For those of you who are interested in keeping the internal plumbing in tip-top condition, but don’t want to feed the pharmaceutical industry anymore than is utterly necessary, this thread should be of interest. If you are perfectly content to rely on Viagra or similar medications to achieve an erection, so be it. Be forewarned, however, that erectile dysfunction should be considered as an “early warning radar” signal that cardiovascular disease may be looming on the not too distant horizon. In offering the following information, please note that I am no MD; my background is in wellness and fitness. As you are probably aware, the wellness paradigm tends to focus more on preventative medicine than conventional medicine does, with its emphasis on pharmaceutical treatment of disease after it has materialized. In any event, I hope that you will find at least a nugget or two within the following information, which you consider to be worthy of further discussion with your primary care physician or, if you have one, cardiologist. It behooves us all to take a proactive stance with respect to our health; dividends accrued there will most definitely have positive repercussions in the bedroom. This post will be long enough without addressing behavioral modification or the relationship between exercise and nutrition, so I will limit my remarks strictly to the nutritional/ supplementation side of the equation.
Let’s begin with an overview of the physiological process by which a pharmaceutically-induced erection occurs. Don’t ask me to interpret the biochemistry of this process, but it “involves the protection of cyclic guanosine monophosphate (cGMP) from degradation by cGMP-specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum. Nitric oxide (NO) in the corpus cavernosum of the penis binds to guanylate cyclase receptors, which results in increased levels of cGMP, leading to smooth muscle relaxation (vasodilation) of the intimal cushions of the helicine arteries. This smooth muscle relaxation leads to vasodilation and increased inflow of blood into the spongy tissue of the penis, causing an erection. [It should be noted that] Robert F. Furchgott, Ferid Murad and Louis Ignarro won the Nobel Prize in Physiology or Medicine in 1998 for their independent study of the metabolic pathway of nitric oxide in smooth muscle vasodilation” (http://en.wikipedia.org/wiki/Sildenafil ).
That is probably about as clear as Mississippi mud. However, in thesimplest possible terms, Viagra and other ED medications mimic the natural process whereby nitric oxide functions as a vasodilator to enhance blood flow into the penis by relaxing the smooth muscle tissue which lines the interior walls of arteries leading into the penis, thus causing the corpus cavernosum to become engorged with blood and produce an erection. The challenge, of course, is to restore normal physiological function. If you are currently taking Viagra or similar medications, you may also be taking statin drugs for cholesterol management. However, has your physician ever informed you that prolonged usage of this class of drugs contributes, over time, to CoQ10 depletion and, ultimately, cardiac failure? Peter H. Langsjoen, MD, the foremost authority on the use of coenzyme Q10 in the treatment of heart disease, describes his 17-year experience with statin drugs as follows:
“I have seen a frightening increase in heart failure secondary to statin usage, ‘statin cardiomyopathy.’ Over the past five years, statins have become more potent, are being prescribed in higher doses, and are being used with reckless abandon in the elderly and in patients with ‘normal’ cholesterol levels.” Dr. Langsjoen attributes these heart failure cases as being caused by “statin-induced coenzyme Q10 depletion” that is preventable if statin drug users supplemented with coenzyme Q10.
For more information on this linkage, the importance of CoQ10 to heart patients and the all too frequently ignored side effects of statin drugs, consult http://www.lef.org/magazine/mag2004/feb2004_awsi_01.htm and http://www.lef.org/magazine/mag2008/feb2008_Alleviating-Congestive-Heart-Failure-With-Coenzyme-Q10_01.htm . (Please note that CoQ10 is available, as a supplement, in more than one form, which differ in their absorption properties. For a brief video which illustrates the superiority of the Ubiquinol form of CoQ10, see http://www.youtube.com/watch?v=fDVfE4iJSvE&feature=re lated .
