The Ultimate Natural Sex Cocktail Stack
By Steve Blechman
Do you have the major risk factors for cardiovascular disease such as: family history (mother, father, sibling, etc.), elevated blood lipids and LDL (bad) cholesterol, low HDL (good) cholesterol, hypertension, elevated triglycerides and C-reactive protein (a measure of inflammation in the body)? If you have any of these risk factors, you need to take charge and lower your risk. See your physician now! Every risk factor that you eliminate, you lower your risk of heart disease and erectile dysfunction. To improve long-term cardiovascular health and erectile function, men should eat a heart-healthy Mediterranean diet and engage in a daily resistance training and vigorous aerobic exercise program. Several studies have shown that men combining physical activity with the Mediterranean diet can provide additional and enhanced benefits to alleviate erectile function. Regular exercise and the Mediterranean diet also stimulate nitric oxide release and promote health and function of endothelial cells lining vascular walls.
Overweight men that lose weight often have improvement in their erectile function, testosterone levels, and sexual health. Research has shown that men following the Mediterranean diet, low in saturated fat and high in monounsaturated fats, omega-3 fats, nitrates, and polyphenols (from extra-virgin olive oil, nuts, fatty fish, fruits, and leafy vegetables) have less erectile dysfunction. Research has also shown that men with the metabolic syndrome – a group of risk factors (i.e., hypertension, high blood lipids and insulin resistance) – were more than 100% likely to have erection problems than people who exercise regularly. The incidents of heart disease were greatest in men suffering from the metabolic syndrome and erectile dysfunction. Exercise and the Mediterranean diet protect against erectile dysfunction and cardiovascular disease.
What are the best nutrients reported in the scientific literature to enhance erectile function and better sexual performance?
- L-citrulline, an amino acid that when taken orally is converted in the body to L-arginine. L-citrulline has been shown in the scientific research to increase L-arginine more efficiently in the body than L-arginine and increase nitric oxide production. Nitric oxide acts as a vasodilator (blood vessel relaxant) and controls blood flow to tissues and to the penis. It is generally accepted that nitric oxide is the principal agent responsible for relaxation of penile smooth muscle. Research has shown that 5.6 grams per day of L-citrulline for seven days reduced blood vessel stiffness in middle-aged men (International Journal of Cardiology, Nov. 8, 2010). Research has also shown that oral citrulline can improve erectile function (Sex Med, 2018). Oral citrulline supplementation of 1.5 grams (for 30 days) improves erectile hardness in men with erectile dysfunction (Urology, January 2011). A study published in the July 2019 issue of the Journal Andrology compared the erectile dysfunction drug sildenafil (50mg) alone or in combination with L-arginine (3 grams) daily for eight weeks. Researchers concluded that, “adding L-arginine to sildenafil demonstrated more efficacy than sildenafil alone for treatment of erectile dysfunction patients.” Since L-citrulline is more effective than L-arginine for raising blood levels of arginine it would be expected that citrulline would be much more effective than L-arginine.†
- Nitrates (NO3) boosts nitric oxide (NO). Research has shown that the traditional Mediterranean diet can enhance sexual function. It contains a high intake of fruits and vegetables rich in nitrates (NO3) that enhance nitric oxide (NO). NO is a potent vasodilator that can enhance blood flow in the penis and helps form an erection more easily.†
A high nitrate (NO3) diet may increase cyclic guanosine monophosphate (cGMP) that helps arteries relax, which can increase blood flow to the penis. Many erectile dysfunction drugs work by enhancing cGMP in men to help achieve and maintain an erection.†
A cohort study among 21,469 men was published November 13, 2020 in the Journal of the American Medical Association (JAMA Network Open) said that following a healthy diet pattern like the Mediterranean diet, “was associated a lower risk of erectile dysfunction, suggesting that a healthy pattern may play a role in maintaining erectile health.”
The most popular nitric oxide (NO) precursors include the amino acid citrulline, which provides one of the body’s two nitric oxide pathway (citrulline arginine pathway). The other pathway is the nitrate-nitrite pathway. Both boost nitric oxide, which may enhance sexual performance.†
- Natural polyphenols from beetroot extract, grape skin extract and pine bark extract contain potent antioxidants that have many health benefits including increasing nitric oxide and vasodilation. Most erection problems are caused by poor blood flow to the penis. Cells lining the blood vessels secrete nitric oxide that controls blood flow. Blood vessel disease disturbs the function of these cells, which reduces the ability to release nitric oxide and maintain erections. Researchers from Norwich Medical School in the U.K. found that men with the greatest dietary polyphenol intake showed a 14% lower risk of erectile dysfunction. Polyphenols are chemicals found in many plants that decrease inflammation, lower blood pressure, act as antioxidants, and boost nitric oxide (American Journal of Clinical Nutrition, 2016).†
- Vitamin C and N-acetylcysteine (NAC) are antioxidants that enhance the function of polyphenols in the body. Men with erectile dysfunction (ED) show higher levels of free radicals and lower levels of antioxidants than men without ED. Antioxidants such as vitamin C and N-acetylcysteine (NAC) combined with the B vitamin folic acid can improve erection capacity in aging men. Vitamin C, NAC, and folic acid work synergistically, together with polyphenols, nitrates, and the amino acid L-citrulline in the production of nitric oxide. Folic acid is a precursor of tetrahydrobiopterin (BH4), and when combined with vitamin C and NAC, plays an important role in sustaining nitric acid bioavailability and endothelial (blood vessel) nitric acid synthase and nitric oxide synthesis. BH4 increases nitric oxide bioavailability and systemic (cGMP) levels in healthy adults, which might be an attractive treatment for erectile dysfunction.†
- N-acetylcysteine (NAC) is a more biologically active and more stable form of the amino acid L-cysteine. NAC increases the important antioxidant glutathione in your body.
