Food Supplements and Vitamins. Arginine

Background

L-arginine was first isolated in 1886, reportedly from the extract of a lupine ( Lupinus spp.) seedling. Lupinus is a genus in the legume (Fabaceae) plant family.
Arginine is a semiessential amino acid; although the body normally makes enough of it, supplementation with additional amounts is sometimes needed. Arginine is found in foods containing protein.
Arginine is a chemical precursor to nitric oxide (a blood vessel-widening agent called a vasodilator). Early evidence suggests that arginine may help treat medical conditions that improve with increased vasodilation. These conditions include chest pain, atherosclerosis (clogged arteries), heart disease or failure, erectile dysfunction, intermittent claudication/peripheral vascular disease, and vascular headaches (headache-inducing blood vessel swelling).
Arginine also triggers the body to make protein and has been studied for healing wounds, bodybuilding, enhancing sperm production, and preventing tissue wasting in people with critical illnesses. However, caution is warranted. Arginine use was associated with death in certain groups of heart patients. Caution is also needed when using arginine to treat pre-eclampsia (high blood pressure in pregnancy).
Arginine hydrochloride has high chloride content and has been used to treat metabolic alkalosis. This use should be under the supervision of a qualified healthcare professional.

Usage and Dosing

NB! The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Dietary Sources of Arginine

Walnuts, filberts (hazelnuts), pecans, Brazil nuts, sesame and sunflower seeds, brown rice, raisins, coconut, gelatin, buckwheat, almonds, barley, cashews, cereals, chicken, chocolate, corn, dairy products, meats, oats, peanuts.

Adults (18 years and older)

Note: There is no current suggested daily intake or tolerable upper intake for arginine. This amino acid is considered to be nonessential. The therapeutic dosage (maximum dose considered to be safe) is 400-6,000 milligrams.

• For altitude sickness, 4 grams in 200 milliliters of fruit punch, three times daily, has been taken by mouth while ascending to altitude (24 hours) and while at altitude (for 24 hours).

• For asthma, a single dose of 50 milligrams of L-arginine per kilogram of body weight has been taken by mouth.

• For breast cancer, 30 grams daily for three days has been taken by mouth.

• For burns, 15 grams of L-arginine has been taken by mouth daily (duration unknown).

• As a chemotherapy adjuvant, 30 grams has been taken by mouth daily for three days.

• For chest pain (noncardiac): L-arginine (dose and duration unknown) has been taken by mouth.

• For cognitive function, 1.6 grams of L-arginine has been taken by mouth daily for three months.

• For coronary artery disease (CAD), up to 9 grams of arginine has been taken by mouth daily in divided doses for three days to six months. 15 grams of L-arginine has been taken by mouth daily in addition to Cardiket™ (isosorbide dinitrate) for 10 days. A dose of 3.2 grams has been taken by mouth twice daily for six months. Three grams of L-arginine has been taken by mouth three times daily for the first three days, followed by 9 grams on day 4. Patients with Prinzmetal’s angina pectoris took 9.26 grams by mouth daily for an unknown duration.

• For diabetes (type 2), 3 grams of L-arginine has been taken by mouth three times daily. Three grams of L-arginine in 10 milliliters of saline has been infused as a single dose.

• For diabetic complications (peripheral neuropathy), 3 grams of L-arginine has been taken by mouth three times. A cream containing 4 milligrams of L-arginine per square centimeter has been applied to the feet in the morning and evening daily for two weeks.

• For erectile dysfunction, 5 grams of L-arginine has been taken by mouth daily for six weeks.

• For exercise performance, a single dose of 6 grams of L-arginine in a 500-milliliter beverage has been taken by mouth. Six grams of L-arginine in Gatorade® has been taken by mouth twice daily for 28 days, as have 6 grams of L-arginine daily with meals for 14 days and 14.2 grams of L-arginine daily for six months.

• For heart failure, 5.6-12.6 grams of L-arginine has been taken by mouth daily for up to six weeks. Doses of 15 grams have been taken by mouth daily for five days. A dose of 2 grams of L-arginine has been taken by mouth three times daily for three months.

• For hyperlipidemia (high cholesterol), 7 grams of L-arginine has been taken by mouth three times daily for four weeks.