As you are also probably aware, mainstream medicine is fixated, almost to the point of obsession, with lipid profile management, specifically cholesterol and triglycerides, as the standard treatment for cardiovascular disease. Of course, this establishes a protocol of prescribing statin drugs to millions of people for years on end, and the target numbers seem to conveniently shift ever downward, thus creating an ever expanding market for big pharmaceutical companies.
Less conventional thinking paints a much more complicated picture of risk factors for CVD. Researchers for The Life Extension Foundation have identified 17 separate risk factors which contribute, to a greater or lesser degree, to heart disease. See the graphic illustration provided at http://www.lef.org/magazine/mag2010/dec2010_Why-Reading-Mainstream-Magazines-Can-be-Detrimental-to-Your-Health_01.htm. Two critically important and highly detailed video presentations on this topic can be found, respectively, at http://www.youtube.com/watch?v=Qaii5EhbGNU and http://www.youtube.com/watch?v=z9jVWYl3hoI. In the unlikely event that you are absolutely fascinated by this topic and the previous materials have only whetted your appetite, LEF has compiled an even more thorough, 4-part video presentation, which can be accessed through the following links:
“Heart Risk - Part 1 of 4 - Life Extension Webinar with Dr. Michael Smith” (http://www.youtube.com/watch?v=DYgHwvlMBDc&feature=re lated )
“Heart Risk - Part 2 of 4 - Life Extension Webinar with Dr. Michael Smith” (http://www.youtube.com/watch?v=aHTxXwHEuHs )
“Heart Risk - Part 3 of 4 - Life Extension Webinar with Dr. Michael Smith” (http://www.youtube.com/watch?v=hV9Ntu8NcIM&feature=re lated )
“Heart Risk - Part 4 of 4 - Life Extension Webinar with Dr. Michael Smith” (http://www.youtube.com/watch?v=bytAwEGHGL8&feature=re lated )
(Warning: This is technical stuff, but for anyone interested in truly taking charge of their health, it is well worth the time and effort to learn and apply this information.)
This alternative perspective should not cause anyone to throw up their hands in surrender to the challenges of managing CVD but may, instead, help to explain why heart attacks continue to happen to people who have the major risk factors (blood pressure, cholesterol and triglycerides) under control.
By contrast, anti-aging physicians and life extensionists consider the endothelium to be the appropriate target, or battleground, of efforts to manage cardiovascular disease. The innermost lining of blood vessels, the endothelium is only a few cells thick and produces nitric oxide, a short-lived, but critically important, compound which functions as a vasodilator and, most interestingly, contributes directly to the erectile process. (Indeed, men with ED should, as previously noted, consider it to be an “early warning radar” signal that CVD is looming on the not too distant horizon.) Keeping the endothelium teflon-smooth is the desired goal. As its integrity is breached through vascular damage or the accumulation of plaque deposits, its ability to produce nitric oxide becomes increasingly impaired.
There are a few foods or neutraceuticals which research studies document as possessing, in conjunction with conventional medical treatments, great promise for CVD risk factor management. The cardiovascular benefits of fish oil consumption are particularly well chronicled. For an overview of the heart-healthy benefits of fish oil, see http://www.lef.org/magazine/mag2006/sep2006_report_omega1_01.htm. For information on the use of fish oil to avert fatal cardiac arrhythymias, a topic that is extremely germane to men who have previously had heart attacks, see http://www.lef.org/magazine/mag2008/jul2008_Averting-Arrhythmias-with-Omega-3-Fatty-Acids_01.htm . And, for guidance on the use of fish oil in conjunction with conventional medicines for treating heart conditions, see http://www.lef.org/magazine/mag2007/apr2007_atp_01.htm .