Research has shown that NAC can prevent oxidative stress and enhance nitric oxide bioavailability. NAC is also a precursor for the synthesis of hydrogen sulfide. Clinical studies are emerging that indicate hydrogen sulfide may be beneficial in the enhancement of cardiovascular health. Research has shown that hydrogen sulfide (H2S) is a potent vasodilator and increases healthy blood flow to the body and penis and enhances penile erection and sexual performance (Journal Andrology, July/August 2012). “The current pharmacotherapy for erectile dysfunction (ED) relies significantly of the use of phosphodiesterase type 5 (PDE5) inhibitors, but quite a proportion of ED patients are resistant to this therapy, necessitating a search for an alternative treatment,” researchers said. “Given the mounting evidence of H2S’ role in erectile function and how it appears to achieve its pro-erectile effects through different mechanisms, H2S represents a potentially alternative treatment or adjunct to PDE5 inhibitors.” (Journal of Sexual Medicine, 2011)† Research has shown that NAC is a safer hydrogen sulfide precursor and hydrogen sulfide donor than sulfide salts such as sodium sulfide. Sulfide salts release hydrogen sulfide in an uncontrolled manner and may cause acute toxicity to organs. NAC is the preferred and safest supplement for increasing hydrogen sulfide.†
- Niacin and horny goat weed extract: Niacin is a B vitamin and potent vasodilator along with horny goat weed extract standardized for icariin. Niacin releases histamine, which has been shown to release nitric oxide from endothelial cells to cause vasorelaxation and improved erectile function. Horny goat weed is an herb that has been a traditional remedy in China for enhancing sexual enhancement for many years. Icariin (a flavonol glycoside) is the active ingredient in horny goat weed that inhibits the phosphodiesterase-5 (PDE5) enzyme in the body that controls blood flow.†
Advanced Molecular Labs (AML) SEX COCKTAIL™ is the most scientifically advanced natural sexual enhancement dietary supplement ever developed!† For best results, take 60 minutes before bedtime daily. It is also recommended to exercise daily and follow a heart-healthy diet such as the Mediterranean diet. No erectile dysfunction drugs are present. It provides the most scientifically researched nutrients (see scientific references below) for helping to support healthy vasodilation, blood flow and natural sexual enhancement. AML SEX COCKTAIL™ is not for use by persons under the age of 18. Do not use if taking recreational nitrate drugs or nitrates for cardiovascular disease. Also, do not take with erectile dysfunction drugs. Do not exceed recommended dosage. Consult your physician prior to use if you have a medical condition before beginning any diet or supplement program.†
ULTIMATE SEX COCKTAIL STACK
Advanced Molecular Labs (AML) NITRATE NO3 BOOSTER, a high-performance, scientifically advanced, super nitrate (NO3) formula. It contains patented citrulline nitrate (NO3T®), a patented nitric oxide (NO) booster that promotes nitric oxide by two pathways (L-citrulline and nitrate) in a single ingredient.†
Citrulline nitrate is a unique nitric oxide-boosting compound containing the amino acid L-citrulline, specifically bonded to nitrate. Nitrate is naturally found in red beets, spinach, kale, and arugula and is converted to nitric oxide in the body. Citrulline is found in a number of foods such as watermelon and as a dietary supplement is superior to L-arginine for increasing blood levels of arginine. Therefore, L-citrulline is more effective than L-arginine for boosting nitric oxide production.†
Arginine is a precursor, which the body uses to generate nitric oxide – an important signaling molecule that may improve muscular function and exercise performance. Nitric oxide (NO) enhances vasodilation (widening of blood vessels), which may favorably impact greater blood flow, oxygen and nutrient delivery to working muscles.†
Greater nitric oxide (NO) production supports better muscle pumps! Nitric oxide (NO) may also enhance energy production, work capacity, time to exhaustion and increasing the number of repetitions performed in the gym during training.†
AML NITRATE (NO3) BOOSTER capsules contain 2000mg of citrulline nitrate per dose (standardized for 27% nitrate providing 540mg nitrate).
AML NITRATE (NO3) BOOSTER also contains a science-based, synergistic blend of nitric oxide-boosting vitamins, antioxidants and polyphenols: Folic Acid, Vitamin B-12, Vitamin C, Pine Bark Extract (standardized for 95% Proanthocyanidins), and Grape Skin Extract (standardized for 30% polyphenols), to help maximize and support nitric oxide (NO) production and bioavailability.†
AML NITRATE (NO3) BOOSTER capsules can also be taken 1-1½ hours before bedtime with AML SEX COCKTAIL for better sexual performance in the bedroom. If preferred, capsules can be opened and added to AML Sex Cocktail.
†These statements have not been evaluated by the Food and Drug administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
© Published by Advanced Research Media, Inc. 2023
© Reprinted with permission from Advanced Research Media, Inc.
1. Bauer SR, Breyer BN, Stampfer MJ, Rimm EB, Giovannucci EL, Kenfield SA. Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study. JAMA Netw Open. 2020;3(11):e2021701. doi:10.1001/jamanetworkopen. November 13, 2020.21701
2. Mediterranean diet shows promise in men with erectile dysfunction. 25 Aug 2021. European Society of Cardiology. https://www.escardio.org/The-ESC/Press-Office/Press-releases/mediterranean-diet-shows-promise-in-men-with-erectile-dysfunction
3. Di Francesco S, Tenaglia RL. Mediterranean diet and erectile dysfunction: a current perspective. Cent European J Urol. 2017 Jun 30;70(2):185-187. doi: 10.5173/ceju.2017.1356. Epub 2017 Jun 11. PMID: 28721287; PMCID: PMC5510347.
4. Yang H, Breyer BN, Rimm EB, Giovannucci E, Loeb S, Kenfield SA, Bauer SR. Plant-based diet index and erectile dysfunction in the Health Professionals Follow-Up Study. BJU Int. 2022 Oct;130(4):514-521. doi: 10.1111/bju.15765. Epub 2022 Jun 9. PMID: 35484829; PMCID: PMC9474604.
5. Lu Y, Kang J, Li Z, Wang X, Liu K, Zhou K, Wang W, Shen C. The association between plant-based diet and erectile dysfunction in Chinese men. Basic Clin Androl. 2021 May 13;31(1):11. doi: 10.1186/s12610-021-00129-5. PMID: 33980148; PMCID: PMC8117588.
6. Carto C, Pagalavan M, Nackeeran S, Blachman-Braun R, Kresch E, Kuchakulla M, Ramasamy R. Consumption of a Healthy Plant-based Diet is Associated With a Decreased Risk of Erectile Dysfunction: A Cross-sectional Study of the National Health and Nutrition Examination Survey. Urology. 2022 Mar;161:76-82. doi: 10.1016/j.urology.2021.12.021. Epub 2022 Jan 1. PMID: 34979217.
