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Nutritional Supplement

Arginine

  • Men's Health

    Erectile Dysfunction

    Blood vessels need arginine to dilate and form an erection. Supplementing with arginine has been shown to help men with erectile dysfunction in some studies.
    Erectile Dysfunction
    ×

    Dilation of blood vessels necessary for a normal erection depends on a substance called nitric oxide, and nitric oxide formation depends on the amino acid arginine. In a preliminary trial, men with ED were given 2,800 mg of arginine per day for two weeks. Six of the 15 men in the trial were helped, though none improved while taking placebo.1 In a larger double-blind trial, men with ED were given 1,670 mg of arginine per day or a matching placebo for six weeks.2 Arginine supplementation was found to be particularly effective at improving ED in men with abnormal nitric oxide metabolism. Although little is known about how effective arginine will be for men with ED or which subset of these men would be helped, available research looks promising and suggests that at least some men are likely to benefit.

    Male Infertility

    The amino acid arginine is needed to produce sperm. Research shows that several months of L-arginine supplementation increases sperm count, quality, and fertility.
    Male Infertility
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    Arginine, an amino acid found in many foods, is needed to produce sperm. Research, most of which is preliminary shows that several months of L-arginine supplementation increases sperm count, quality,3,4,5 and fertility.6,7 However, when the initial sperm count was extremely low (such as less than 10 million per ml), L-arginine supplementation produced little or no benefit.8,9 While some pregnancies have been attributed to arginine supplementation in preliminary reports,10 no controlled research has confirmed these claims. For infertile men with sperm counts greater than 10 million per milliliter, many doctors recommend up to 4 grams of L-arginine per day for several months.

  • Heart and Circulatory Health

    Angina

    In one study, taking arginine improved the ability of angina sufferers to exercise. Detailed studies have proven that arginine works by stimulating blood vessel dilation.
    Angina
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    Nitroglycerin and similar drugs cause dilation of arteries by interacting with nitric oxide, a potent stimulus for dilation. Nitric oxide is made from arginine, a common amino acid. Blood cells in people with angina are known to make insufficient nitric oxide,11 which may in part be due to abnormalities of arginine metabolism. Taking 2 grams of arginine three times per day for as little as three days has improved the ability of angina sufferers to exercise.12 Seven of ten people with severe angina improved dramatically after taking 9 grams of arginine per day for three months in an uncontrolled study.13 Detailed studies have investigated the mechanism of arginine and have proven it operates by stimulating blood vessel dilation.14

    Congestive Heart Failure

    The body needs arginine to make nitric oxide, which increases blood flow. This process is impaired in people with CHF. It also has been shown to improve kidney function in people with CHF.
    Congestive Heart Failure
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    The body needs arginine, another amino acid, to make nitric oxide, which increases blood flow. This process is impaired in people with CHF. Arginine supplementation (5.6–12.6 grams per day) has been used successfully in double-blind trials to treat CHF.15A double-blind trial has also found that arginine supplementation (5 grams three times daily) improves kidney function in people with CHF.16

    Hypertension

    The amino acid arginine is needed by the body to make nitric oxide, a substance that allows blood vessels to dilate, thus reducing blood pressure. Arginine given orally and intravenously has been reported to help reduce blood pressure.
    Hypertension
    ×
     

    The amino acid arginine is needed by the body to make nitric oxide, a substance that allows blood vessels to dilate, thus leading to reduced blood pressure. Intravenous administration of arginine has reduced blood pressure in humans in some reports.17 In one controlled trial, people not responding to conventional medication for their hypertension were found to respond to a combination of conventional medication and oral arginine (2 grams taken three times per day.)18

  • Sexual Health

    Erectile Dysfunction

    Blood vessels need arginine to dilate and form an erection. Supplementing with arginine has been shown to help men with erectile dysfunction in some studies.
    Erectile Dysfunction
    ×

