Citrulline, Viagra® and BiDil®—bad medicine

Alternative Medicine Review, Dec, 2005 by Al Czap

A prime example of this philosophy is the sales of glucosamine/chondroitin combination products. Simply because of a popular book and a few studies showing the combination of these two ingredients is helpful in the treatment of joint conditions, the market has demanded this product. Companies have added the product to their line simply to accommodate the demand of their customers. I have told every doctor who mentions the words glucosamine or chondroitin to purchase the less expensive glucosamine and save the patient money. The individual ingredient, if made in a properly absorbable dosage form, works equally as well as the combination of the two ingredients.

Utilizing the same model, some supplement companies are marketing L-citruiline--a by-product of the arginine-to-nitric oxide pathway--as a substance to increase nitric oxide synthesis in vascular endothelial cells. Although safe, citrulline does not directly convert to nitric oxide, but instead is recycled to L-arginine (an ATP-dependent process), which then converts to nitric oxide. Ferid Murad, MD, PhD, Nobel-prize winner for his research on nitric oxide, has said the use of L-citrulline to increase nitric oxide is only marginally effective. However, ever in the spirit of making a silk purse out of a sow's ear, there will be created a market for this product, at a much greater expense to the patient. As with chondroitin, the marketing machine is gearing up and the patient will pay for it.

Common sense says toss out the Viagra, the BiDil and the citrulline, and utilize L-arginine. Change bad medicine to good medicine and ignore the hype.