7. Hydrogen sulfide compensates nitric oxide deficiency in murine corpus cavernosum. Pharmacological research, November 2016. Yetik-Anacak, Günay; Dikmen, Aycan; Coletta et al. https://doi.org/10.1016/j.phrs.2016.08.015
8. Hydrogen sulfide as a mediator of human corpus cavernosum smooth-muscle relaxation. March 2009. d'Emmanuele di Villa Bianca R, Sorrentino R, Maffia P, et al. Proc Natl Acad Sci USA. 2009;106(11):4513-4518. doi:10.1073/pnas.0807974105
9. Possible role for the novel gasotransmitter hydrogen sulphide in erectile dysfunction - a pilot study. March 2006. European Journal of Pharmacology. Balasubramanian Srilatha, P. Ganesan Adaikan, Philip K. Moore. https://doi.org/10.1016/j.ejphar.2006.02.001
10. Meng, J., Ganesan Adaikan, P. & Srilatha, B. Hydrogen sulfide promotes nitric oxide production in corpus cavernosum by enhancing expression of endothelial nitric oxide synthase. Int J Impot Res25, 86-90 (2013) doi:10.1038/ijir.2012.39
11. Qiu X, Villalta J, Lin G, Lue TF. Role of hydrogen sulfide in the physiology of penile erection. J Androl. 2012;33(4):529-535. doi:10.2164/jandrol.111.014936
12. N-acetylcysteine Ameliorates the Erectile Dysfunction Caused by Chronic Intermittent Hypoxia in Rats: Partly Involvement of Endoplasmic Reticulum Stress. Zhu, Die et al. October 2015. Journal of Urology.
13. Hydrogen sulfide and erectile function: a novel therapeutic target. d'Emmanuele di Villa Bianca, R., Sorrentino, R., Mirone, V. et al.Nat Rev Urol 8, 286-289 (April 2011) doi:10.1038/nrurol.2011.45
14. Hydrogen Sulfide: From Physiology to Pharmacology, Inflammation & Allergy. Fiorucci, S. Drug Targets (Discontinued) (April 2011) 10: 77. https://doi.org/10.2174/187152811794776277
15. Contribution of cysteine aminotransferase and mercaptopyruvate sulfurtransferase to hydrogen sulfide production in peripheral neurons. Ryo Miyamoto et al. Neurochem.(2014) 130, 29-40. February 2014. https://doi.org/10.1111/jnc.12698
16. Hydrogen sulfide: role in vascular physiology and pathology. Kim Holwerda, S. Karumanchi, and A. Lely. Current Opinion in Nephrology and Hypertension. Mar 1, 2015. doi: 10.1097/MNH.0000000000000096
17. Martelli, A., Testai, L., Breschi, M. C., Blandizzi, C., Virdis, A., Taddei, S. and Calderone, V. (2012), Hydrogen sulphide: novel opportunity for drug discovery. Med. Res. Rev., 32: 1093-1130. doi:1002/med.20234
18. Suzuki K, Olah G, Modis K, et al. Hydrogen sulfide replacement therapy protects the vascular endothelium in hyperglycemia by preserving mitochondrial function. Proc Natl Acad Sci USA. 2011;108(33):13829-13834. doi:10.1073/pnas.1105121108
19. Short-term effects of l-citrulline supplementation on arterial stiffness in middle-aged men. Ochiai, Masayuki et al. (March 2012) International Journal of Cardiology, Volume 155, Issue 2, 257-261 doi: 10.1016/j.ijcard.2010.10.004
20. Effects of Hydrogen Sulfide on Erectile Function and Its Possible Mechanism(s) of Action. Liaw, Roeswita Leono et al. July 2011. The Journal of Sexual Medicine, Volume 8, Issue 7, 1853-1864 doi: 10.1111/j.1743-6109.2011.02279.x
21. Oxidative Stress and Antioxidant Status in Patients with Erectile Dysfunction. Barassi, Alessandra et al. October 2009. The Journal of Sexual Medicine, Volume 6, Issue 10, 2820-2825. DOI: https://doi.org/10.1111/j.1743-6109.2009.01279.x
22. Maiorino MI, Bellastella G, Chiodini P et al. (2016) Primary Prevention of Sexual Dysfunction With Mediterranean Diet in Type 2 Diabetes: the MÈDITA Randomized Trial. Diabetes Care 39:e143-e144. September 2016. https://care.diabetesjournals.org/content/39/9/e143.abstract
23. Yan WJ, Yu N, Yin TL, Zou YJ, Yang J. A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency. Asian J Androl 2014;16(6):902-906. doi:10.4103/1008-682X.135981
24. Aldemir, M., Okulu, E., Neşelioğlu, S. et al.Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction. Int J Impot Res 23, 32-38 (2011) doi:10.1038/ijir.2010.33
25. Ng, C., Lee, C., Ho, A. L. and Lee, V. W. (2011). Effect of Niacin on Erectile Function in Men Suffering Erectile Dysfunction and Dyslipidemia. The Journal of Sexual Medicine, 8: 2883-2893. doi:1111/j.1743-6109.2011.02414.x
26. Effects of tetrahydrobiopterin on nitric oxide bioavailability and renal hemodynamics in healthy volunteers. Ferruh Artunc et al. 2008. J. Nephrology 21: 850-860.
27. Aedín Cassidy, Mary Franz, Eric B Rimm, Dietary flavonoid intake and incidence of erectile dysfunction. The American Journal of Clinical Nutrition, Volume 103, Issue 2, February 2016, Pages 534-541, https://doi.org/10.3945/ajcn.115.122010
28. Jon Cartledge, Suks Minhas & Ian Eardley (2001) The role of nitric oxide in penile erection, Expert Opinion on Pharmacotherapy, 2:1, 95-107, DOI: 1517/146565126.96.36.199
29. Hydrogen Sulphide: A Novel Endogenous Gasotransmitter Facilitates Erectile Function. The Journal of Sexual Medicine. Balasubramanian Srilatha, P. Ganesan Adaikan, Ling Li, Philip K. Moore. Volume 4, Issue 5, 2007, Pages 1304-1311. https://doi.org/10.1111/j.1743-6109.2007.00561.x.