• For hypertension (cardiac and pulmonary), 12 grams of L-arginine has been taken by mouth daily for four weeks. A single dose of 2 grams of L-arginine as an adjunct to 60 milligrams of isosorbide mononitrate has been taken by mouth. A dose of 0.5-1.5 grams of L-arginine per 10 kilograms of body weight has been taken by mouth for one week.

• As an immunomodulator, L-arginine (dose unknown) has been taken by mouth for 60 days.

• For infertility, up to 4 grams or 16 grams of L-arginine has been taken by mouth daily for unknown duration.

• For interstitial cystitis, 1.5-2.4 grams of L-arginine has been taken by mouth daily for up to three months.

• For intrauterine growth retardation, 3 grams has been taken by mouth daily for 20 days.

• For MELAS syndrome, L-arginine (dose unknown) has been taken by mouth for up to two years. Intravenous L-arginine (dose and duration unknown) has been used.

• For myocardial infarction (heart attack), 3 grams of L-arginine has been taken by mouth three times daily for up to six months. A dosage of 3 grams of L-arginine has been taken by mouth three times daily for 30 days.

• For peripheral vascular disease and claudication, 24 grams of L-arginine has been taken by mouth daily for eight weeks, and 3.3 grams of L-arginine has been taken by mouth twice daily. Eight grams of L-arginine has been given intravenously twice daily for three weeks.

• For pre-eclampsia (high blood pressure in pregnancy), 3 grams of L-arginine has been taken by mouth daily, in addition to standard therapy, for three weeks. Three grams of L-arginine has been taken by mouth every six hours, or intravenously (10 grams every eight hours) if the L-arginine taken by mouth was not tolerated, from diagnosis until day 10 postpartum. A dose of 4 grams of L-arginine has been taken by mouth daily for 10-12 weeks. A single intravenous infusion of L-arginine (20 grams per 500 milliliters) has been used. Five consecutive single daily infusions of L-arginine (20 grams per 500 milliliters), followed by 4 grams of arginine taken by mouth daily for two weeks, have been used. A dosage of L-arginine (20 grams per 500 milliliters) has been infused over two hours for four consecutive days.

• For Raynaud’s phenomenon, 8 grams of L-arginine has been taken by mouth daily for 28 days.

• For respiratory infections, L-arginine (dose unknown) has been taken by mouth for 60 days.

• For transplants, 0.1 gram of L-arginine per kilogram of body weight has been taken by mouth daily for six weeks, and 6 grams has been taken by mouth twice daily for six weeks. Also, 0.5 grams of L-arginine per kilogram has been given intravenously over 60 minutes, two hours prior to surgery.

• For wound healing, 30 grams of arginine aspartate, containing 17 grams of arginine, has been taken by mouth in three divided doses for two weeks. A dose of 36.2 grams of L-arginine HCl has been taken by mouth daily for five days.

• For anal fissures, a gel containing 400 milligrams of L-arginine per milliliter has been applied to the skin five times daily for at least 12 weeks.

• For adrenoleukodystrophy (ALD), arginine butyrate (dose unknown) has been intravenously infused over four months.

• For autonomic failure, a single dose of 0.5 grams of L-arginine per kilogram of body weight has been given intravenously.

• For cardiovascular disease, 5 milligrams per kilogram of body weight per minute has been infused intravenously for 20 minutes prior to exercise testing. Infusion of 60 grams of L-arginine over 20 minutes has also been reported.

• For circulation problems, a single dose of 30 grams of L-arginine has been intravenously given over 60 minutes.

• For cyclosporine toxicity, graded doses of L-arginine (50, 100, or 150 milligrams per kilogram of body weight) have been delivered intravenously over three consecutive hours.

• For growth hormone reserve test/pituitary disorder diagnosis, 30 grams of arginine hydrochloride has been injected.

• For heart protection during coronary artery bypass grafting (CABG), a single venous infusion of 10% arginine hydrochloride (30 grams) over 15 minutes has been used. A dose of 7.5 grams of L-arginine in 500 milliliters of cardioplegic solution has been given intravenously.

• For inborn errors of urea synthesis, doses of FDA-approved prescription parenteral arginine hydrochloride generally depend on specific institutional dosing guidelines.

• For kidney protection during angiography, 330 milligrams of L-arginine per kilogram of body weight has been given intravenously over 20-30 minutes.

• For malaria, 3, 6, and 12 grams of intravenous L-arginine has been infused over 30 minutes.

Children (younger than 18 years)

There is no proven safe or effective dose of arginine in children.

