Q. I have been working with a nutritionist who trained as a pharmacist. She has been very helpful.
I emailed her a list of my husband’s medications and asked which ones could cause erectile dysfunction. She said it could be enalapril with hydrochlorothiazide.
She recommended L-arginine, an amino acid that increases nitric oxide and boosts blood flow. The instructions are to take 500 mg twice a day, preferably on an empty stomach. Can you tell me more?
A. L-arginine is a natural compound that is found throughout our bodies and in foods such as nuts, seeds, whole grains, seafood and chocolate. It is an amino acid that is a building block for proteins, and as you have said, it is important for nitric-oxide production.
Nitric oxide relaxes blood vessels and improves circulation. Drugs for erectile dysfunction (ED), such as Cialis and Viagra, work through the release of nitric oxide.
As a dietary supplement, L-arginine has a mixed record of success for ED. In one controlled trial, it worked no better than placebo (Urologia Internationalis, No. 4, January 2000); in another, it only helped men whose own nitric-oxide production was subpar (BJU International, February 1999). Combining L-arginine with other compounds such as Pycnogenol (Journal of Sex and Marital Therapy, May-June 2003), adenosine monophosphate (Andrology, March 2013) or even drugs such as Cialis or Viagra (Journal of Sexual Medicine, January 2013) produced better results.
Side effects are uncommon but may include digestive distress, asthma or allergic reactions. In some people, L-arginine could trigger a cold sore or other herpes simplex outbreak. Whether it would serve as an antidote to the blood pressure pill is unknown.
Q. After my migraines began flaring up weekly, I started taking riboflavin (vitamin B-2) daily. Ten weeks into this regimen, I have only had two really bad headaches.
I still have Maxalt as a backup, but I haven’t needed to take it in a few months. The only side effect I’ve had from the B-2 is bright yellow urine. Compared to the migraines, I’ll take it!
A. Riboflavin has been used as a way of preventing migraines for many years (Neurology, February 1998). A review of research suggests that it may work even better in combination with Coenzyme Q10 (Headache, Supplement s2, October 2012). While riboflavin will turn urine almost fluorescent yellow, other side effects are rare.
We discuss the use of riboflavin, feverfew, Coenzyme Q10, magnesium and other nondrug approaches to migraine prevention in our Guide to Headaches and Migraines. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. M-98, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q. I get plantar warts on the soles of my feet. The doctor scrapes them, applies acid cream and covers them for 48 hours. They go away and then come back a few months later.
Help! How can I get rid of them without going back to the doctor?
A. We have collected several plantar wart remedies through the years. They include:
• Taping a banana peel (fleshy side on skin) to warts overnight.
• Applying an olive oil and turmeric mixture to the wart.
• Taking cimetidine (Tagamet) orally.
• Soaking warts in hot water with salt.
Details can be found at www.PeoplesPharmacy.com.