    Dilation of blood vessels necessary for a normal erection depends on a substance called nitric oxide, and nitric oxide formation depends on the amino acid arginine. In a preliminary trial, men with ED were given 2,800 mg of arginine per day for two weeks. Six of the 15 men in the trial were helped, though none improved while taking placebo.19 In a larger double-blind trial, men with ED were given 1,670 mg of arginine per day or a matching placebo for six weeks.20 Arginine supplementation was found to be particularly effective at improving ED in men with abnormal nitric oxide metabolism. Although little is known about how effective arginine will be for men with ED or which subset of these men would be helped, available research looks promising and suggests that at least some men are likely to benefit.

  • Immune System Support

    Pre- and Post-Surgery Health

    The amino acid arginine has a role in immune function, infection prevention, and tissue repair after injury, including surgery.
    Pre- and Post-Surgery Health
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    The amino acid arginine has a role in immune function, infection prevention, and tissue repair after injury, including surgery.21 Animal research suggests that supplemental arginine may improve the outcomes in cardiovascular22 and colon surgeries.23 Other animal studies suggest a possible role for arginine in prevention of adhesions, a painful type of internal scarring that can occur with surgery.24 Human trials of formulas including arginine are discussed below, but the benefits of supplemental arginine alone have not been studied in surgery patients.

    HIV and AIDS Support and Preservation of Lean Body Mass

    The combination of glutamine, arginine, and HMB may prevent loss of lean body mass in people with AIDS-associated wasting.
    HIV and AIDS Support and Preservation of Lean Body Mass
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    The combination of glutamine, arginine, and the amino acid derivative, hydroxymethylbutyrate (HMB), may prevent loss of lean body mass in people with AIDS-associated wasting. In a double-blind trial, AIDS patients who had lost 5% of their body weight in the previous three months received either placebo or a nutrient mixture containing 1.5 grams of HMB, 7 grams of L-glutamine, and 7 grams of L-arginine twice daily for eight weeks.25 Those supplemented with placebo gained an average of 0.37 pounds, mostly fat, but lost lean body mass. Those taking the nutrient mixture gained an average of 3 pounds, 85% of which was lean body weight.

  • Healthy Pregnancy and New Baby

    Preeclampsia

    In one study in which pregnant women at an increased risk of developing preeclampsia received either arginine or a placebo, the arginine group had a significantly lower incidence of preeclampsia compared with the placebo group.
    Preeclampsia
    ×
    In a double-blind study, 100 pregnant women at increased risk of developing preeclampsia received 3 grams of arginine once a day or a placebo, starting in the 20th week of gestation and continuing until delivery. The incidence of preeclampsia was significantly lower by 74% in the arginine group than in the placebo group (6.1% vs. 23.4%).26
  • Digestive Support

    Gastritis

    The amino acid arginine may both protect the stomach and increase its blood flow.
    Gastritis
    ×
     

    Various amino acids have shown promise for people with gastritis. In a double-blind trial, taking 200 mg of cysteine four times daily provided significant benefit for people with bleeding gastritis caused by NSAIDs (such as aspirin).27 Cysteine is a sulfur-containing amino acid that stimulates healing of gastritis. In a preliminary trial, 1–4 grams per day of NAC (N-acetyl cysteine) given to people with atrophic gastritis for four weeks appeared to increase healing.28Glutamine, another amino acid is a main energy source for cells in the stomach and supplementation may increase blood flow to this region.29 Patients in surgical intensive care units often develop gastrointestinal problems related to a glutamine deficiency.30 When burn victims were supplemented with glutamine, they did not develop stress ulcers, even after several operations.31 Nevertheless, it remains unclear to what extent glutamine supplementation might prevent or help existing gastritis. Preliminary evidence suggests the amino acid arginine may both protect the stomach and increase its blood flow,32 but research has yet to investigate the effects of arginine supplementation in people with gastritis.

