Arginine has been found in double-blind studies to help angina, burn patients, congestive heart failure, enterocolitis in premature infants, female sexual arousal, muscle strength in the elderly, peripheral vascular disease, and weight loss in AIDS.  Most of these have only a single study and need replication and a couple studies have included other supplements so it is not certain that arginine was a necessary factor. 

L-arginine is available at health food stores and still cheaper on the internet.  The cost runs about 15 cents a gram.  Thus, for the amounts mentioned below, the arginine might cost $20-$60 per month plus more if other amino acids are used as well.  Thus, while it does seem to help some conditions, it is not cheap.  

On the internet, arginine is sold for sexual enhancement and stronger erections as well as heart disease, impotence, wound healing, and fighting cancer instead of what is available in published research noted on this page.  I haven't seen studies on any of these indications except heart attack where it's benefit, if any, was slight.  It certainly seems highly irresponsible to be promoting it for fighting cancer or heart disease where there are numerous proven treatments available.

Angina: L-Arginine Helps Nitroglycerin Therapy: The effect of supplemental L-arginine on tolerance development during continuous transdermal nitroglycerin therapy. Parker JO, Parker JD, Caldwell RW, Farrell B, Kaesemeyer WH. J Am Coll Cardiol. 2002 Apr 3;39(7):1199-203;Also, Randomized trial of a medical food for the dietary management of chronic, stable angina. Maxwell AJ, Zapien MP, Pearce GL, MacCallum G, Stone PH. J Am Coll Cardiol. 2002 Jan 2;39(1):37-45.

Athletes: Arginine Didn’t Helps Athletes: no obvious metabolic benefit derived from the chronic supplementation with arginine aspartate. And since furthermore the consequences of a reduction of the total plasma amino acid level are not known, the practice of using single amino acid supplements as potential ergogenics should be critically reevaluated. Chronic arginine aspartate supplementation in runners reduces total plasma amino acid level at rest and during a marathon run. Colombani PC, Bitzi R, et al. Eur J Nutr. 1999 Dec;38(6):263-70

Athlete: Arginine No Help Marathoners: Chronic arginine aspartate supplementation in runners reduces total plasma amino acid level at rest and during a marathon run. Colombani PC, Bitzi R, Frey-Rindova P, Frey W, Arnold M, Langhans W, Wenk C. Eur J Nutr. 1999 Dec;38(6):263-70

Bone Loss: L-Arginine, the Natural Precursor of NO, Is Not Effective for Preventing Bone Loss in Postmenopausal Women. Baecker N, Boese A, Schoenau E, et al. Cologne, Germany. J Bone Miner Res. 2005 Mar;20(3):471-9.

Burns: L-Arginine Helped in Burn Patients:

Congestive Heart Failure: L-Arginine Helps Exercise in Heart Failure: L-arginine, a precursor of nitric oxide (NO), may improve endothelium- dependent vasodilatation and exercise capacity. In a DB PC cross-over study of 21 patients with stable NYHA II-III congestive heart failure, L-arginine (9 g/day for 7 days) resulted in a higher prolongation of exercise duration time than placebo (99 vs. 70 seconds, p<0.05). L-arginine supplementation prolongs duration of exercise in congestive heart failure. Bednarz B, Jaxa-Chamiec T, Gebalska J, Herbaczynska-Cedro K, Ceremuzynski L. Warsaw, Poland. Kardiol Pol. 2004 Apr;60(4):348-53

Cystic Fibrosis: Nebulized Arginine Helped: Nitric oxide formation is deficient in airways of patients with cystic fibrosis. Since nitric oxide has bronchodilatory effects, nitric oxide deficiency may contribute to airway obstruction in cystic fibrosis. Inhalation of L-arginine, the precursor of enzymatic nitric oxide formation, increased exhaled nitric oxide concentrations and resulted in a sustained improvement of FEV1 in cystic fibrosis patients. Oxygen saturation also increased significantly after the inhalation of L-arginine. Inhaled L-arginine Improves Exhaled Nitric Oxide and Pulmonary Function in Cystic Fibrosis Patients. Grasemann H, et al. University of Duisburg-Essen, Germany. Am J Resp Crit Care Med 2006 Apr 20.

