L-Arginine: benefits, dosage, contraindications
Other name(s)
2-Amino-5-guanidinopentanoic acid
Scientific name(s)
2-Amino-5-guanidinopentanoic acid
Family or group:
Amino acids
Indications
Scoring methodology
EFSA approval.
Angina pectoris ✪✪✪✪✪
Oral intake of L-arginine appears to alleviate symptoms and improve exercise tolerance and quality of life in patients with mild to severe angina. Some patients with severe angina who experience frequent attacks at rest despite treatment with standard anti-anginal agents may also benefit from L-arginine.nnDoses of 2 to 6 g have been used three times a day for up to one month.nn
Posologie
Oral
2 - 6 g
1 - month
Adults
Effect of supplementation with long-chain ω-3 polyunsaturated fatty acids on behavior and cognition in children with attention deficit/hyperactivity disorder (ADHD): a randomized placebo-controlled intervention trial.
Clinical and inflammatory effects of dietary L-arginine in patients with intractable angina pectoris.
Effect of supplemental oral L-arginine on exercise capacity in patients with stable angina pectoris.
Effects of oral L-arginine supplementation on exercise-induced QT dispersion and exercise tolerance in stable angina pectoris.
High blood pressure ✪✪✪✪✪
It has been shown that oral administration of L-arginine can slightly reduce systolic and diastolic blood pressure in healthy individuals and in patients with mild hypertension. Furthermore, L-arginine appears to have additive vasodilatory effects when used with angiotensin-converting enzyme inhibitors or with nitrate derivatives (medications used in high blood pressure). Daily oral doses of 4 to 12 g have been used for 2 to 24 weeks.
Posologie
By mouth
4 - 12 g
24 - weeks
Adults
Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension, positive exercise tests, and normal coronary arteries.
Effects of L-arginine infusion on renal hemodynamics in patients with mild essential hypertension.
Short-term oral administration of L-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmonary hypertension.
L-arginine in the management of cardiovascular diseases.
Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension.
Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials.
[Pressor, renal and endocrine effects of systemic infusion of L-arginine in hypertensive patients].
Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave.
Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation.
Blood pressure and metabolic changes during dietary L-arginine supplementation in humans.
Pregnancy ✪✪✪✪✪
Most research shows that L-arginine is beneficial for patients with pre-eclampsia (gestational hypertension). Indeed, taking 3 g orally for 3 weeks decreases the systolic and diastolic blood pressure of pregnant women with hypertension compared with placebo. L-arginine also appears to prevent pre-eclampsia. One clinical study showed that taking L-arginine at a dose of 3 g per day from the 20th week of gestation reduced the risk of pre-eclampsia by approximately 74% compared with placebo in high-risk women.
Posologie
Oral administration
3 g
3 weeks
Pregnant women
L-arginine supplementation in women with chronic hypertension: impact on blood pressure and maternal and neonatal complications.
Therapeutic Benefits of L-Arginine: An Umbrella Review of Meta-analyses
Effects of acute L-arginine infusion on non-stress test in hypertensive pregnant women.
L-arginine supplementation in patients with gestational hypertension: a pilot study.
Effect of L-arginine therapy on the glomerular injury of preeclampsia: a randomized controlled trial.
Effect of L-arginine on blood pressure in pregnancy-induced hypertension: a randomized placebo-controlled trial.
Arginine supplementation for improving maternal and neonatal outcomes in hypertensive disorder of pregnancy: a systematic review
Effects of prolonged oral supplementation with l-arginine on blood pressure and nitric oxide synthesis in preeclampsia.
Dietary supplementation with L-arginine or placebo in women with pre-eclampsia.
Type 2 diabetes ✪✪✪✪✪
Taking 3 grams of L-arginine orally three times a day for one month appears to improve insulin sensitivity in patients with type 2 diabetes. Other preliminary clinical research shows that taking 8 grams of L-arginine orally with a meal increases postprandial insulin secretion in patients with type 2 diabetes. In a recent randomized, double-blind, placebo-controlled study in subjects with glucose intolerance and metabolic syndrome, arginine supplementation (6.4 g/day) for 18 months did not reduce the incidence of diabetes, but it significantly improved glucose tolerance due to better insulin sensitivity and improvement of β-cell function.
