L-arginine is commonly sold in health food specialty shops as a supplement capable of improving vascular health and sexual function in men. The herb may be beneficial in improving health in individuals with congestive heart failure, peripheral artery disease, angina, hypertension, hyperlipidemia, and type 2 diabetes. The herb appears to increase nitric oxide concentrations. Abnormalities of the vascular endothelial cells may cause vasoconstriction, inflammation, and thrombolytic activity. These abnormalities are partially attributable to degradation of nitric oxide. L-arginine's ability to increase nitric oxide is the basis for its effectiveness in improving some vascular disease states. Oral doses of 9 to 30 g per day are well tolerated. No adverse reactions were reported in those taking 9 g/d. Higher doses may cause nausea and mild diarrhea. L-arginine may exacerbate sickle cell crisis and should be used with caution in those with sickle cell anemia.
• The Patient Receiving a Peripheral Vasodilating Drug
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