Hello. Today we're going to talk about arginine l-arginine some of you may
recognize that that term from other videos I've done recently on citrulline
in fact there's a debate in the internet about whether tea for people that want
to take supplements in this space whether it takes
citrulline as a supplement or arginine I'm not going to get into that today I
made in a later video but why is there a debate over those two because they go to
a common endpoint an endpoint called nitric oxide so I am going to talk a
little bit about nitric oxide why that's important the discovery of nitric oxide
and whether or not l-arginine actually helps but first a brief introduction my
name is Ford brewer I'm a doc I have been in prevention preventive medicine
for a long time this is a channel about preventive medicine the science behind
preventive medicine I had a viewer complain recently that I talked a lot
but didn't tell him what to do I'm not going to tell you what to do on this
channel you can find out what to do in plenty of places on the Internet
this is more about the science the background giving you the facts so you
can decide for yourself what you need to do in terms of longevity and prevention
so I mentioned nitric oxide we've known about nitric oxide for a while in fact
if you look at this article out of circulation 1998 they're announcing this
is about the the Nobel Prize for medicine that year and and it was for
nitric oxide discoveries here's a few things about it it went to three
scientists dr. Robert furchgot at SUNY I think dr. louis ignarro in
la and doctor Farid Murad I think it in Texas they received the 1998 Nobel Prize
and obviously in Stockholm and then came back to the states and did some some
other things and I'll describe what one of them did in a few minutes twenty
years before that doctor furchgot at suny began studies back around 1980 and
what he found was there's a substance made by the endothelium the intima you
may remember that I've mentioned it many times in many videos the endothelium he
said creates a chemical it's a signaling chemical and it relaxes vascular smooth
muscle cells remember that's the media so the the intima is making a chemical
that relaxes the the media when you relax the media that's going to lower
the blood pressure and it's going to do a lot of very interesting things dr.
Murad in an unrelated set of experiments at the University of Texas in Houston
was analyzing how nitroglycerin works in 1977 he found that the nitrates released
nitric oxide which releases which relaxes those smooth muscle cells
resulting in vasodilation in fact we still use nitrates one of the classic
things when I went through Medical School was use of nitrates for angina
heart pain associated with plaque in the coronary arteries he was fascinated by
the colorless odorless gas and the fact that a colorless odorless gas could be a
signaling chemical within the walls of the arteries now dr. ignarro who was now
a professor at UCLA in medicine in California concluded through a series of
experiments that this chemical the endothelial cell produced this
endothelial cells smooth muscle relaxing factor or EDR F that was
described in the beginning by dr. furchgot in Texas
he called it endothelial endothelium derived relaxing factor that's what he
called it meanwhile over in LA dr. ignarro
identified endothelium derived relaxing factor and he said it's nitric
oxide so some very interesting pieces of research and they also connect some dots
that i think a lot of people didn't know that citrulline and arginine are all
related to the nitrates nitroglycerin so we'll talk about those briefly in a few
minutes before we go on I mean before we do that just a couple of other comments
about the Nobel Prize that year Michael DeBakey the heart surgeon was the
chairman of the Lasker Award jury and there had been some back-and-forth about
there were a lot of scientists involved in these discoveries around nitric oxide
and there was some some Doc's were were included in the Lasker Award some
doctors were included in the in the Nobel Prize award but again there wasn't
total overlap there was some Jawigng and back & forth doctor forgot who was 82
years old said you know what I'm just surprised to have gotten the prize
usually the nobel prize goes to something there's a lot more popular
than molecular research I'm just an old-fashioned pharmacologist now
DeBakey I mentioned him a minute ago he made the point and this is this is a
critical point this work all of this work going around nitric oxide is very
important because it's a fundamental finding affecting circulation
it's a fundamental and important observation
so if Michael DeBakey said that about nitric oxide and arginine and citrulline
are precursors of nitric oxide now you start to get some understanding of why
people are so interested in those supplements okay so enough about the
Nobel Prize other than to just give you a picture of one of the winners I'm not
going to go into the pictures of the other winners here's dr. ignarro
actually I will show you the pictures no I want dr. ignarro you'll see them again
in a few minutes now let's go to arginine here is a does arginine
actually work so we've got some theoretical background this is a study
on the effect of oral arginine supplementation on on blood pressure
it's a meta-analysis you remember that's where a meta-analysis is where you find
a lot of other studies that have been done and you analyze you create a study
of those studies so you analyze you get a lot bigger numbers that way some of
the smaller studies may not actually they may not be good they may have bias
they may not be totally looking at the same research question so you have to go
through all of those issues when you do a meta-analysis this a meta-analysis was
part of the Cochrane central register of trials they used the Cochran study
information they used information out of clinical trials comp so don't go so
these are both really good resources and you would think the you know so far as
you start looking through the science here the science is pretty good what did