Diabetes Foot Circulation Helped by L-Arginine: In a DB crossover study of 16 diabetics, a particular topical L-ariginine cream improved circulation by 34% and the average food temperature by 6 degrees, both major accomplishments. L-arginine, an amino acid classified as a dietary supplement, is the biochemical precursor of nitric oxide, which controls local blood flow by relaxing endothelial smooth muscle. In diabetes, L-arginine levels are reduced while levels of asymmetric dimethylarginine, an inhibitor of the enzyme that converts L-arginine to nitric oxide, are elevated. Eric T. Fossel, Wellesley, Massachusetts, Diabetes Care. 2004;27:284-285. The manufacturer did the study.

Elderly Muscles: HMB-Lysine-Arginine Helped Elderly Muscles and Strength: In a 12-week DB PC study of 50 women (mean 76.7 y) of 2 g beta-hydroxy-beta-methylbutyrate, 5 g arginine, and 1.5 g lysine daily or placebo, there was a 17% improvement in the "get-up-and-go" functionality test in the experimental group but no change in the placebo group (P = 0.002). The improvement in functionality also was reflected by increased limb circumference, leg strength, and handgrip strength (all P < 0.05) and positive trends in fat-free mass (P = 0.08). Whole-body protein synthesis, estimated with the (15)N-glycine tracer technique over a 24-h free-living period, increased approximately 20% in the experimental treatment group as opposed to the placebo group (P = 0.03). Effect of beta-hydroxy-beta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Flakoll P, Sharp R, et al. Iowa. Nutrition. 2004 May;20(5):445-51

Female Sex Arousal: L-Arginine Herbal Combo Helps: DB PC with 73% vs. 37% improved with increase sex, decreased dryness, increased orgasm. A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function. Ito TY, Trant AS, Polan ML. U Hawaii. J Sex Marital Ther. 2001 Oct-Dec;27(5):541-9

Heart: L-Arginine May Increase Death Rate After Heart Attack: In a DB PC 6-month study of 153 patients following a first ST-segment elevation myocardial infarction, L-arginine (goal dose of 3 g 3 times a day) had 8.6% die vs none in the placebo group (P = .01). L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial. Schulman SP, et al. Johns Hopkins. . JAMA 2006 Jan 4;295(1):58-64.

Heart: L-Arginine Might Help Heart Attacks a Little: L-arginine is a substrate for nitric oxide synthesis in vascular endothelial cells, NO bioavailability is decreased during myocardial infarction (MI). In a 30-day DB PC study of 792 patients with heart attacks within 24 hours, oral L-arginine (3.0 g t.i.d for 30 days) had a composite of 30 day cardiovascular death, reinfarction, successful resuscitation, shock/pulmonary edema or recurrent myocardial ischemia in 24% patients treated with L-arginine and 27% with placebo (OR 0.63, p=0.06). The end point was observed less frequently in 226 patients with hyperlipidemia (19 vs 31, p<0.05). No serious adverse effects were observed during L-arginine supplementation. Efficacy and safety of oral l-arginine in acute myocardial infarction. Results of multicenter, randomized, double-blind, placebo-controlled ARAMI pilot trial. Bednarz B, Jaxa-Chamiec T, et al. Grochowski Hospital, Warsaw. Kardiol Pol. 2005 May;62(5):421-427.

