Volume 11, Issue 74 September 8, 2014
Why taking l-arginine for heart
disease and diabetes helps some
people, but not others
If you have diabetes, cardiovascular disease, hypertension, metabolic syndrome, or erectile dysfunction, you might be getting some conflicting news about treating it. You see, studies have shown that many people with these disorders can find help by taking the amino acid l-arginine. But here's the problem. Not all of them will benefit. For some it will be a waste of time. So how can you tell if you would benefit? A new paper is helping to show the way.

The reason that l-arginine can work so well in these diseases is that the body uses it to make nitric oxide. You have heard me talk about nitric oxide many times. It is incredibly important for almost every function of the body including cardiovascular function, immunity, sexual function, and nervous system and brain function. And a lot of people don't make enough. But why? The reason is probably due to how much asymmetric dimethylarginine they make. Here's how it works.

Your body converts l-arginine to nitric oxide by using the enzyme nitric oxide synthase, or NOS for short. The average adult eats about five grams of l-arginine a day, which should be enough. So as long as they have enough NOS around, they should be able to make all the nitric oxide they need. But there is another molecule that can also use NOS. You guessed it. It's asymmetric dimethylarginine, or ADMA for short.

Your body produces ADMA naturally. It is a byproduct of protein metabolism. But there's a problem with it. When there is too much of it, it uses up NOS. And that means that there is not enough of the NOS to interact with l-arginine to produce nitric oxide. This interference is referred to as competitive inhibition. And the result is lower levels of nitric oxide and all the problems that come with that. So that's why ADMA levels are so important.

When your ADMA levels are low, you won't have increased nitric oxide levels from taking l-arginine because there is already plenty of NOS. Taking more l-arginine will not help. But if your ADMA levels are elevated, that's when you can benefit. You can benefit because the increased levels of l-arginine from the supplement will outweigh the competition of ADMA for NOS. And the result will be an increased production of nitric oxide. So what is your level of ADMA?

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You can find out by measuring ADMA in the blood. The lab I use is Metametrix lab. Your doctor can obtain the specimen collections kits by contacting Metametrix at www.metametrix.com. Metametrix does a great job. They will measure your ADMA, as well as your l-arginine levels. Then they will give you the ratio. If your l-arginine to ADMA ratio is less than 115, you will benefit from taking l-arginine as a supplement. If it is up around 200, you probably won't.

A typical starting dose of l-arginine depends on how low the l-arginine/ADMA ratio is. If it is below 115, I would start with 5 grams of l-arginine (about 1 heaping tsp of powder) in water when you first wake up and before bed. If the ratio is higher, you might do well with half that dose. How do you know when you are taking enough? Just recheck the ratio and get it up around 200. Some clinical studies have used as much as 20 grams of l-arginine per day. But this is probably not needed especially if measures are taken to reduce ADMA levels at the same time.

ADMA levels go up because of inflammation, lack of adequately vigorous exercise, and a diet low in antioxidants. So besides taking the l-arginine supplement, make sure that you reduce your inflammation, tighten up on your diet with a lot of vegetables (especially the leafy green ones), and get in great cardiovascular condition. And even if you don't have diabetes, cardiovascular disease, hypertension, metabolic syndrome, or erectile dysfunction, but they run high in your family, it might be a good idea to check your ratio just in case.

Yours for better health,

Böger RH. The pharmacodynamics of L-arginine. Altern Ther Health Med. 2014 May-Jun;20(3):48-54.

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