  • Pain Management

    Wound Healing

    Arginine appears to improve wound healing by increasing protein synthesis.
    Wound Healing
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    Arginine supplementation increases protein synthesis and improves wound healing in animals.33 Two controlled trials have shown increased tissue synthesis in surgical wounds in people given 17–25 grams of oral arginine per day.34,35

     
  • Skin Protection

    Wound Healing

    Arginine appears to improve wound healing by increasing protein synthesis.
    Wound Healing
    ×

    Arginine supplementation increases protein synthesis and improves wound healing in animals.36 Two controlled trials have shown increased tissue synthesis in surgical wounds in people given 17–25 grams of oral arginine per day.37,38

     
  • Strength and Muscle Gain

    Athletic Performance and Body Composition and Strength

    At very high intakes, the amino acid arginine has increased growth hormone levels, which stimulate muscle growth. Trials combining weight training with arginine and ornithine showed decreases in body fat and increases in total strength and lean body mass.
    Athletic Performance and Body Composition and Strength
    ×

    At very high intakes (approximately 250 mg per 2.2 pounds of body weight), the amino acid arginine has increased growth hormone levels,39 an effect that has interested body builders due to the role of growth hormone in stimulating muscle growth.40 However, at lower amounts recommended by some manufacturers (5 grams taken 30 minutes before exercise), arginine failed to increase growth hormone release and may even have impaired the release of growth hormone in younger adults.41 Large quantities (170 mg per 2.2 pounds of body weight per day) of a related amino acid, ornithine, have also raised growth hormone levels in some athletes.42 High amounts of arginine or ornithine do not appear to raise levels of insulin,43,44 another anabolic (bodybuilding) hormone. More modest amounts of a combination of these amino acids have not had measurable effects on any anabolic hormone levels during exercise.45,46

    Nonetheless, double-blind trials conducted by one group of researchers, combining weight training with either arginine and ornithine (500 mg of each, twice per day, five times per week) or placebo, found the amino-acid combination produced decreases in body fat,47 resulted in higher total strength and lean body mass, and reduced evidence of tissue breakdown after only five weeks.48

  • Fitness

    Athletic Performance and Body Composition and Strength

    At very high intakes, the amino acid arginine has increased growth hormone levels, which stimulate muscle growth. Trials combining weight training with arginine and ornithine showed decreases in body fat and increases in total strength and lean body mass.
    Athletic Performance and Body Composition and Strength
    ×

    At very high intakes (approximately 250 mg per 2.2 pounds of body weight), the amino acid arginine has increased growth hormone levels,49 an effect that has interested body builders due to the role of growth hormone in stimulating muscle growth.50 However, at lower amounts recommended by some manufacturers (5 grams taken 30 minutes before exercise), arginine failed to increase growth hormone release and may even have impaired the release of growth hormone in younger adults.51 Large quantities (170 mg per 2.2 pounds of body weight per day) of a related amino acid, ornithine, have also raised growth hormone levels in some athletes.52 High amounts of arginine or ornithine do not appear to raise levels of insulin,53,54 another anabolic (bodybuilding) hormone. More modest amounts of a combination of these amino acids have not had measurable effects on any anabolic hormone levels during exercise.55,56

    Nonetheless, double-blind trials conducted by one group of researchers, combining weight training with either arginine and ornithine (500 mg of each, twice per day, five times per week) or placebo, found the amino-acid combination produced decreases in body fat,57 resulted in higher total strength and lean body mass, and reduced evidence of tissue breakdown after only five weeks.58

  • Women's Health

    Female Infertility and In Vitro Fertilization

    Supplementing with L-arginine has been shown to improve fertility in women with a history of failed attempts at in vitro fertilization.
    Female Infertility and In Vitro Fertilization
    ×
     

    Supplementation with the amino acid, L-arginine (16 grams per day), has been shown to improve fertilization rates in women with a previous history of failed attempts at in vitro (test tube) fertilization.59

What Are Star Ratings?
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

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References

1. Zorgniotti AW, Lizza EF. Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction. Int J Impot Res 1994;6:33-6.

2. Chen J, Wollman Y, Chernichovsky T, et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized study. BJU Int 1999;83:269-73.

