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Safety Issues
There is good evidence that arginine is safe and well tolerated at levels up to 20 g per day, 1 although minor gastrointestinal upset can occur. However, there are some potential safety issues regarding high-dose arginine. These cautions are based on findings from animal studies and hospital experiences of intravenous administration.
For example, arginine may stimulate the body's production of gastrin, a hormone that increases stomach acid. 2 For this reason, there are concerns that arginine could be harmful for people with ulcers or who take drugs that are hard on the stomach. In addition, a double-blind trial found that arginine (30 g/day) may increase the risk of esophageal reflux (heartburn) by relaxing the sphincter at the bottom of the esophagus. 3 Arginine might also alter potassium levels in the body, especially in people with severe liver disease. 4 This is a potential concern for individuals who take drugs that also alter potassium balance (such as potassium-sparing diuretics and ACE inhibitors ), as well as those with severe kidney disease. If you fall into any of these categories, do not use high-dose arginine except under physician supervision.
Evidence that arginine can improve insulin sensitivity 5 raises theoretical concerns that, if you have diabetes and take arginine, your blood sugar could fall too low. However, one study suggests that arginine is safe for use by people with stable type 2 (adult-onset) diabetes. 6 The amino acid lysine has been advocated for use in oral or genital herpes . According to the theory behind this recommendation, it is important to simultaneously restrict arginine intake. If true, this would tend to suggest that arginine supplements would be harmful for people with a tendency to develop herpes. However, there is no meaningful evidence to support this hypothesis.
Maximum safe doses in pregnant or nursing women, young children, and those with severe liver or kidney disease have not been established.
Interactions You Should Know About
If you are taking:
- Drugs that are hard on the stomach (such as nonsteroidal anti-inflammatory medications ): Taking high doses of arginine might stress your stomach additionally.
- Medications that can alter the balance of potassium in your body (such as potassium-sparing diuretics or ACE inhibitors ): High doses of arginine should be used only under physician supervision.
- Transdermal nitroglycerin : Arginine may help prevent the development of tolerance. ( Note: Your doctor's supervision is essential.)
References
- Shao A, Hathcock JN. Risk assessment for the amino acids taurine, L-glutamine and L-arginine. Regul Toxicol Pharmacol. 50(3):376-99.
- AHFS Drug Information. Bethesda, MD: American Society of Hospital Pharmacists. 2000:2306-2307.
- Luiking YC, Weusten BL, Portincasa P, Van Der Meer R, Smout AJ, Akkermans LM. Effects of long-term oral L-arginine on esophageal motility and gallbladder dynamics in healthy humans. Am J Physiol. 274(6 Pt 1):G984-91.
- AHFS Drug Information. Bethesda, MD: American Society of Hospital Pharmacists. 2000:2306-2307.
- Piatti PM, Monti LD, Valsecchi G, Magni F, Setola E, Marchesi F, Galli-Kienle M, Pozza G, Alberti KG. Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients. Diabetes Care. 24(5):875-80.
- Bruinsma KA, Anderson BE, Prendergast JJ, et al. Effects of an L-arginine-enriched medical food in patients with type II diabetes [abstract]. Diabetes. 2001;50(suppl 2):1796-PO.
- Griffith RS, DeLong DC, Nelson JD. Relation of arginine-lysine antagonism to herpes simplex growth in tissue culture. Chemotherapy. 27(3):209-13.
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