Arginine: A Marvel or Quackery?

David Mendosa Health Guide
  • Anything that seems too good to be true almost always is. It’s hard for me to believe that taking anything can cure or prevent a huge number of conditions.

    That’s why I have kept changing my mind about arginine (also known as L-arginine). I have known about its powers for years. In 1998 a leading endocrinologist, Dr. Joe Prendergast, brought it to my attention for its ability to reverse the most common complication of diabetes, heart disease.

    Arginine is one of the 20 amino acids that make up proteins. It is the only amino acid that generates significant amounts of nitric oxide.

    It was in 1998 that three American pharmacologists won the Nobel Prize in Physiology or Medicine for their discoveries concerning “nitric oxide as a signalling molecule in the cardiovascular system”. Nitric oxide protects the heart, stimulates the brain, kills bacteria, and has a role in protecting our lungs, preventing cancer and reversing impotence.
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    Those are huge claims and not the claims of a quack. That is just part of what the Nobel Assembly at Karolinska Institutet, which awards the Nobel Prize in Physiology or Medicine, said in its press release.

    The claims of nitric oxide are, if anything, greater in a new book that I just finished reading. Again, the author is no quack. Louis J. Ignarro is one of the three pharmacologists who won the Nobel Prize for their work on nitric oxide. Since 1985 he has been a professor in the department of pharmacology at the UCLA School of Medicine.


    His book, NO More Heart Disease : How Nitric Oxide Can Prevent--Even Reverse--Heart Disease and Stroke came out last year. A paperback version just appeared.

    Dr. Ignarro says that among other things nitric oxide relaxes and enlarges the blood vessels, prevents blood clots that trigger strokes and heart attacks, and regulates blood pressure and the accumulation of plaque in the blood vessels. Low levels of nitric oxide are associated with several complications of diabetes, he says.

    Both Dr. Ignarro and Dr. Joe recommend that we take about 5 grams of arginine together with 200 to 1000 mg of another amino acid, L-citrulline, daily. The L-citrulline is supposed to boost the arginine.

    That’s a lot of pills. But that’s what I’m taking, although I will probably stop taking L-citrulline when my present supply runs out.

    I am feeling much better. But I made other changes in my life at the same time, particularly starting on Byetta so it’s hard to say why. And, of course, many of the benefits of arginine are hidden in my arteries.

    Each of these doctors sells a concoction of these amino acids together with antioxidants through separate multi-level marketers. There is no way that I would ever buy anything from an MLM, and if you are tempted, please read Dr. Stephen Barrett’s “The Mirage of Multilevel Marketing” and other related Quackwatch articles.

    Still, there is excellent scientific evidence for arginine There are two caveats. A recent study concluded that you shouldn’t use arginine after having an “acute myocardial infarction,” commonly known as a heart attack. And arginine supplements may be harmful for people with a tendency to develop oral or genital herpes.

  • On the other hand, there is little scientific evidence for L-citrulline. Dr. Ferid Murad says that except for L-citrulline, Dr. Ignarro’s blend of ingredients makes sense. Dr. Murad shared the 1998 Nobel Prize in Medicine with Dr. Ignarro and Robert Furchgott.

    Until now we have had little evidence showing that nitric oxide can directly benefit people with diabetes. But a technical study, “Nitric Oxide Cytoskeletal–Induced Alterations Reverse the Endothelial Progenitor Cell Migratory Defect Associated With Diabetes” just appeared in Diabetes.

    Just as Dr. Joe inspired me to take Byetta, he also inspired me to take arginine. He told me about it years ago. I took it for a while in the form of HeartBars, which unfortunately are no longer available.
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    Now, his new book, The Uncommon Doctor: Dr. Joe’s Rx for Managing Your Health reinspired me. The benefits to his patients are far too remarkable to ignore.

    “In 1991, 30 percent of my diabetic patients ended up seeing a cardiologist for bypass procedures,” he writes. “I started routinely recommending L-arginine. In just nine short years, less than 1 percent of my patients needed to see a cardiologist for any reason. Since 1991, my practice has not had one patient suffer from a heart attack or stroke.”

    As a journalist, I am naturally skeptical of big claims. But sometimes big claims are true. Anyone who is skeptical of everything will never learn anything. I think that arginine and nitric oxide are worth knowing about.

    Editors Note :

    This comment is from Dr. Joe Prendergast

    There are over 40,000 articles which are generally positive on the use of l-arginine to reverse arterial lining (endothelium) elasticity, atherosclerosis, homocysteine and viral damage. How did these authors come to opposite conclusions?

    · They started with smaller amounts of l-arginine, 3 gm rather
    than the 5 grams thought to be the therapeutic amount.
    · They reduced the 3 gm to lower amounts if the patients had “side
    effects” symptoms. They did not state who and how much.
    · The source of l-arginine is from a company whose product I do
    not know.

    Patient management had other curious notes.
    · Elasticity did not change on treatment. Most research note
    that this reflects insufficient l-arginine given to the patient.
    · Diabetes was “well controlled” – meaningless in the hands of
    cardiologists unless there are HbA1c etc. to prove control.
    · Plasma l-arginine changed to less on treatment – how little
    were they taking? At what times and how often was it decreased in those who died?

    This is cardiologists’ research. If treatment does not change elasticity/vascular stiffness like it did for all the references the authors quote shouldn’t investigators change the treatment to more l- arginine?
    · They quoted 6 articles in the introduction that said l-
    arginine improved vascular elasticity. Why not follow these articles’ protocol? This study set out to show endothelial integrity (effect on heart attack) not arterial elasticity.
  • · Why do a study that didn’t achieve the basic starting point
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    and then pronounce l-arginine is dangerous.
    · How long did the patients have diabetes? What were other co-
    morbid states? HbA1c values? What treatments were used for those with diabetes? How well were they controlled during the study? Were the cardiologists attentive to the diabetes care?
    · Were the cardiologists who reviewed this paper aware of the
    prior science of l-arginine?

    There are all sorts of bad science with “significant outcomes” that get published and quoted over the years even though the study design is seriously flawed. Put this publication on the list to join,
    · The University Group Diabetes Project – Diabetes – 1970 –
    don’t give all the Orinase in a maximum dose at one time.
    · The Effect of Monochromatic Infrared Energy on Sensation in
    Patients With Diabetic Peripheral Neuropathy. Diabetes Care 28:2896-2900, 2005 – don’t use subjective measurement of neuropathy when it can be quantitated with FDA approved testing.

    Dr. Joe, the Diabetes Doctor



Published On: March 16, 2006