Although it is certainly beneficial to consume omega-3s by actually eating fish, "pharmaceutial-grade" fish oil supplements concentrate EPA and DHA, the essential fatty acids contained therein, at levels significantly higher than they naturally occur in fish, while eliminating the impurities found in mercury and other toxins, through a process known as molecular distillation. A specific fish oil supplement that I have used in the past, and highly recommend, is “Super Omega-3 EPA/DHA with Sesame Lignans & Olive Fruit Extract,” produced by the Life Extension Foundation. See http://www.lef.org/Vitamins-Supplements/Item01482/Super-Omega-3-EPA-DHA-with-Sesame-Lignans-Olive-Fruit-Extract.html Be sure to refrigerate fish oil supplements after opening them; omega-3 fatty acids are extremely sensitive to heat, light and oxygen. (You may also want to consult http://www.youtube.com/watch?v=nakBMTZEJcQ for a brief video by Dr. Christine Milrod, a Ph.D.-credentialed sexologist, entitled “Food that will increase your Sex Drive,” which emphasizes the role of fish oil in stimulating blood flow.)
Cocoa polyphenols. One of the most astounding properties of cocoa polyphenols is their status as one of the exceedingly few nutrients known to significantly improve beneficial HDL levels, something that I have personally experienced. You can certainly obtain cocoa polyphenols by regularly consuming high-quality dark chocolate, but that option carries an undesirable “price tag” in terms of calories and fat, not to mention the self-discipline required to consume it only in moderation, something which I personally do not possess. A healthier option is to regularly consume a standardized cocoa polyphenol supplement. For persons who may be interested in knowing what an appropriate dosage is, the Life Extension Foundation recommends, tentatively, 100-130 mg a day. For an overview of the research on cocoa polyphenols, consult http://www.lef.org/magazine/mag2007/ss2007_report_aging_arteries_0 1.htm; a brief video on this topic can also be found at http://www.youtube.com/watch?v=a5pupL9W6pE).
Almonds (1 ounce daily, which works out to about 24-25 almonds). Almonds contain the most favorable unsaturated:saturated fat ratio of any nut and are also one of the richest naturally occurring sources of arginine, an amino acid necessary for the synthesis of nitric oxide, which, as previously noted, is a short-lived compound essential to the erectile process. For information on a study testing the effect of arginine supplementation on nitric oxide production and erectile function, see http://www.dietaryfiberfood.com/l-arginine-benefits.php .
Pomegranate juice/extract. Research studies have proven that pomegranate consumption, typically in a juice or standardized extract form, is quite effective in stimulating nitric oxide synthase, the enzyme necessary for nitric oxide production. An Israeli study of elderly patients at high risk for the development of stroke discovered that daily consumption of pomegranate juice (1.7 oz), over the course of 12 months, resulted in a 35% drop in carotid artery thickness, which was indicative of an actual reduction in existing plaque deposits, and was accompanied, predictably, by a marked reduction in blood pressure. (For additional information on this study and other research findings which document the effectiveness of pomegranate consumption, see http://www.lef.org/magazine/mag2007/feb2007_report_pomegranate_01. htm ). For information specifically on the health benefits of pomegranate consumption for diabetics, consult http://www.lef.org/magazine/mag2007/may2007_report_pomegranate_01. htm .
Diabetics or persons with impaired insulin sensitivity obviously should not consume any fruit juice with impunity because of its high sugar content. A standardized, pomegranate extract supplement would be a much more appropriate option for persons suffering from these conditions.
If you would like a recommendation for a supplement in this category, see “Endothelial Defense™ with Full-Spectrum Pomegranate,™” also manufactured by the Life Extension Foundation (http://www.lef.org/Vitamins-Supplements/Item01498/Endothelial-Defense-with-Full-Spectrum-Pomegranate.html ).
Although it may be obvious, please note that this approach will not produce an erection on demand a la Viagra. However, consistent adherence to a lifestyle that incorporates regular exercise, sound nutrition and targeted supplementation will gradually improve your health, sexual function and, hopefully, eliminate you as a long-term revenue stream for the pharmaceutical industry. And what greater satisfaction can a man experience than an erection as nature intended, as opposed to one pharmaceutically induced? You have probably noticed that many of the references provided in this post are from publications or supplements produced by the Life Extension Foundation. Please be aware that I have no affiliation, professional or financial, with that organization. I simply agree with the anti-aging and life extensionist goals of LEF.