Posologie
Oral
6.4 - 9 g
Adults
Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients
Evaluation of beta cell dysfunction by mixed meal tolerance test and oral L-arginine in patients with newly diagnosed type 2 diabetes mellitus
Intermittent claudication ✪✪✪✪✪
Clinical evidence shows that short-term use of L-arginine (up to 8 weeks) increases arterial dilation and improves intermittent claudication associated with peripheral arterial disease. However, long-term oral administration of L-arginine for 6 months does not improve walking speed or distance in patients with peripheral arterial disease.nnL-arginine has been used daily at 6 to 24 grams in divided doses for 8 weeks. nn
Posologie
Oral
6 - 24 g
8 - weeks
Adults
ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocyst(e)inemia: effects of L-arginine and B vitamins
A pilot study of L-arginine supplementation on functional capacity in peripheral arterial disease
L-arginine in the management of cardiovascular diseases
L-arginine supplementation in peripheral arterial disease: no benefit and possible harm
Restoring vascular nitric oxide formation by L-arginine improves the symptoms of intermittent claudication in patients with peripheral arterial occlusive disease
Erectile dysfunction ✪✪✪✪✪
Most clinical research shows that oral intake of L-arginine can improve the symptoms of erectile dysfunction. In a clinical trial, taking 5 grams of L-arginine per day for 8 weeks improved desire, orgasm, and sexual satisfaction about twice as much as placebo. There is also evidence that taking L-arginine in combination with type 5 phosphodiesterase (PDE5) inhibitors (a treatment that facilitates erection) improves the symptoms of erectile dysfunction. Clinical research shows that taking 5 grams of L-arginine per day in combination with 10 mg/day of tadalafil (a PDE5 inhibitor) for 8 weeks improved erectile function by about 83%, which was more effective than L-arginine or tadalafil alone in patients with type 2 diabetes suffering from mild to moderate erectile dysfunction. A dose of 2.5 to 5 grams of L-arginine per day has been used for up to 12 weeks.
Posologie
Oral
2.5 - 5 g
3 months
Men
Clinical assessment of a supplement of Pycnogenol® and L-arginine in Japanese patients with mild to moderate erectile dysfunction.
Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study.
Sports performance ✪✪✪✪✪
Several researchers believe that arginine can improve physical performance because it stimulates the secretion of growth hormone (GH) and contributes to the production of creatine, a substance that plays an important role in muscle contraction. Furthermore, clinical research shows that L-arginine appears to increase exercise endurance, but not strength, when used for athletic performance. Indeed, some clinical studies in healthy, active men show that taking 6 grams of L-arginine increases time to exhaustion during high-intensity exercise compared with placebo. Research in male soccer players shows that taking 2 grams of L-arginine per day for 45 days increases maximal oxygen uptake and thus cardiorespiratory capacity by about 3.3 times compared with placebo. However, it does not affect lean mass. Other research in male soccer players shows that taking 1.2 grams of L-arginine and 1.2 grams of L-citrulline per day for 7 days increases total power on a 10-minute cycling test and improves subjective perceptions of effort compared with placebo.
Posologie
Orally
1.2 - 6 g
Adults
Obesity ✪✪✪✪✪
Preliminary clinical research suggests that taking L-Arginine at a dose of 3 grams orally three times daily for 12 weeks, in addition to following dietary advice, reduces waist circumference by 4-6 cm and reduces weight by 1.8-2.9 kg in obese women aged 18 to 40 years. nn
Posologie
Oral
9 g
12 - weeks
Adults
Wound ✪✪✪✪✪
A number of studies have shown that L-arginine supplementation improves wound healing. Indeed, a randomized, controlled study showed that taking 17 g/day of arginine in the form of arginine aspartate for 14 days improved healing in healthy elderly individuals. Another study conducted in healthy adults showed improvement in surgical wounds with a dose of 17 to 25 g per day of arginine taken orally. nn
Posologie
Oral
17 - 25 g
14 - days
Adults
Cancer ✪✪✪✪✪
Enteral nutrition supplemented with L-arginine appears to reduce wound complications and overall infections after surgery in patients with head and neck cancer, but it does not appear to have beneficial effects on immune function markers such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) or on postoperative length of hospital stay.nnAnother prospective randomized study in patients with head and neck cancer who had recent weight loss showed that taking an oral supplement containing omega-3 fatty acids and arginine for 12 weeks postoperatively was beneficial, with improvements in biomarker levels such as albumin, prealbumin, and lymphocyte counts, and improved weight gain.nnEnteral nutrition supplemented with L-arginine at 0.81 to 1.3 grams was used.nn
Posologie
Oral
0.81 - 1.3 g
Adults
A randomized clinical trial with two doses of a omega 3 fatty acids oral and arginine enhanced formula in clinical and biochemical parameters of head and neck cancer ambulatory patients
Effect of c-reactive protein and interleukins blood levels in postsurgery arginine-enhanced enteral nutrition in head and neck cancer patients
Properties
Antioxidant
L-arginine has antioxidant effects and may reduce lipid peroxidation. It could prevent damage caused by reactive oxygen species in certain conditions, notably in myocardial ischemia, atherosclerosis, and stress.
