Erectile Dysfunction (ED) : Supplements

The terms yohimbine , yohimbine hydrochloride , and yohimbe bark extract are related but not interchangeable. Yohimbine is an active chemical (indole alkaloid) found in the bark of the Pausinystalia yohimbe tree. Yohimbine hydrochloride is a standardized form of yohimbine that is available as a prescription drug in the United States, and has been shown in human studies to be effective in the treatment of male impotence. Yohimbine hydrochloride has also been used for the treatment of sexual side effects caused by some antidepressants (SSRIs), female hyposexual disorder, as a blood pressure boosting agent in autonomic failure, xerostomia, and as a probe for noradrenergic activity.

Yohimbe( Corynanthe yohimbe) is an herb derived from the bark of the yohimbe tree found primarily in the West African nations of Cameroon, Gabon, and Zaire. The major active constituent of the bark is yohimbine.

DHEA (dehydroepiandrosterone) is an endogenous hormone (made in the human body), and secreted by the adrenal gland. DHEA serves as precursor to male and female sex hormones (androgens and estrogens). DHEA levels in the body begin to decrease after age 30, and are reported to be low in some people with anorexia, end-stage kidney disease, type 2 diabetes (non-insulin dependent diabetes), AIDS, adrenal insufficiency, and in the critically ill. DHEA levels may also be depleted by a number of drugs, including insulin, corticosteroids, opiates, and danazol. There is sufficient evidence supporting the use of DHEA in the treatment of adrenal insufficiency, depression, induction of labor, and systemic lupus erythematosus. No studies on the long-term effects of DHEA have been conducted. DHEA can cause higher than normal levels of androgens and estrogens in the body, and theoretically may increase the risk of prostate, breast, ovarian, and other hormone-sensitive cancers. Therefore, it is not recommended for regular use without supervision by a licensed health professional.

DHEA is the acronym for dehydroepiandrosterone, a hormone produced naturally from cholesterol in the adrenal glands of males and females. It is a precursor to the male sex hormone testosterone.

L-arginine was first isolated in 1886. In 1932, L-arginine was found to be required for the generation of urea, which is necessary for the removal of toxic ammonia from the body. In 1939, L-arginine was also shown to be required for the synthesis of creatine. Creatine degrades to creatinine at a constant rate, and is cleared from the body by the kidney. Arginine is considered a semi-essential amino acid, because although it is normally synthesized in sufficient amounts by the body, supplementation is sometimes required (for example, due to inborn errors of urea synthesis, protein malnutrition, excess ammonia production, excessive lysine intake, burns, infection, peritoneal dialysis, rapid growth, or sepsis). Symptoms of arginine deficiency include poor wound healing, hair loss, skin rash, constipation, and fatty liver. Arginine is a precursor of nitric oxide, which causes blood vessel relaxation (vasodilation). Preliminary evidence suggests that arginine may be useful in the treatment of medical conditions that are improved by vasodilation, such as angina, atherosclerosis, coronary artery disease, erectile dysfunction, heart failure, intermittent claudication/peripheral vascular disease, and vascular headache. Arginine also stimulates protein synthesis and has been studied for wound healing, bodybuilding, enhancement of sperm production (spermatogenesis), and prevention of wasting in people with critical illness. Arginine hydrochloride contains high chloride content and has been used for the treatment of metabolic alkalosis. This use should be under the supervision of a qualified healthcare professional. Most people likely do not need to take arginine supplements because the body usually makes sufficient amounts.

Arginine is one of the amino acids produced in the human body by the digestion, or hydrolysis of proteins. Arginine can also be produced synthetically.

Pycnogenol® is the patented trade name for a water extract of the bark of the French maritime pine ( Pinus pinaster ssp. atlantica ), which is grown in coastal south-west France. Pycnogenol® contains oligomeric proanthocyanidins (OPCs) as well as several other bioflavonoids: catechin, epicatechin, phenolic fruit acids (such as ferulic acid and caffeic acid), and taxifolin. Procyanidins are oligometric catechins found at high concentrations in red wine, grapes, cocoa, cranberries, apples, and some supplements such as Pycnogenol®. There has been some confusion in the U.S. market regarding OPC products containing Pycnogenol® or grape seed extract (GSE), because one of the generic terms for chemical constituents ("pycnogenols") is the same as the patented trade name (Pycnogenol®). Some GSE products were formerly erroneously labeled and marketed in the U.S. as containing "pycnogenols." Although GSE and Pycnogenol® do contain similar chemical constituents (primarily in the OPC fraction), the chemical, pharmacological, and clinical literature on the two products is distinct. The term Pycnogenol® should therefore only be used to refer to this specific proprietary pine bark extract. Scientific literature regarding this product should not be referenced as a basis for the safety or effectiveness of GSE.

Pine bark extract is made from the bark of a European coastal pine tree called the Landes or maritime pine, whose scientific name is Pinus maritima. The maritime pine is a member of the Pineaceae family.

Coleus forskohlii is a perennial plant, with a strong, camphor-like odor. It is in the mint family.

Coleus species have been used in the Asian traditional medicine to treat angina (chest pain), asthma, bronchitis, epilepsy, insomnia, painful urination, skin rashes, and a wide range of digestive problems. Since the 1970s, research was predominantly concentrated on forskolin, a root extract of Coleus forskohlii . Preliminary study suggests that forskolin may have clinical use in treating cardiovascular dilatation and bronchodilation, and reducing intra-ocular pressure. Although most studies have used the isolated forskolin extract, it is believed that the whole coleus plant may be more effective, due to the presence of multiple compounds that may act synergistically. Generally, coleus appears to be well tolerated with few adverse effects.

The main function of L-carnitine is to transfer long-chain fatty acids in the form of their acyl-carnitine esters across the inner mitochondrial membrane before beta-oxidation. In humans, it is synthesized in the liver, kidney, and brain and actively transported to other areas of the body. For example, 98% of the total body L-carnitine is confined to the skeletal and cardiac muscle at concentrations approximately 70 times higher than in the blood serum. Supplementation may be necessary in rare cases of primary carnitine deficiency, which may be caused by a defect in carnitine biosynthesis, a defect in carnitine active transport into tissue, or a defect in renal (kidney) conservation of carnitine. Known conditions of secondary deficiency of carnitine (insufficiency), in which L-carnitine is effective, include chronic stable angina and intermittent claudication characterized by distinct tissue hypoxia (low oxygen levels). Another condition that may benefit from carnitine supplementation is decreased sperm motility. Although use in preterm infants suggests carnitine supplementation may aid in maintaining or increasing plasma carnitine levels and possibly weight gain, carnitine is not routinely added to preterm total parenteral nutrition (TPN). However, soy-based infant formulas are fortified with carnitine to levels found in breast milk. In 1986, the U.S. Food and Drug Administration (FDA) approved L-carnitine for use in primary carnitine deficiency. D-carnitine or DL-carnitine may cause secondary L-carnitine deficiency and should not be used.

Amino acid derivative; naturally occurring substance required in mammalian energy metabolism.

Carnitine is an amino acid that is essential for babies and nonessential for others. In this context, essential means it must be obtained in the diet.