Erectile dysfunction (ED) is a common problem in men who have had diabetes for five years of longer. Constant high blood sugars eventually "sugar coats" the nerves controlling the blood vessels into the penis. This biochemical caramelizing of nerve fibers takes away their ability to release nitric oxide, the chemical that causes blood vessels to open and engorge the penis with blood to make it erect. Fortunately, there are things diabetic men can do about ED that don't require medication.
Far and away the one most effective treatment for diabetic ED is keeping blood sugars down. Men who manage to keep their blood sugars below 100 mg/dl (5.5 mM) all the time may notice improvement in as little as six weeks without any drug treatment at all. But for diabetic men who cannot control blood glucose readings quite that tightly, there's alpha-lipoic acid, also known as ALA.
ALA is the best-researched and most reliable over-the-counter aid to recovery from any kind of diabetic nerve damage, including ED. Doctors recommend up to 3,000 milligrams a day, although much more than 1,800 milligrams a day is likely to be more than the body can use. ALA depletes the B vitamin biotin, so it's important to take supplemental biotin or to use a brand of ALA that includes biotin in the formula.
Diabetic men who use ALA report that it restores sensation before it restores erection. ALA will enhance the ability of either the conventional prescription drugs Viagra, Cialis, and Levitra or the herbs that contain yohimbine, namely yohimbe and quebracho, to enable damaged nerves to release nitric oxide (NO). The antioxidant NO opens the blood vessels that fill the penis with blood to enable intercourse. ALA may also restore sensation in feet, hands, and other parts of the body.
Many nutritional experts and some holistically oriented doctors recommend supplementing with the amino acid L-arginine for erectile dysfunction. It's a complement to either the "little blue pill" or alpha-lipoic acid. L-arginine provides the raw materials from which nitric oxide, NO, is made. ALA and/or Viagra, Cialis, and Levitra stimulate nerve endings to release it.
Men get L-arginine from food, especially soy and meat, but it's simply not possible (unless you can wolf down a 72-ounce steak every day) to get all the L-arginine that your body can use from food. Take up to 5 grams (that's 5,000 milligrams) of L-arginine daily. L-arginine is not likely to be the complete remedy for erectile dysfunction all by itself, but it will greatly enhance the effects of either prescription medications (that is, those taken by mouth, not the papaverine injection) or ALA.
L-arginine is frequently recommended for ED, and may increase the effectiveness of Viagra, since it provides the chemicals from which NO is made. Clinical studies of L-arginine have used relatively small doses, no more than 3,000 milligrams per day,7,8 and using more than 5,000 milligrams of L-arginine may make ED worse. The herbs damiana, ginseng, and muira puama are also frequently recommended for ED, but their effects are unpredictable and they do not help the majority of men who take them.
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