Usages associés
Cardiovascular
Nitric oxide produced from L-arginine induces vasodilation, which may be responsible for a slight reduction in blood pressure. L-arginine also reduces the activity of angiotensin-converting enzyme, thereby decreasing the conversion of angiotensin I to angiotensin II. Angiotensin II is a vasoconstrictor. Consequently, the antihypertensive effects of L-arginine may be attributed to the reduced conversion of angiotensin I. Finally, L-arginine may reduce blood viscosity by decreasing platelet aggregation.
Usages associés
Metabolic
People with diabetes appear to have lower-than-normal L-arginine levels. L-arginine may help increase glucose clearance, increase insulin sensitivity, and raise postprandial plasma insulin levels in diabetic and prediabetic patients. In animals, dietary L-arginine appears to increase lipolysis.
Usages associés
Fertility effect
In vitro research suggests that nitric oxide from L-arginine may stimulate sperm motility and metabolism in men suffering from asthenospermia. In addition, nitric oxide is involved in erectile function.
Usages associés
Anticancer
There is evidence that L-arginine modifies immune system function and could potentiate tumor cells' response to anticancer drugs and possibly reduce the immunosuppressive effects of chemotherapy agents. L-arginine appears to increase lymphocyte reactivity to polyclonal mitogenic agents and may also improve natural cytotoxicity. nnMoreover, L-arginine also promotes tumor growth by providing a source of nitrogen, and in some situations the nutritional value of L-arginine may outweigh its antitumor effects. nn
Usages associés
Neurological
Animal research shows that administration of L-arginine to rats experiencing drug-induced seizures increases the time to the first seizure and decreases seizure-related mortality. This effect may be due to an increase in nitric oxide levels caused by L-arginine.nn
Wound healing
L-arginine is metabolized into L-ornithine, then into L-proline, which is used in collagen synthesis and wound healingnn
Usages associés
Safe dosage
Adult: 1.5 g - 30 g
L-arginine is taken at 1.5 to 6 g per day in divided doses to improve absorption. L-arginine has been used safely at doses up to 30 g per day for 18 months in clinical studies.nnnn
Pregnant woman: 12 g
L-arginine has been used at a dose of 12 g per day for 2 days, with apparent safety, in pregnant women during the third trimester. Lower doses have also been used safely for up to 8 weeks.nnnn
Interactions
Médicaments
Antihypertensive : moderate interaction
The combination of L-arginine with certain antihypertensives, notably angiotensin-converting enzyme (ACE) inhibitors, appears to have additive effects on vasodilation and the reduction of blood pressure. Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk of hypotension.
Antidiabetic: moderate interaction
Preliminary human research suggests that L-arginine lowers blood glucose levels in patients with type 2 diabetes. Theoretically, concomitant use of L-arginine may require an adjustment of the dosage of antidiabetic medications.
Diuretics: moderate interaction
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use may increase the risk of hyperkalemia.nn
Sildenafil: moderate interaction
In vivo, concomitant use of L-arginine and sildenafil resulted in increased vasodilation. Theoretically, concomitant use could lead to hypotension. However, this interaction has not been reported in humans.
Nitrates: moderate interaction
Theoretically, concomitant use may cause additive vasodilation and have a hypotensive effect. Use with caution.
Precautions
Breastfeeding woman : avoid
It is preferable to avoid the use of L-arginine in breastfeeding women due to a lack of reliable information. nn
Liver disorders : use with caution
A metabolic acidosis associated with arrhythmia, hyperkalemia, and increased blood urea can be seen in patients with liver disease and/or renal failure. nn
Hypotension : avoid
L-arginine increases nitric oxide, which causes vasodilation. Theoretically, L-arginine could worsen hypotension.nn
Renal failure : use with caution
A metabolic acidosis associated with arrhythmia, hyperkalemia, and increased blood urea can be seen in patients with liver disease and/or renal failure. nn
Herpes : use with caution
Theoretically, L-arginine could exacerbate herpes. Indeed, preliminary evidence suggests that L-arginine may be necessary for viral replication. nn
Contraindications
Myocardial infarction : contraindicated
There is concern that L-arginine may increase mortality when taken by patients following a myocardial infarction. Indeed, researchers believe that L-arginine could increase reactive oxygen species and homocysteine. nn