30. Ali, M. Y., Ping, C.Y., Mok, Y., Ling, L., Whiteman, M., Bhatia, M. and Moore, P.K. (2006). Regulation of vascular nitric oxide in vitroand in vivo; a new role for endogenous hydrogen sulphide? British Journal of Pharmacology, 149: 625-634. doi:1038/sj.bjp.0706906
31. Physiological Implications of Hydrogen Sulfide: A Whiff Exploration That Blossomed. Rui Wang. Physiological Reviews 2012 92:2, 791-896. April 2012 https://www.physiology.org/doi/full/10.1152/physrev.00017.2011#
32. Jacqueline Barona, Juan C. Aristizabal, Christopher N. Blesso, Jeff S. Volek, Maria Luz Fernandez. Grape Polyphenols Reduce Blood Pressure and Increase Flow-Mediated Vasodilation in Men with Metabolic Syndrome. The Journal of Nutrition, Volume 142, Issue 9, September 2012, Pages 1626-1632 https://doi.org/10.3945/jn.112.162743
33. Matthew Whiteman, Sophie Le Trionnaire, Mohit Chopra, Bridget Fox, Jacqueline Whatmore; Emerging role of hydrogen sulfide in health and disease: critical appraisal of biomarkers and pharmacological tools. Clin Sci (Lond)1 December 2011; 121 (11): 459-488. doi: https://doi.org/10.1042/CS20110267
34. Meldrum, D., Gambone, J., Morris, M. et al.Lifestyle and metabolic approaches to maximizing erectile and vascular health. Int J Impot Res 24, 61-68 (March 2012) doi:10.1038/ijir.2011.51
35. Shirai M, Hiramatsu I, Aoki Y, et al. Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study. Sex Med 2018;6(4):291-296. doi:10.1016/j.esxm.2018.07.001
36. Uddin SMI, Mirbolouk M, Dardari Z, et al. Erectile Dysfunction as an Independent Predictor of Future Cardiovascular Events. Circulation. 2018;138(5):540-542. doi:10.1161/CIRCULATIONAHA.118.033990
37. Long-Term N-Acetylcysteine and l-Arginine Administration Reduces Endothelial Activation and Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes. Valentino Martina, Andi Masha, Anna Iannone et al. Diabetes Care May 2008, 31 (5) 940-944; DOI: 10.2337/dc07-2251
38. Olga Pecháňová, Josef Zicha, Stanislava Kojšová, Zdenka Dobešová, Lýdia Jendeková, Jaroslav Kuneš. Effect of chronic N-acetylcysteine treatment on the development of spontaneous hypertension. Clin Sci (Lond) 1 February 2006; 110 (2): 235-242. doi: https://doi.org/10.1042/CS20050227
39. Liu, L., Zhang, T., Zhang, Y. et al.Metabolic syndrome and risk for ED: a meta-analysis. Int J Impot Res 26, 196-200 (September 2014) doi:10.1038/ijir.2014.3
40. McKinley-Barnard, S., Andre, T., Morita, M. et al.Combined L-citrulline and glutathione supplementation increases the concentration of markers indicative of nitric oxide synthesis. J Int Soc Sports Nutr 12, 27 (2015) doi:10.1186/s12970-015-0086-7
41. Hyperhomocysteinaemia in rats is associated with erectile dysfunction by impairing endothelial nitric oxide synthase activity. Sci Rep6, 26647 (May 2016) doi:10.1038/srep26647
42. Suganya, N., Bhakkiyalakshmi, E., Sarada, D., & Ramkumar, K. (2016). Reversibility of endothelial dysfunction in diabetes: Role of polyphenols. British Journal of Nutrition,116(2), 223-246. doi:10.1017/S0007114516001884
43. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. H Drexler, A.M Zeiher, K Meinzer, H Just. December 1991 https://doi.org/10.1016/0140-6736(91)92372-9.
44. Tsuboi T, Maeda M, Hayashi T (2018) Administration of L-arginine plus L-citrulline or L-citrulline alone successfully retarded endothelial senescence. PLoS ONE 13(2): e0192252. https://doi.org/10.1371/journal.pone.0192252
45. Devaraj, S., Vega‐López, S., Kaul, N., Schönlau, F., Rohdewald, P. and Jialal, I. (October 2002). Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profile. Lipids, 37: 931-934. doi:1007/s11745-006-0982-3
46. Pycnogenol®, French maritime pine bark extract, improves endothelial function of hypertensive patients. Ximing Liu, Junping Wei, Fengsen Tan, Shengming Zhou, Gudrun Würthwein, Peter Rohdewald. January 2004. Life Sciences, https://doi.org/10.1016/j.lfs.2003.07.037
47. A randomized, double-blind, placebo-controlled, prospective, 16 week crossover study to determine the role of Pycnogenol in modifying blood pressure in mildly hypertensive patients. Saeed Hosseini, Jeongmin Lee, Ramon T. Sepulveda. Nutrition Research, Volume 21, Issue 9,2001,Pages 1251-1260. https://www.sciencedirect.com/science/article/pii/S0271531701003426
48. Endothelium-Dependent Vascular Effects of Pycnogenol. Fitzpatrick, David F.; Bing, Bettye; Rohdewald, Peter. Journal of Cardiovascular Pharmacology: October 1998 https://journals.lww.com/cardiovascularpharm/Fulltext/1998/10000/Endothelium_Dependent_Vascular_Effects_of.1.aspx
49. Stanislavov R, Rohdewald P. Improvement of erectile function by a combination of French maritime pine bark and roburins with aminoacids. Minerva Urol Nefrol. 2015 Mar;67(1) 27-32. PMID: 25664962.