3. De Aloysio D, Mantuano R, Mauloni M, Nicoletti G. The clinical use of arginine aspartate in male infertility. Acta Eur Fertil 1982;13:133-67.

4. Tanimura J. Studies on arginine in human semen. Part II. The effects of medication with L-arginine-HCl on male infertility. Bull Osaka Med School 1967;13:84-9.

5. Scibona M, Meschini P, Capparelli S, et al. L-arginine and male infertility. Minerva Urol Nefrol 1994;46:251-3.

6. Schacter A, Goldman JA, Zukerman Z. Treatment of oligospermia with the amino acid arginine. J Urol 1973;110:311-3.

7. Schacter A, Friedman S, Goldman JA, Eckerling B. Treatment of oligospermia with the amino acid arginine. Int J Gynaecol Obstet 1973;11:206-9.

8. Mroueh A. Effect of arginine on oligospermia. Fertil Steril 1970:21:217-9.

9. Pryor JP, Blandy JP, Evans P, et al. Controlled clinical trial of arginine for infertile men with oligozoospermia. Br J Urol 1978;50:47-50.

10. Aydin S, Inci O, Alagol B. The role of arginine, indomethacin and kallikrein in the treatment of oligoasthenospermia. Int Urol Nephrol 1995;27:199-202.

11. Mollace V, Romeo F, Martuscelli E, et al. Low formation of nitric oxide in polymorphonuclear cells in unstable angina pectoris. Am J Cardiol 1994;74:65-8.

12. Ceremuzynski L, Chamiec T, Herbaczynska-Cedro K. Effect of supplemental oral L-arginine on exercise capacity in patients with stable angina pectoris. Am J Cardiol 1997;80:331-3.

13. Blum A, Porat R, Rosenschein U, et al. Clinical and inflammatory effects of dietary L-arginine in patients with intractable angina pectoris. Am J Cardiol 1999;83:1488-90.

14. Egashira K, Hirooka Y, Kuga T, et al. Effects of L-arginine supplementation on endothelium-dependent coronary vasodilation in patients with angina pectoris and normal coronary arteriograms. Circulation 1996;94:130-4.

15. Rector TS, Bank A, Mullen KA, et al. Randomized, double-blind, placebo controlled study of supplemental oral L-arginine in patients with heart failure. Circulation 1996;93:2135-41.

16. Watanabe G, Tomiyama H, Doba N. Effects of oral administration of L-arginine on renal function in patients with heart failure. J Hypertens 2000;18:229-34.

17. Calver A, Collier J, Vallance P. Dilator actions of arginine in human peripheral vasculature. Clin Sci 1991;81:695-700.

18. Pezza V, Bernardini F, Pezza E, et al. Study of supplemental oral l-arginine in hypertensives treated with enalapril + hydrochlorothiazide. Am J Hypertens 1998;11:1267-70 [letter].

19. Zorgniotti AW, Lizza EF. Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction. Int J Impot Res 1994;6:33-6.

20. Chen J, Wollman Y, Chernichovsky T, et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized study. BJU Int 1999;83:269-73.

21. Evoy D, Lieberman MD, Fahey TJ 3rd, Daly JM. Immunonutrition: the role of arginine. Nutrition 1998;14:611-7 [review].

22. Szabo G, Bahrle S, Batkai S, et al. L-arginine: effect on reperfusion injury after heart transplantation. World J Surg 1998;22:791-7.

23. Shashidharan M, Lin KM, Ternent CA, et al. Influence of arginine dietary supplementation on healing colonic anastomosis in the rat. Dis Colon Rectum 1999;42:1613-7.

