What supplements are best for ED?

Some research supports supplementing with vitamin D, red ginseng, L-alanine, L-carnitine, and Tribulus terrestris to treat mild to moderate ED. In some cases, they may also improve the effectiveness of ED medications, such as Viagra.

healthline.com - Erectile Dysfunction and Vitamins: What's the Connection? - Healthline

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In particular, many people may wonder whether certain supplements and vitamins are effective. This article tells you which supplements and vitamins may help manage ED. Though ED is treatable through prescription medications or medical procedures, there has been an increased interest in alternative remedies to improve ED symptoms. You can’t prevent some causes of ED, such as aging. However, research shows that a healthy lifestyle can lower the risk of ED. For example, maintaining a body weight that’s healthful for you through physical activity has been associated with lower rates of ED ( 3 , 4 ). Erectile dysfunction (ED) is characterized as a symptom, not a condition. Though there are many causes of ED, the most common include health conditions such as diabetes , sleep disorders , and heart disease , as well as lifestyle habits such as smoking and alcohol misuse ( 2 ). By 2025, it’s expected that 322 million men will be affected by erectile dysfunction worldwide ( 1 ). Though there’s no conclusive data to support taking supplements to treat ED, some research shows that certain vitamins and herbal remedies may improve ED symptoms.

Vitamin D

Vitamin D is one of the most studied vitamins in the treatment of ED. It’s a steroid hormone that has been linked with sexual function and cardiovascular health. One 2020 analysis showed a significant association between low vitamin D levels and ED severity. This suggests that low levels may make symptoms worse, compared with adequate vitamin D levels ( 5 ). Another study from 2016 in 92 males with type 2 diabetes showed higher rates of ED and worsened ED symptoms in those with low vitamin D levels, compared with people with adequate levels ( 6 ). Other studies have also shown an association between vitamin D deficiency and ED ( 7 , 8 ). That said, one 2019 analysis showed no significant association between vitamin D deficiency and ED. Though, it suggested ED symptoms may be heightened in those with other chronic conditions (e.g., type 2 diabetes, heart disease) and low vitamin D levels ( 9 ). It’s believed that vitamin D may support ED by improving blood flow to the penis and supporting the production of male hormones, such as testosterone. While this theory is promising, more research is needed to confirm it ( 10 , 11 ).

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If you suspect you or a loved one has a vitamin D deficiency, get your levels checked by a healthcare professional. For most people, vitamin D levels can be easily balanced with a vitamin D supplement.

Red ginseng

Red ginseng is commonly referred to as the “herbal Viagra” for its ability to help with ED. It’s also known as panax ginseng. Red ginseng contains compounds called ginsenosides, which may help to relax smooth muscle in the penis to support an erection. Plus, it’s believed to improve cardiovascular health, which is commonly associated with ED ( 12 ). One 2018 analysis showed significant improvements in International Index of Erectile Dysfunction (IIEF) scores with red ginseng, compared with a placebo. There were also significant improvements in erectile function and sexual satisfaction ( 13 ). Another 2021 review showed minor improvements in ED symptoms, but the authors suggested the effects may not be clinically relevant ( 14 ).

That said, more research is needed.

L-arginine

L-arginine is a naturally occurring amino acid that increases nitric oxide production, which can help stimulate an erection. One 2019 analysis showed that supplementing with 1,500 to 5,000 mg of L-arginine led to significant improvements in IIEF scores. The authors concluded L-arginine may be effective in treating mild to moderate ED ( 15 ). Another 2020 randomized study showed L-arginine (2,500 mg per day) was equally as effective in treating mild and moderate ED as tadalafil (5 mg), a common ED medication. And a combination of both therapies showed the most improvements ( 16 ). Another study showed similar improvements in ED with L-alanine by itself as well as when combined with tadalafil ( 17 ).

L-carnitine

L-carnitine is an amino acid derivative that supports fat metabolism, sperm production, and cardiovascular health. It may support ED by improving penile blood flow ( 18 ). In particular, Propionyl-L-carnitine has been shown to improve ED when combined with other remedies, such as L-arginine and sildenafil (Viagra).

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In one study in 54 men with ED, taking a supplement containing Propionyl-L-carnitine, L-arginine, and niacin (vitamin B3) for 3 months led to significant improvements in IIEF scores ( 19 ). Notably, 37% and 46% of subjects reported minor or substantial improvements in ED symptoms, respectively. That said, the study couldn’t attribute the improvement in symptoms solely to L-carnitine ( 19 ). One review showed that non-responders to sildenafil (Viagra) may have low L-carnitine and vitamin D levels, suggesting supplementation may improve medication effectiveness ( 20 ). While this is promising, more clinical research is needed before it can be recommended as a stand-alone remedy.

Tribulus terrestris

Tribulus terrestris is a small, leafy plant that has been used in traditional Chinese medicine and Ayurvedic medicine as an aphrodisiac. Research on it is mixed, though ( 21 ). In one 2014 randomized, double-blind study, supplementing with Tribestan (Tribulus terrestris, 800 mg per day) for 30 days was not effective in improving IIEF scores compared to a placebo ( 22 ). In contrast, a 2017 randomized, double-blind study showed significant improvements in IIEF scores after supplementing with Tribestan (Tribulus terrestris, 1,500 mg per day) for 12 weeks. The authors suggested it may be an effective option in treating mild to moderate ED ( 23 ). Another 2016 review suggested that though research on Tribulus terrestris in treating ED is inconclusive, it may provide modest improvements in symptoms. The authors concluded that more human trials are needed ( 24 ). While these remedies may help reduce ED, it’s important to speak with a healthcare professional before starting any new supplements to make sure it’s right for you and won’t interact with any medications you may be taking.

healthline.com - Erectile Dysfunction and Vitamins: What's the Connection? - Healthline

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