50. Stanislavov & V. Nikolova (November 2003). Treatment of Erectile Dysfunction with Pycnogenol and L-arginine, Journal of Sex & Marital Therapy, 29:3, 207-213, DOI: 10.1080/00926230390155104
51. Toru Okazaki, Hajime Otani, Takayuki Shimazu, Kei Yoshioka, Masanori Fujita & Toshiji Iwasaka (2011). Ascorbic acid and N-acetyl cysteine prevent uncoupling of nitric oxide synthase and increase tolerance to ischemia/reperfusion injury in diabetic rat heart. Free Radical Research, 45:10, 1173-1183, DOI: 10.3109/10715762.2011.605361
52. Luigi Cormio, Mario De Siati, Fabrizio Lorusso, Oscar Selvaggio, Lucia Mirabella, Francesca Sanguedolce, Giuseppe Carrieri. Oral L-Citrulline Supplementation Improves Erection Hardness in Men With Mild Erectile Dysfunction. January 2011. Urology. https://www.sciencedirect.com/science/article/pii/S0090429510016614
53. Zhang, R, Wang, Y, Pan, L, Tian, H. N‐Acetylcysteine potentiates the haemodynamic‐improving effect of sildenafil in a rabbit model of acute pulmonary thromboembolism via the p38 MAPK pathway. Clin Exp Pharmacol Physiol. 2019; 46: 163-172. https://doi.org/10.1111/1440-1681.13039
54. Elshahid, A.R., Shahein, I.M., Mohammed, Y.F., Ismail, N.F., Zakarria, H.B. and Gamal El Din, S.F. (2019). Folic acid supplementation improves erectile function in patients with idiopathic vasculogenic erectile dysfunction by lowering peripheral and penile homocysteine plasma levels: a case‐control study. Andrology. doi:1111/andr.12672
55. Low serum folic acid can be a potential independent risk factor for erectile dysfunction: a prospective case–control study. Attia, A.A.A., Amer, M.A.E.M., Hassan, M. et al. Int Urol Nephrol (Jan 2019) 51: 223. https://doi.org/10.1007/s11255-018-2055-y
56. Massimiliano Sansone, Andrea Sansone, Mariagrazia Romano, Silvia Seraceno, Luigi Di Luigi & Francesco Romanelli (2018). Folate: a possible role in erectile dysfunction? The Aging Male, 21:2, 116-120, DOI: 10.1080/13685538.2017.1404022
57. Karabakan, M., Erkmen, A.E., Guzel, O., Aktas, B.K., Bozkurt, A. and Akdemir, S. (2016). Association between serum folic acid level and erectile dysfunction. Andrologia, 48: 532-535. doi:1111/and.12474
58. Yan WJ, Yu N, Yin TL, Zou YJ, Yang J. A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency. Asian J Androl. 2014;16(6):902–906. doi:10.4103/1008-682X.135981
59. Hamidi Madani, A, Asadolahzade, A, Mokhtari, G, Shahrokhi Damavand, R, Farzan, A, and Esmaeili, S. Assessment of the efficacy of combination therapy with folic acid and tadalafil for the management of erectile dysfunction in men with type 2 diabetes mellitus. J Sex Med. January 2013 https://doi.org/10.1111/jsm.12047
60. High-dose ascorbic acid infusion abolishes chronic vasoconstriction and restores resting leg blood flow in healthy older men. Kristen L. Jablonski, Douglas R. Seals, Iratxe Eskurza, Kevin D. Monahan, and Anthony J. Donato. Journal of Applied Physiology November 2007 103:5, 1715-1721 https://www.physiology.org/doi/full/10.1152/japplphysiol.00533.2007
61. Wulf Hildebrandt, Roland Sauer, Gabriel Bonaterra, Klaus A Dugi, Lutz Edler, Ralf Kinscherf. Oral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status. The American Journal of Clinical Nutrition, Volume 102, Issue 5, November 2015, Pages 1014-1024, https://academic.oup.com/ajcn/article/102/5/1014/4564368
62. Fitzpatrick, D.F., Bing, B., Maggi, D.A., Fleming, R.C. and O'malley, R.M. (2002). Vasodilating Procyanidins Derived from Grape Seeds. Annals of the New York Academy of Sciences, 957: 78-89. doi:10.1111/j.1749-6632.2002.tb02907.x
63. Isolation and Characterization of Endothelium-Dependent Vasorelaxing Compounds from Grape Seeds. David F. Fitzpatrick,*,†, Richard C. Fleming,‡, Bettye Bing,†, David A. Maggi,† and, and Rebecca M. O'Malley‡ Journal of Agricultural and Food Chemistry 2000 48 (12), 6384-6390. DOI: 10.1021/jf0009347
64. N-acetylcysteine restores nitric oxide-mediated effects in the fetoplacental circulation of preeclamptic patients. Bisseling, T.M.; Roes, E.M., Raijmakers, M., Steegers, E.A.P., Peters, W.H.M., Smits, P. 2004. American Journal of Obstetrics and Gynecology, vol. 191, iss. 1, (2004), DOI: http://dx.doi.org/10.1016/j.ajog.2003.12.033
65. Hélène Girouard, Chantal Chulak, Lingyun Wu, Mireille Lejossec, Jacques de Champlain, N-acetylcysteine improves nitric oxide and α-adrenergic pathways in mesenteric beds of spontaneously hypertensive rats. American Journal of Hypertension, Volume 16, Issue 7, July 2003, Pages 577-584, https://doi.org/10.1016/S0895-7061(03)00863-X
66. Judy M. Muller-Delp, Ascorbic acid and tetrahydrobiopterin: looking beyond nitric oxide bioavailability, Cardiovascular Research, Volume 84, Issue 2, 1 November 2009, Pages 178-179, https://doi.org/10.1093/cvr/cvp307
67. Early Use of N-acetylcysteine With Nitrate Therapy in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction Reduces Myocardial Infarct Size (the NACIAM Trial [N-acetylcysteine in Acute Myocardial Infarction]) Sivabaskari Pasupathy, BS, PhD, Rosanna Tavella, BS, PhD, Suchi Grover, MBBS, PhD, Betty Raman, MBBS, Nathan E.K. Procter, BS, PhD, Yang Timothy Du, MBBS, Gnanadevan Mahadavan, MBBS, PhD, Irene Stafford, BS, Tamila Heresztyn, BS, Andrew Holmes, BS, PhD, Christopher Zeitz, MBBS, PhD, Margaret Arstall, MBBS, PhD, Joseph Selvanayagam, MBBS, PhD, John D. Horowitz, MBBS, PhD, and John F. Beltrame, BS, BMBS, PhD. June 2017. Journal of AHA Circulation https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.117.027575
68. Potentiation of the cardiovascular effects of nitroglycerin by N-acetylcysteine. J D Horowitz, E M Antman, B H Lorell, W H Barry, and T W Smith. December 1983. Journal of AHA Circulation https://www.ahajournals.org/doi/abs/10.1161/01.cir.68.6.1247
69. Horny goat weed could be better than Viagra. By Catherine Brahic. September 26, 2008. New Scientist. https://www.newscientist.com/article/dn14825-horny-goat-weed-could-be-better-than-viagra/#ixzz64iSVGj1S
70. Potent Inhibition of Human Phosphodiesterase-5 by Icariin Derivatives. Mario Dell’Agli, Germana V. Galli, Esther Dal Cero, Federica Belluti, Riccardo Matera, Elisa Zironi, Giampiero Pagliuca, and Enrica Bosisio. Journal of Natural Products September 2008 71 (9), 1513-1517. DOI: 10.1021/np800049y