24. Kaleli B, Ozden A, Aybek Z, Bostanci B. The effect of L-arginine and pentoxifylline on postoperative adhesion formation. Acta Obstet Gynecol Scand 1998;77:377-80.

25. Clark RH, Feleke G, Din M, et al. Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study. JPEN J Parenter Enteral Nutr 2000;24:133-9.

26. Camarena Pulido EE, Garcia Benavides L, Panduro Baron JG, et al. Efficacy of L-arginine for preventing preeclampsia in high-risk pregnancies: A double-blind, randomized, clinical trial. Hypertens Pregnancy 2016;35:217–25.

27. Salim AS. Sulfhydryl-containing agents in the treatment of gastric bleeding induced by non-steroidal anti-inflammatory drugs. Can J Surg 1993;36(1):53-8.

28. Farinati F, Cardin R, Della Libera G, et al. Effects of N-acetyl-L-cysteine in patients with chronic atrophic gastritis and nonulcer dyspepsia: a phase III pilot study. Curr Ther Res 1997;58:724-33.

29. Houdijk AP, Van Leeuwen PA, Boermeester MA, et al. Glutamine-enriched enteral diet increases splanchnic blood flow in the rat. Am J Physiol 1994;267(6 Pt 1):G1035-40.

30. Wilmore DW, Smith RJ, O'Dwyer ST, et al. The gut: a central organ after surgical stress. Surgery 1988;104:917-23.

31. Yan R, Sun Y, Sun R. Early enteral feeding and supplement of glutamine prevent occurrence of stress ulcer following severe thermal injury. Chung Hua Cheng Hsing Shao Shang Wai Ko Tsa Chih 1995;11(3):189-92.

32. Brzozowski T, Konturek SJ, Sliwowski Z, et al. Role of L-arginine, a substrate for nitric oxide-synthase, in gastroprotection and ulcer healing. J Gastroenterol 1997;32(4):442-52.

33. Barbul A, Rettura G, Levenson SM, et al. Wound healing and thymotropic effects of arginine: a pituitary mechanism of action. Am J Clin Nutr 1983;37:786-94.

34. Kirk SJ, Hurson M, Regan MC, et al. Arginine stimulates wound healing and immune function in elderly human beings. Surgery 1993;114:155-60.

35. Barbul A, Lazarou SA, Efron DT, et al. Arginine enhances wound healing and lymphocyte immune responses in humans. Surgery 1990;108:331-7.

36. Barbul A, Rettura G, Levenson SM, et al. Wound healing and thymotropic effects of arginine: a pituitary mechanism of action. Am J Clin Nutr 1983;37:786-94.

37. Kirk SJ, Hurson M, Regan MC, et al. Arginine stimulates wound healing and immune function in elderly human beings. Surgery 1993;114:155-60.

38. Barbul A, Lazarou SA, Efron DT, et al. Arginine enhances wound healing and lymphocyte immune responses in humans. Surgery 1990;108:331-7.

39. Besset A, Bonardet A, Rondouin G, et al. Increase in sleep related GH and Prl secretion after chronic arginine aspartate administration in man. Acta Endocrinol 1982;99:18-23.

40. Macintyre JG. Growth hormone and athletes. Sports Med 1987;4:129-42 [review].

41. Marcell TJ, Taaffe DR, Hawkins SA, et al. Oral arginine does not stimulate basal or augment exercise-induced GH secretion in either young or old adults. J Gerontol A Biol Sci Med Sci 1999;54:M395-9.

42. Bucci L, Hickson JF, Pivarnik JF, et al. Ornithine ingestion and growth hormone release in body-builders. Nutr Res 1990;10:239-45.

43. Gater DR, Gater DA, Uribe JM, et al. Effects of arginine/lysine supplementation and resistance training on glucose tolerance. J Appl Physiol 1992;72:1279-84.

44. Bucci LR, Hickson JF Jr, Wolinsky I, et al. Ornithine supplementation and insulin release in bodybuilders. Int J Sport Nutr 1992;2:287-91.