they find well the results was this compared with
placebo l-arginine interventions significantly lowered blood pressure
five point three milligrams mercury
systolic and two point six six diastolic here's another thing you whenever you
see studies you'll also see these numbers P equals or P is less than and
that's the probability of this occurring in these studies by a random event is
less than so the p-value is very good on these there were less than 1/10 of 1% so
that sounds pretty good right well I tell you you get a much
bigger decrease in blood pressure from the from a lot of other medications but
a lot of people don't want to take medications they'd rather take
supplements things that have not been researched and and pushed by big pharma
things that have not gone through safety trials by and reviewed by the FDA and I
understand fully so if you've got a mild impact on your blood pressure that
you're looking to get and you want to go supplements versus medications that's
what the science says I'll get back to those in just a minute before I do
though just wanted to make a brief comment regarding nitrates if you look
up nitrates and nitroglycerin you'll find that nitrates have a significant
impact in a couple of different ways they release the they dilate the veins
so you get a decrease with blood returned to the heart you get it
that's called a decreased preload that increases the ventricular load that
decreases the wall tension in the ventricles and so again that's how
nitric oxide from nitrates or nitroglycerin helps with angina excuse
the coffee I'm I do take ramipril by the way and sometimes I do get a call that's
an ACE inhibitor that's another way of decreasing your blood pressure at higher
doses nitrates will actually even dilate arteries if you dilate arteries since
just veins you're going to decrease peripheral resistance and therefore
afterload as well in other words decrease the load coming into the heart
also decreased the load the heart is pushing against so again how many people
do you know or have you heard of that had angina and we're taking nitrates
again that's what we're talking about here relaxing the artery walls relaxing
the veins relaxing the heart so back to arginine for a minute
arginine is a supplement this is another study effective long-term oral arginine
supplementation on glucose now this was not this is in diabetes and obesity
metabolism 2012 October by Montild and a group and this is not a
meta-analysis like the other two this is just a clinical trial basically what
they did was they took a hundred and forty-four individuals they gave them
arginine 6.4 grams per day on average for 18 months plus a 12-month extended
period did they get an improvement in diabetes or insulin resistance the
answer is yes they did not get an improvement in the probability of
becoming full-blown diabetic they did get an improvement however in the
probability of return to a normal glucose tolerance now how should we and
again fairly good p-values on this less than 0.001 less than a tenth of a
percent how do we interpret that those of us who work with diabetes and insulin
resistance a lot can tell you look if the pancreas is shot your
the islets we call the islets of langerhans the the part that produces
insulin if that's shot there's really not much you can do for it but if you've
got mild problems with insulin resistance and therefore pushing your
your pancreas harder than normal with some changes like lifestyle changes and
maybe even with arginine you can get some evidently maybe get some
improvement how much of an improvement again it's sort of like the the picture
with the blood pressure not a lot but some people really prefer supplements to
to medications so another question about research around arginine this is safety
and performance benefits of arginine supplements for military personnel this
was also a meta-analysis basically this looks like their point was these people
were in their military this was published in nutritional review 2016
November and they're saying look a lot of military people are taking arginine
supplementation does it work does it help in terms of performance their
answer was no they reviewed 2687 articles most of them were not so good
research and were dumped they did use sixty-two articles in terms of meeting
all the inclusion criteria in in other words they didn't see a lot of risk of
bias consistency directness precision of the of the research here was their
summary l-arginine supplementation provided a little enhancement of
athletic performance or improvements in recovery
short-term supplementation with arginine may result in adverse gastrointestinal
and cardiovascular effects the GI I don't think it's a very serious one I
will investigate maybe and do something a little bit deeper on potential
cardiovascular effects
so again maybe not so good for performance they were actually seeing
maybe the opposite effect in terms of not minimal improvement but they thought
maybe some risk in terms of cardiovascular so again I'm not going to
tell you what the heck arginine or not I'm going to tell you a little bit about
the science and as usual there's confusion there's mixed signals within
the science you remember I told you about dr. ignarro he went to Stockholm
to receive his Nobel Prize and then he came home he got a job with Herbalife so
he actually made a quite a few advertisements for an Herbalife product
called and here he is in his herbal life
wearable billboard cycle cycling shirt and I think the product they were called
they were selling at that point was called Night Watch and his point was yes
you can really increase your nitric oxide and it'll do a lot of great things
for your health so here's part of the point if you win a Nobel Prize and I
have not - a lot of people are going to listen to you about whether to take
something as I said before I'm not gonna tell you whether to take something or
not I will just tell you a little bit more about the science and again
unfortunately the science is not always that clear thank you for your interest