71. American Chemical Society. Natural Viagra? 'Horny Goat Weed' Shows Promise. ScienceDaily. ScienceDaily, 30 September 2008. sciencedaily.com/releases/2008/09/080929084954.htm
72. Chau Y, Li FS, Levsh O, Weng JK. Exploration of icariin analog structure space reveals key features driving potent inhibition of human phosphodiesterase-5. PLoS One. 2019;14(9):e0222803. Published 2019 Sep 20. doi:10.1371/journal.pone.0222803
73. Effect of icariin on cyclic GMP levels and on the mRNA expression of cGMP-binding cGMP-specific phosphodiesterase (PDE5) in penile cavernosum. Jiang, Z., Hu, B., Wang, J. et al. J. Huazhong Univ. Sc. Technol. (September 2006) 26: 460. https://doi.org/10.1007/s11596-006-0421-y
74. El‐Wakeel, L.M., Fouad, F.A., Saleem, M.D. and Saber‐Khalaf, M. (2019). Efficacy and tolerability of sildenafil/l‐arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrologia. doi:10.1111/andr.12671
75. Daily Oral l-Arginine Plus Tadalafil in Diabetic Patients with Erectile Dysfunction: A Double-Blinded, Randomized, Controlled Clinical Trial. The Journal of Sexual Medicine, September 2019 https://doi.org/10.1016/j.jsxm.2019.06.009
76. The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. Hye Chang Rhim, Min Seo Kim, Young-Jin Park, Woo Suk Choi, Hyoung Keun Park, Hyeong Gon Kim, Aram Kim, Sung Hyun Paick. The Journal of Sexual Medicine, February 2019 https://doi.org/10.1016/j.jsxm.2018.12.002
77. Barassi, A., Corsi Romanelli, M.M., Pezzilli, R., Damele, C.A., Vaccalluzzo, L., Goi, G., Papini, N., Colpi, G.M., Massaccesi, L. and Melzi d'Eril, G. V. (2017), Levels of l‐arginine and l‐citrulline in patients with erectile dysfunction of different etiology. Andrology, 5: 256-261. doi:10.1111/andr.12293
78. Hotta, Y., Shiota, A., Kataoka, T., Motonari, M., Maeda, Y., Morita, M. and Kimura, K. (June 2014). Oral l‐citrulline supplementation improves erectile function and penile structure in castrated rats. Int J Urol, 21: 608-612. doi:10.1111/iju.12362
79. Ozge Un, Didem Yilmaz, Nur Bayatli, Ecem Kaya & Serap Gur (2014). L-Arginine and tetrahydrobiopterin, but not sodium nitrite partially restored erectile dysfunction in aged rats. The Aging Male, 17:4, 248-255, DOI: 10.3109/13685538.2014.921150
80. Oral L‐Citrulline Supplementation Improves Erectile Function in Rats with Acute Arteriogenic Erectile Dysfunction. Arufumi Shiota, Yuji Hotta, Tomoya Kataoka, Masahiko Morita, Yasuhiro Maeda, Kazunori Kimura. The Journal of Sexual Medicine. 2013 https://doi.org/10.1111/jsm.12260
81. Tagliabue, M., Pinach, S., Di Bisceglie, C., Brocato, L., Cassader, M., Bertagna, A., Manieri, C. and Pescarmona, G. (2005). Glutathione levels in patients with erectile dysfunction, with or without diabetes mellitus. International Journal of Andrology, 28: 156-162. doi:10.1111/j.1365-2605.2005.00528.x
82. Chen J, Wollman Y, Chernichovsky T, Iaina A, Sofer M, Matzkin H. (1999). Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. Br J Urol Int 83:269-273
83. Hongxiu Ning, Zhong-Cheng Xin, Guiting Lin, Lia Banie, Tom F. Lue, Ching-Shwun Lin. Effects of icariin on phosphodiesterase-5 activity in vitro and cyclic guanosine monophosphate level in cavernous smooth muscle cells. Urology 2006. https://doi.org/10.1016/j.urology.2006.09.031
84. Shindel, A.W., Xin, Z., Lin, G., Fandel, T.M., Huang, Y., Banie, L., Breyer, B.N., Garcia, M.M., Lin, C. and Lue, T. F. (2010). Erectogenic and Neurotrophic Effects of Icariin, a Purified Extract of Horny Goat Weed (Epimedium spp.) In Vitro and In Vivo. The Journal of Sexual Medicine, 7: 1518-1528. doi:10.1111/j.1743-6109.2009.01699.x
85. Xin, Zhongcheng & Kim, E.K. & Lin, C.S. & Liu, W.J. & Tian, L & Yuan, Y.M. & Fu, J. (2003). Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities. Asian journal of andrology. 5. 15-8.
86. Taylor J. Mediterranean diet linked to improved cardiovascular function in erectile dysfunction patients. Eur Heart J. 2015 Apr;36(14) 836. PMID: 26034790.
87. Di Francesco S, Tenaglia RL. Mediterranean diet and erectile dysfunction: a current perspective. Cent European J Urol. 2017;70(2):185-187. doi:10.5173/ceju.2017.1356
88. Erectile dysfunction and cardiovascular risk factors in a Mediterranean diet cohort. R. Ramírez J. Pedro‐Botet M. García E. Corbella J. Merino D. Zambón X. Corbella X. Pintó the Xarxa de Unitats de Lípids i Arteriosclerosi (XULA) Investigators Group. 20 October 2015 https://doi.org/10.1111/imj.12937
89. Adherence to Mediterranean Diet and Erectile Dysfunction in Men with Type 2 Diabetes Li, HaiZhang, Hong‐LiangWu, Jiang et al. The Journal of Sexual Medicine, Volume 8, Issue 2, 631
90. Giugliano, D., Giugliano, F., & Esposito, K. (2006). Sexual dysfunction and the Mediterranean diet. Public Health Nutrition, 9(8A), 1118-1120. doi:10.1017/S1368980007668542
91. Esposito, K., Ciotola, M., Giugliano, F. et al. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int J Impot Res 18, 405-410 (2006) doi:10.1038/sj.ijir.3901447
92. La, Vignera, S., Condorelli, R., Vicari, E., D'Agata, R. and Calogero, A.E. (2012). Physical Activity and Erectile Dysfunction in Middle‐Aged Men. Journal of Andrology, 33: 154-161. doi:10.2164/jandrol.111.013649
93. Beneficial Impact of Exercise and Obesity Interventions on Erectile Function and Its Risk Factors. The Journal of Sexual Medicine. Johanna L. Hannan, M. Tina Maio, Marina Komolova, Michael A. Adams. 2009 https://doi.org/10.1111/j.1743-6109.2008.01143.x. http://www.sciencedirect.com/science/article/pii/S1743609515326965
94. Esposito, K., Giugliano, F., Ciotola, M. et al. Obesity and sexual dysfunction, male and female. Int J Impot Res 20, 358-365 (April 2008) doi:10.1038/ijir.2008.9
95. Metabolic syndrome and endothelial dysfunction and associated high proportions of erectile dysfunction in men: Innocent bystanders or accessories to the crime? Ahmed, M.H. Diabetes Research and Clinical Practice, Volume 75, Issue 3, 370-371
96. Esen O, Dobbin N, Callaghan MJ. The Effect of Dietary Nitrate on the Contractile Properties of Human Skeletal Muscle: A Systematic Review and Meta-Analysis. J Am Nutr Assoc. 2023 May-Jun;42(4):327-338. doi: 10.1080/07315724.2022.2037475. Epub 2022 May 23. PMID: 35604074.