45. Suminski RR, Robertson RJ, Goss FL, et al. Acute effect of amino acid ingestion and resistance exercise on plasma growth hormone concentration in young men. Int J Sport Nutr 1997;7:48-60.

46. Fogelholm GM, Naveri HK, Kiilavuori KT, et al. Low-dose amino acid supplementation: no effects on serum human growth hormone and insulin in male weightlifters. Int J Sport Nutr 1993;3:290-7.

47. Elam RP. Morphological changes in adult males from resistance exercise and amino acid supplementation. J Sports Med Phys Fitness 1988;28:35-9.

48. Elam RP, Hardin DH, Sutton RA, et al. Effects of arginine and ornithine on strength, lean body mass and urinary hydroxyproline in adult males. J Sports Med Phys Fitness 1989;29:52-6.

49. Besset A, Bonardet A, Rondouin G, et al. Increase in sleep related GH and Prl secretion after chronic arginine aspartate administration in man. Acta Endocrinol 1982;99:18-23.

50. Macintyre JG. Growth hormone and athletes. Sports Med 1987;4:129-42 [review].

51. Marcell TJ, Taaffe DR, Hawkins SA, et al. Oral arginine does not stimulate basal or augment exercise-induced GH secretion in either young or old adults. J Gerontol A Biol Sci Med Sci 1999;54:M395-9.

52. Bucci L, Hickson JF, Pivarnik JF, et al. Ornithine ingestion and growth hormone release in body-builders. Nutr Res 1990;10:239-45.

53. Gater DR, Gater DA, Uribe JM, et al. Effects of arginine/lysine supplementation and resistance training on glucose tolerance. J Appl Physiol 1992;72:1279-84.

54. Bucci LR, Hickson JF Jr, Wolinsky I, et al. Ornithine supplementation and insulin release in bodybuilders. Int J Sport Nutr 1992;2:287-91.

55. Suminski RR, Robertson RJ, Goss FL, et al. Acute effect of amino acid ingestion and resistance exercise on plasma growth hormone concentration in young men. Int J Sport Nutr 1997;7:48-60.

56. Fogelholm GM, Naveri HK, Kiilavuori KT, et al. Low-dose amino acid supplementation: no effects on serum human growth hormone and insulin in male weightlifters. Int J Sport Nutr 1993;3:290-7.

57. Elam RP. Morphological changes in adult males from resistance exercise and amino acid supplementation. J Sports Med Phys Fitness 1988;28:35-9.

58. Elam RP, Hardin DH, Sutton RA, et al. Effects of arginine and ornithine on strength, lean body mass and urinary hydroxyproline in adult males. J Sports Med Phys Fitness 1989;29:52-6.

59. Battaglia C, Salvatori M, Maxia N, et al. Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients. Hum Reprod 1999;14:1690-7.

60. Schulman SP, Becker LC, Kass DA, et al. L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial. JAMA 2006;295:58-64.

61. Resnick DJ, Softness B, Murphy AR, et al. Case report of an anaphylactoid reaction to arginine. Ann Allergy Asthma Immunol 2002;88:67-8.

62. Park KGM. The immunological and metabolic effects of L-arginine in human cancer. Proc Nutr Soc 1993;52:387-401.

63. Takeda Y, Tominga T, Tei N, et al. Inhibitory effect of L-arginine on growth of rat mammary tumors induced by 7,12-dimethlybenz(a)anthracine. Cancer Res 1975;35:2390-3.

64. Brittenden J, Park KGM, Heys SD, et al. L-arginine stimulates host defenses in patients with breast cancer. Surgery 1994;115:205-12.

Copyright © 2020 TraceGains, Inc. All rights reserved.

Learn more about TraceGains, the company.

The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2020.

Copyright © 2020 TraceGains, Inc. All rights reserved.

The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2020.