Safety

NB! There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid with known allergy or hypersensitivity to arginine. Symptoms may include rash, itching, or shortness of breath. Anaphylaxis has occurred after arginine injections. In clinical research, one patient experienced a mild allergic skin reaction to intravenous L-arginine. Hives have also been reported.
For treatment of allergy to arginine, epinephrine and antihistamines have been suggested.

Side Effects and Warnings

Note : According to the U.S. Food and Drug Administration (FDA) website, pediatric overdosing of arginine hydrochloride injection (R-Gene 10®) has been reported, due to packaging and labeling confusion. Revisions have since been made to the product’s packaging. The new label warns that R-Gene 10® infusions should be used cautiously in children to prevent overdose, which may result in hyperchloremic metabolic acidosis, cerebral edema, or possibly death.
There is no current suggested daily intake or tolerable upper intake for arginine. This amino acid is considered to be nonessential. The therapeutic dosage (maximum dose considered to be safe) is 400-6,000 milligrams.
In general, L-arginine is well tolerated when taken by mouth, delivered intravenously, or applied to the skin.

• Arginine may cause bloating; diarrhea; endocrine changes; gastrointestinal discomfort; hives; increased blood urea nitrogen, serum creatine, and serum creatinine; increased inflammatory response; leg restlessness, lower back pain; nausea, numbness (with arginine injection); rash; reduction in hematocrit; severe tissue necrosis with extravasation; systemic acidosis; or venous irritation. In heart disease patients, arginine may cause high white blood cell count, increased post-heart attack deaths, lack of energy and strength, and vertigo or increased blood pressure (in heart transplant patients).

• Arginine may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

• Arginine may change blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

• Use cautiously in patients with impaired kidney function or those at risk for hyperkalemia (abnormally high levels of blood potassium), including those with diabetes or using drugs that elevate potassium levels, such as potassium-sparing diuretics and potassium supplements, as arginine may cause hyperkalemia. Fatal cardiac arrhythmia occurred in one patient.

• Use caution with phosphodiesterase inhibitors (e.g., sildenafil [Viagra®]), due to a theoretical risk of additive blood vessel widening and blood pressure lowering.

• Use with caution in postmenopausal patients, as night sweats and flushing have been reported.

• Use with caution in patients with herpes virus, as L-arginine may worsen this condition. L-arginine may increase the risk of herpes simplex cold sores.

• Use with caution in individuals at risk for headaches, as headache has been a reported side effect. In mountain climbers, L-arginine increased the risk of developing a headache.

• Use with caution in patients with immunological disorders.

• Use cautiously in patients with acrocyanosis, sickle cell anemia, and hyperchloremic acidosis, as arginine may cause worsening of symptoms.

• Use cautiously in patients with guanidinoacetate methyltransferase (GAMT) deficiency. This enzyme is involved in the conversion of amino acids such as arginine to creatine.

• Avoid in women with high-risk pregnancies, as, in women with multiple diseases, intravenous arginine resulted in premature delivery, pre-eclampsia, and death in two cases.

• Avoid use in those with low blood pressure or those using blood pressure-lowering agents, due to the reported blood vessel-widening and blood pressure-lowering effects of L-arginine.

• Avoid with nitrates, as concurrent use may result in additive blood pressure-lowering and blood vessel-widening effects.

• Avoid use in patients given spironolactone, because arginine monohydrochloride has resulted in abnormally high potassium levels and fatal cardiac arrhythmia.

• Avoid use in patients with asthma, as arginine may cause an allergic and response, aggravate airway inflammation, and amplify inflammatory airway response. In human research, L-arginine increased exhaled nitric oxide, suggesting increased inflammatory response in asthmatic and cystic fibrosis subjects.

• Avoid use in patients at risk for or with a history of heart attack, as arginine may worsen outcomes and increase the risk of mortality.

• Avoid use in breast cancer patients.

• Avoid with known allergy or hypersensitivity to arginine. Symptoms may include rash, itching, or shortness of breath. Anaphylaxis has occurred after arginine injections. In clinical research, one patient experienced a mild allergic skin reaction to intravenous L-arginine. Hives have been reported.

• Avoid in pregnant or breastfeeding women, due to a lack of sufficient available safety and efficacy data.

Pregnancy and Breastfeeding

Avoid in pregnant or breastfeeding women, due to a lack of sufficient available safety and efficacy data.

source: http://www.mayoclinic.com