97. Gonzalez AM, Townsend JR, Pinzone AG, Hoffman JR. Supplementation with Nitric Oxide Precursors for Strength Performance: A Review of the Current Literature. Nutrients. 2023 Jan 28;15(3):660. doi: 10.3390/nu15030660. PMID: 36771366; PMCID: PMC9921013.
98. Macuh M, Knap B. Effects of Nitrate Supplementation on Exercise Performance in Humans: A Narrative Review. Nutrients. 2021 Sep 13;13(9):3183. doi: 10.3390/nu13093183. PMID: 34579061; PMCID: PMC8465461.
99. Anderson OK, Martinez-Ferran M, Lorenzo-Calvo J, Jiménez SL, Pareja-Galeano H. Effects of Nitrate Supplementation on Muscle Strength and Mass: A Systematic Review. J Strength Cond Res. 2022 Dec 1;36(12):3562-3570. doi: 10.1519/JSC.0000000000004101. Epub 2021 Jul 8. PMID: 36417361.
100. Aucouturier J, Boissière J, Pawlak-Chaouch M, Cuvelier G, Gamelin FX. Effect of dietary nitrate supplementation on tolerance to supramaximal intensity intermittent exercise. Nitric Oxide. 2015 Sep 15;49:16-25. doi: 10.1016/j.niox.2015.05.004. Epub 2015 May 29. PMID: 26028570.
101. Aucouturier J, Boissière J, Pawlak-Chaouch M, Cuvelier G, Gamelin FX. Effect of dietary nitrate supplementation on tolerance to supramaximal intensity intermittent exercise. Nitric Oxide. 2015 Sep 15;49:16-25. doi: 10.1016/j.niox.2015.05.004. Epub 2015 May 29. PMID: 26028570.
102. Le Roux-Mallouf T, Pelen F, Vallejo A, Halimaoui I, Doutreleau S, Verges S. Effect of chronic nitrate and citrulline supplementation on vascular function and exercise performance in older individuals. Aging (Albany NY). 2019 May 29;11(10):3315-3332. doi: 10.18632/aging.101984. PMID: 31141497; PMCID: PMC6555465.
103. San Juan AF, Dominguez R, Lago-Rodríguez Á, Montoya JJ, Tan R, Bailey SJ. Effects of Dietary Nitrate Supplementation on Weightlifting Exercise Performance in Healthy Adults: A Systematic Review. Nutrients. 2020 Jul 26;12(8):2227. doi: 10.3390/nu12082227. PMID: 32722588; PMCID: PMC7469052.
104. Tan R, Cano L, Lago-Rodríguez Á, Domínguez R. The Effects of Dietary Nitrate Supplementation on Explosive Exercise Performance: A Systematic Review. Int J Environ Res Public Health. 2022 Jan 11;19(2):762. doi: 10.3390/ijerph19020762. PMID: 35055584; PMCID: PMC8775572.
105. Coggan AR, Baranauskas MN, Hinrichs RJ, Liu Z, Carter SJ. Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis. J Int Soc Sports Nutr. 2021 Oct 9;18(1):66. doi: 10.1186/s12970-021-00463-z. PMID: 34625064; PMCID: PMC8501726.
106. Garnacho-Castaño MV, Sánchez-Nuño S, Molina-Raya L, Carbonell T, Maté-Muñoz JL, Pleguezuelos-Cobo E, Serra-Payá N. Circulating nitrate-nitrite reduces oxygen uptake for improving resistance exercise performance after rest time in well-trained CrossFit athletes. Sci Rep. 2022 Jun 11;12(1):9671. doi: 10.1038/s41598-022-13786-x. PMID: 35690665; PMCID: PMC9188609.
107. Husmann F, Bruhn S, Mittlmeier T, Zschorlich V, Behrens M. Dietary Nitrate Supplementation Improves Exercise Tolerance by Reducing Muscle Fatigue and Perceptual Responses. Front Physiol. 2019 Apr 24;10:404. doi: 10.3389/fphys.2019.00404. PMID: 31068827; PMCID: PMC6491676.
108. Richards JC, Racine ML, Hearon CM Jr, Kunkel M, Luckasen GJ, Larson DG, Allen JD, Dinenno FA. Acute ingestion of dietary nitrate increases muscle blood flow via local vasodilation during handgrip exercise in young adults. Physiol Rep. 2018 Jan;6(2):e13572. doi: 10.14814/phy2.13572. PMID: 29380952; PMCID: PMC5789727.
109. Jones AM, Thompson C, Wylie LJ, Vanhatalo A. Dietary Nitrate and Physical Performance. Annu Rev Nutr. 2018 Aug 21;38:303-328. doi: 10.1146/annurev-nutr-082117-051622. PMID: 30130468.
110. Nyakayiru J, van Loon LJC, Verdijk LB. Could intramuscular storage of dietary nitrate contribute to its ergogenic effect? A mini-review. Free Radic Biol Med. 2020 May 20;152:295-300. doi: 10.1016/j.freeradbiomed.2020.03.025. Epub 2020 Mar 26. PMID: 32224084.
111. (Poly)phenols and nitrolipids: Relevant participants in nitric oxide metabolism. César G. Fraga,Andrés Trostchansky,Barbara S. Rocha,João Laranjinha,Homero Rubbo,Monica Galleano
112. Molecular Aspects of Medicine. February 2023
113. Kadach S, Park JW, Stoyanov Z, Black MI, Vanhatalo A, Burnley M, Walter PJ, Cai H, Schechter AN, Piknova B, Jones AM. 15 N-labeled dietary nitrate supplementation increases human skeletal muscle nitrate concentration and improves muscle torque production. Acta Physiol (Oxf). 2023 Mar;237(3):e13924. doi: 10.1111/apha.13924. Epub 2023 Jan 18. PMID: 36606507.
