestion to building muscle. They are classified as conditionally essential nutrients because it may be difficult for people to obtain adequate levels to gain any benefits. L-arginine and L-citrulline are particularly interesting, in terms of their ability to positively affect the body’s cardiovascular system by increasing nitric oxide levels. This process can provide any number of health benefits for your patients. Let’s take a look at some of the ways in which L-arginine and L-citrulline supplements can improve your patients’ cardiac health, as well as a number of other conditions related to the peripheral circulatory system.
How do L-arginine and L-citrulline improve cardiac health and circulation?
Before getting into the research behind the benefits of L-arginine and L-citrulline, let’s first look at how these amino acids actually work. As mentioned previously, they work in conjunction to increase levels of nitric oxide, which helps dilate the blood vessels, thus improving circulation.1 The body converts L-citrulline into L-arginine, which then stimulates nitric oxide production in the cardiovascular system. Improved circulation both helps to lower blood pressure and contribute to cardiac health. Furthermore, increased nitric oxide levels may also improve vasodilation further downstream in the smaller vessels and capillaries of the peripheral circulatory system, leading to improvement in a number of conditions, including neuropathic pain and erectile dysfumction.1
Natural sources of L-arginine and L-citrulline
As mentioned previously, both L-arginine and L-citrulline can be found in a number of food sources, most often animal proteins. Common food sources include:1
- red meat
- chicken or turkey breast
- pork loin
- dairy products
Lentils, chickpeas, and soybeans are all excellent plant-based sources of L-arginine and L-citrulline. However, you should discuss any change in diet with your vegetarian or vegan patients to be certain they will be consuming adequate levels of protein.
Blood pressure and cardiac health
Blood pressure: Small sample sizes were one major drawback of many early studies of L-arginine and L-citrulline. A 2016 article in the Journal of Chiropractic Medicine attempted to overcome this by performing a meta-analysis study to determine their effectiveness in treating hypertension.2 This type of study pools together results from smaller studies to look for patterns of similarity, in the hopes of increasing their individual strength. In the case of this article, the researchers found that the combined findings showed significantly positive benefits from L-arginine supplementation for reducing both systolic and diastolic blood pressure in hypertensive adults.2
Cardiac health: Another 2016 article in Nutrition & Metabolism examined the effect of plant-based L-arginine intake on blood pressure and incidence of coronary heart disease.3 A group of 2,284 adults who were part of a large lipid and glucose study were followed over the course of almost five years to evaluate changes in serum lipids and blood pressure. At the end of the study period, the researchers found a significant negative association between plant-based L-arginine intake and systolic/diastolic blood pressure and coronary heart disease. Interestingly, those subjects who took animal-derived L-arginine showed the exact opposite for both blood pressure and coronary heart disease.3
Neuropathy is a common circulatory complication from diabetes. It often occurs in the legs and feet, and manifests as spontaneous, sharp pain and extreme sensitivity to touch and heat. A 2018 article in the European Journal of Nutrition examined the potential effect of L-arginine supplementation on symptoms of induced neuropathy in rats with induced type 1 diabetes.4 Although L-arginine supplementation did not affect the symptoms of diabetes, it did normalize nitric oxide levels, thereby reducing some of the symptoms of neuropathy, particularly sensitivity to touch and heat.4
Any way you look at it, that “little blue pill” known as Viagra is a runaway financial success. In 2016 alone, it brought in approximately $1.6 billion in global sales. Viagra stops the phosphodiesterase type 5 (PDE5) enzyme from restricting vascular blood flow in the penis, thereby allowing for an erection. However, PDE5 inhibitors may also have the same effect on the cardiopulmonary system, so Viagra has a number of warnings, particularly for people with a history of stroke, high blood pressure, or cardiac issues.
A 2019 article in the Journal of Sexual Medicine conducted a meta-analysis to determine if L-arginine supplements could offer a possible alternative to Viagra and other PDE5 inhibitors for treating erectile dysfunction.5 In looking at outcomes from 540 patients with mild or moderate erectile dysfunction, L-arginine supplements ranging from 1500 mg to 5000 mg significantly improved a number of symptoms, including overall satisfaction, intercourse satisfaction, orgasmic function, and erectile function.5
The important take-home message from this recent interest in L-arginine and L-citrulline is that you should pay attention not only to your patients’ diet, but how their health issues may affect it. They may be dangerously low on certain conditionally essential nutrients such as L-arginine and L-citrulline. Fortunately, diet counseling and supplementation can offer an easy way to help them get their diet back in proper balance.
About Fenix Nutrition
Since 2010, Fenix Nutrition has been providing the highest quality L-Arginine/L-Citrulline product on the market to healthcare professionals and wholesale partners, successfully bringing a wide variety of benefits to their patients.
Products are created in a GMP certified facility, which received its certification through the NSF (The highest quality certification you can receive). Fenix products are formulated under the guidance of highly qualified chemists, nutritionists and researchers. Ingredients used in L-Arginine Complete have clinical trials backing their effectiveness.
- What are the health benefits of supplementing with the amino acid l-arginine? The American Chiropractor.
- McRae MP. Therapeutic benefits of l-arginine: An umbrella review of meta-analyses. Journal of Chiropractic Medicine. 2016;15(3):184-189.
- Bahadoran Z, Mirmiran P, Tahmasebinejad Z, Azizi F. Dietary L-arginine intake and the incidence of coronary heart disease: Tehran lipid and glucose study. Nutrition & Metabolism (London). 2016;13:23.
- Rondón LJ, Farges MC, Davin N, et al. L-Arginine supplementation prevents allodynia and hyperalgesia in painful diabetic neuropathic rats by normalizing plasma nitric oxide concentration and increasing plasma agmatine concentration. European Journal of Nutrition. 2018;57(7):2353-2363.
- Rhim HC, Kim MS, Park YJ, et al. The potential role of arginine supplements on erectile dysfunction: A systemic review and meta-analysis. Journal of Sexual Medicine. 2019;16(2):223-234.
About the Author
Tina Beychok is an editor and writer with expertise in technical, academic and scientific materials. She is a regular contributor to Chiropractic Economics and resides in Long Beach, Calif. Her online portfolio can be viewed at thatwordgrrl.com, and she can be contacted at firstname.lastname@example.org.