HIV Weight Loss: L-Arginine + Glutamine +HMB Help: 3 g HMB, 14 g L-glutamine, and 14 g L-arginine given in two divided doses daily for 8 weeks, 68 patients DB PC. Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study. Clark RH, Feleke G, Din M, Yasmin T, Singh G, Khan FA, Rathmacher JA. JPEN J Parenter Enteral Nutr. 2000 May-Jun;24(3):133-9

Hypertension: Some Benefit: Vascular endothelial function is crucial to cardiovascular function. A number of substances are produced and secreted by vascular endothelial cells, the most important of which is nitric oxide, a potent regulator of vascular function. Nitric oxide diffuses from endothelial cells into underlying smooth muscle, causing relaxation, which results in vasodilation. Such endothelial dysfunction also causes increased platelet and monocyte adhesiveness and smooth muscle proliferation, processes thought to be at the genesis of atherosclerotic plaque formation. Since L-arginine is the body's only substrate for nitric oxide synthesis, adequate L-arginine must be present for proper nitric oxide production. In an open label trial, 29 asymptomatic individuals were given L-arginine (1,050 mg) twice daily for one week. Systolic blood pressure was reduced in 62%, with a non-significant mean decrease of 4 mm Hg. Diastolic was reduced in 69% by 3.7 mm Hg (p = 0.005). In the 10 individuals who were borderline or hypertensive (systolic > 130 or diastolic > 85), there was a mean systolic reduction of 11 mm Hg (p = 0.05), while normotensives (n = 19) had a mean systolic decrease of only 0.22 mm Hg. There was a significant increase in large artery compliance (mean 23% improvement; p = 0.02) and a non-significant increase in small artery compliance (mean 23% improvement; p = 0.15). The effects of sustained-release-L-arginine formulation on blood pressure and vascular compliance in 29 healthy individuals. Miller AL. Dover, ID. . Altern Med Rev 2006 Mar;11(1):23-9.

Hypertension: No Benefit in Pre-eclampsia: Obstet Gyn 2006 Apr;107(4):886-95.

Kidney Failure: L-Arginine Not Help in Chronic Renal Failure: Oral L-arginine does not improve endothelial dysfunction in children with chronic renal failure. Bennett-Richards KJ, Kattenhorn M, Donald AE, Oakley GR, Varghese Z, Bruckdorfer KR, Deanfield JE, Rees L. Kidney Int. 2002 Oct;62(4):1372-8; Study with adults with same finding.

Peripheral Arterial Occlusive Disease: L-Arginine Helps: 27 hyperhomocyst & PAOD patients assigned to oral treatment with combined B vitamins (folate, 10 mg; vitamin B-12, 200 microg; vitamin B-6, 20 mg/day), L-arginine (24 g/day) or placebo, for 8 weeks in a double-blind fashion. Vitamin B supplementation significantly lowered plasma homocyst(e)ine concentration from 15.8+/-1.8 to 8.7+/-1.1 micromol/l (P<0.01). However, B vitamins had no significant effect on FDD (baseline, 7.8+/-0.7%, B vitamins, 8.3+/-0.9%, placebo 8.9+/-0.7%; P=n.s.). In contrast, L-arginine treatment did not affect homocyst(e)ine levels, but significantly improved FDD. ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocyst(e)inemia: effects of L-arginine and B vitamins. Sydow K, Schwedhelm E, Arakawa N, Bode-Boger SM, Tsikas D, Hornig B, Frolich JC, Boger RH. Cardiovasc Res. 2003 Jan;57(1):244-52; However, ACE Inhibitor may achieve similar results at lower cost: (Long-term angiotensin-converting enzyme inhibition reduces plasma asymmetric dimethylarginine and improves endothelial nitric oxide bioavailability and coronary microvascular function in patients with syndrome X. Chen JW, Hsu NW, Wu TC, Lin SJ, Chang MS. Am J Cardiol. 2002 Nov 1;90(9):974-82

Premee Enterocolitis: L-Arginine Helps: DB PC 156 premees. Arginine supplementation prevents necrotizing enterocolitis in the premature infant. Amin HJ, Zamora SA, McMillan DD, Fick GH, Butzner JD, Parsons HG, Scott RB. J Pediatr. 2002 Apr;140(4):425-31.

Thomas E. Radecki, M.D., J.D.

 modern-psychiatry.com