114. Bryan NS, Ahmed S, Lefer DJ, Hord N, von Schwarz ER. Dietary nitrate biochemistry and physiology. An update on clinical benefits and mechanisms of action. Nitric Oxide. 2023 Mar 1;132:1-7. doi: 10.1016/j.niox.2023.01.003. Epub 2023 Jan 20. PMID: 36690137.
115. Zhang Y, Zhang H, An W, Li D, Qin L. Regulatory effect of dietary nitrate on blood pressure: a meta-analysis of randomized controlled trials. Food Funct. 2023 Feb 21;14(4):1839-1850. doi: 10.1039/d2fo03140j. PMID: 36740972.
116. Lbban E, Ashor A, Shannon OM, Idris I, Siervo M. Is vitamin C a booster of the effects of dietary nitrate on endothelial function? Physiologic rationale and implications for research. Nutrition. 2023 May;109:111995. doi: 10.1016/j.nut.2023.111995. Epub 2023 Feb 7. PMID: 36917872.
117. Esen O, Dobbin N, Callaghan MJ. The Effect of Dietary Nitrate on the Contractile Properties of Human Skeletal Muscle: A Systematic Review and Meta-Analysis. J Am Nutr Assoc. 2023 May-Jun;42(4):327-338. doi: 10.1080/07315724.2022.2037475. Epub 2022 May 23. PMID: 35604074.
118. Pekas EJ, Anderson CP, Park SY. Moderate dose of dietary nitrate improves skeletal muscle microvascular function in patients with peripheral artery disease. Microvasc Res. 2023 Mar;146:104469. doi: 10.1016/j.mvr.2022.104469. Epub 2022 Dec 21. PMID: 36563997.
119. Mattos S, Cunha MR, Marques BC, D El-Rei J, Baião DDS, Paschoalin VMF, Oigman W, Neves MF, Medeiros F. Acute Effects of Dietary Nitrate on Central Pressure and Endothelial Function in Hypertensive Patients: A Randomized, Placebo-Controlled Crossover Study. Arq Bras Cardiol. 2023 Jan 9;120(1):e20220209. English, Portuguese. doi: 10.36660/abc.20220209. PMID: 36629601; PMCID: PMC9833313.
120. Serreli G, Deiana M. Role of Dietary Polyphenols in the Activity and Expression of Nitric Oxide Synthases: A Review. Antioxidants (Basel). 2023 Jan 7;12(1):147. doi: 10.3390/antiox12010147. PMID: 36671009; PMCID: PMC9854440.
121. Kwak CJ, Kubo E, Fujii K, Nishimura Y, Kobuchi S, Ohkita M, Yoshimura M, Kiso Y, Matsumura Y. Antihypertensive effect of French maritime pine bark extract (Flavangenol): possible involvement of endothelial nitric oxide-dependent vasorelaxation. J Hypertens. 2009 Jan;27(1):92-101. doi: 10.1097/hjh.0b013e3283186994. PMID: 19145776.
122. Nishioka K, Hidaka T, Nakamura S, Umemura T, Jitsuiki D, Soga J, Goto C, Chayama K, Yoshizumi M, Higashi Y. Pycnogenol, French maritime pine bark extract, augments endothelium-dependent vasodilation in humans. Hypertens Res. 2007 Sep;30(9):775-80. doi: 10.1291/hypres.30.775. PMID: 18037769.
123. Madeira SV, de Castro Resende A, Ognibene DT, de Sousa MA, Soares de Moura R. Mechanism of the endothelium-dependent vasodilator effect of an alcohol-free extract obtained from a vinifera grape skin. Pharmacol Res. 2005 Oct;52(4):321-7. doi: 10.1016/j.phrs.2005.05.005. PMID: 16023862.
124. Fitzpatrick DF, Hirschfield SL, Coffey RG. Endothelium-dependent vasorelaxing activity of wine and other grape products. Am J Physiol. 1993 Aug;265(2 Pt 2):H774-8. doi: 10.1152/ajpheart.1993.265.2.H774. PMID: 8396352.
125. Ledda A, Belcaro G, Cesarone MR, Dugall M, Schönlau F. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU Int. 2010 Oct;106(7):1030-3. doi: 10.1111/j.1464-410X.2010.09213.x. Epub 2010 Feb 22. PMID: 20184576.
126. Trebaticky B, Muchova J, Ziaran S, Bujdak P, Breza J, Durackova Z. Natural polyphenols improve erectile function and lipid profile in patients suffering from erectile dysfunction. Bratisl Lek Listy. 2019;120(12):941-944. doi: 10.4149/BLL_2019_158. PMID: 31855055.
127. Stanhewicz AE, Kenney WL. Role of folic acid in nitric oxide bioavailability and vascular endothelial function. Nutr Rev. 2017 Jan;75(1):61-70. doi: 10.1093/nutrit/nuw053. PMID: 27974600; PMCID: PMC5155615.
128. Taira J, Ogi T. Nitric Oxide Modulation by Folic Acid Fortification. Antioxidants (Basel). 2020 May 7;9(5):393. doi: 10.3390/antiox9050393. PMID: 32392814; PMCID: PMC7278735.
129. Stanhewicz AE, Alexander LM, Kenney WL. Folic acid supplementation improves microvascular function in older adults through nitric oxide-dependent mechanisms. Clin Sci (Lond). 2015 Jul;129(2):159-67. doi: 10.1042/CS20140821. PMID: 25748442; PMCID: PMC8080301.
130. Romero SA, Gagnon D, Adams AN, Moralez G, Kouda K, Jaffery MF, Cramer MN, Crandall CG. Folic acid ingestion improves skeletal muscle blood flow during graded handgrip and plantar flexion exercise in aged humans. Am J Physiol Heart Circ Physiol. 2017 Sep 1;313(3):H658-H666. doi: 10.1152/ajpheart.00234.2017. Epub 2017 Jun 30. PMID: 28667051; PMCID: PMC5625172.
131. Zhang Y, Zhang W, Dai Y, Jiang H, Zhang X. Serum Folic Acid and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Sex Med. 2021 Jun;9(3):100356. doi: 10.1016/j.esxm.2021.100356. Epub 2021 May 26. PMID: 34051538; PMCID: PMC8240352.