Michael Guth: I am curious whether you are taking any supplements to improve your endothelial health. I take two supplements, but I want to see if you take anything before I tell you about them.
Primary Care Doctor With Specialty on Hormone Therapy: Mike, the question that my article will attempt to answer is “Why are we being so rapidly affected by this change in diet? “ What is the metabolic defect that is causing the obesity and diabetes when we overload with sugar and carbs. The answer to this is the gene polymorphism associated with thiamine metabolism , the MTHFR. Twenty percent of people are homozygous and 70% hetro in a white population, and 90 -100% in indigenous populations. And so the supplements I take are to avoid the endothelial consequences of carrying this polymorphism are folinic acid 500 mg and DIM 300 mg . I also take testosterone and run my levels at 25 nmols/lt (25 year old levels) and use human growth hormone at night . We eat low carb , high protein , use a lot of olive oil and cumin and enjoy a glass of beautiful South Australian red wine every night. If I could just convince my wife the benefits of having sex three times a day, then life would be perfect ( she thinks 3 x a year too much!). I am in my mid 60’s now and my colleagues and friends are all talking about retirement and dying, and I’m excited about going back to University and doing another course (Archaeology) . I’m interested to hear what you take and why.
Michael Guth: I used to take DIM as an estrogen modulator, but I found I needed a stronger prescription-type drug, so I now take Anastrozole. I have never heard of folinic acid, but I will have to look it up.
I take 1000 mg of Arginine AKG three times per day — roughly 6 hours apart. You can read about the enhanced bioavailability of the AKG form of arginine here: http://www.swansonvitamins.com/SWU341/ItemDetail
According to the Sloan-Kettering Memorial website (which is one of the top cancer treatment and research hospitals in the USA), “Arginine is unique among amino acids for its vasodilatory properties (11). Arginine acts as a precursor for the synthesis of endogenous nitric oxide (NO) via the action of nitric oxide synthase (NOS). Nitric oxide’s functions as a paracrine-signaling molecule mediating vasodilation and inhibition of platelet activation, monocyte and leucocyte adhesion, and smooth muscle cell proliferation. Nitric oxide also helps to control vascular oxidative stress and redox-regulated gene expression (22). Arginine is also needed for the synthesis of creatine which is important in muscle contraction (22). In colorectal adenoma cells, arginine reduces the expression of survivin, an inhibitor of apoptosis, and induces iNOS expression (23).”
http://www.mskcc.org/cancer-care/herb/arginine
Furthermore, I take Pine Bark Extract (also sold as brand name Pycnogenol) at the same time as the Arginine AKG, because it somehow stimulates the body to produce more nitric oxide. I am not sure what enzyme it activates, but I have seen research studies where Pycnogenol had a synergistic effect on Arginine to increase nitric oxide production — thus dilating blood vessels.
“Pine bark extract acts as an antioxidant by scavenging reactive oxygen and nitrogen species and suppressing production of peroxides (21). It increases the activities of antioxidant enzymes by increasing the intracellular glutathione levels (22). In addition to increasing NO production which induces vasodilation (2), pine bark extract also blocks the NF-kB activation stimulated by tumor necrosis factor-alpha (TNF-alpha) and inhibits production of adhesion proteins that cause inflammation and atherosclerosis (22). An in vitro study suggests that Pycnogenol induces apoptosis in human breast cancer cells and not in normal breast cells although the mechanism is not clear (23). Other in vitro studies have also shown that it reduces neuronal apoptosis, an important feature of Alzheimer’s disease, by decreasing free radical generation (24). In animal studies, pine bark extract exhibits a protective effect on cardiotoxicity caused by antitumor drugs, such as doxorubicin, due to its ability to act as a free-radical scavenger (20).”
http://www.mskcc.org/cancer-care/herb/pine-bark-extract
Concerning endothelial health, the Life Extension website says:
“Endothelial Dysfunction and Stroke Risk
Most strokes are caused by blood clots that form as a result of atherosclerosis (Gorelick PB 2002). Once known as “hardening of the arteries,” atherosclerosis occurs when the arteries become clogged with plaque deposits and the structure and function of the inner arterial wall (the endothelium) are compromised. If atherosclerotic plaque deposits become brittle and rupture, blood clots can form that lead to stroke. Scientists have spent decades unraveling the complicated biological processes that lead to atherosclerosis. We now understand atherosclerosis as a long-term disease, one that accelerates as we age, raising the risk of heart attack and stroke.
For many years, conventional science has depicted the arteries as pipes, often using plumbing analogies to describe procedures such as balloon angioplasty or endarterectomy, an operation in which plaque is stripped away from the linings of arteries. The problem with the plumbing analogy, however, is that the arteries are actually muscular, complex organs that play an active role in regulating blood pressure and other biological functions.
Arteries are composed of three layers. The outer layer is mostly connective tissue and provides structure to the layers beneath. The middle layer is smooth muscle and contracts and dilates to help blood flow and maintain blood pressure. And the inner layer is a thin layer of endothelial cells and provides a smooth, protective surface. Endothelial cells prevent toxic, blood-borne substances from penetrating the smooth muscle of the artery. They also respond to changes in blood pressure and release substances into the cells of the smooth muscle that help change the tone of the artery. Furthermore, endothelial cells secrete chemicals that provoke a protective response in the artery after an injury.
In the event an artery is injured, the endothelium signals smooth muscle cells to gather at the site of the injury. Endothelial cells also signal white blood cells to congregate on the injured vessel wall, provoking an immune response. As we age, however, the endothelium becomes leaky, allowing lipids and toxins to penetrate the endothelial layer into the smooth muscle cells. As a result, smooth muscle cells gather at the site of the injury, and the artery in turn loses some flexibility. In response, the endothelium signals white blood cells to congregate along the cell wall. The endothelium is further weakened by the pro-inflammatory immune response, in which leukotrienes and prostaglandins contribute to inflammation, which aggravates the abnormal smooth muscle tone of the arterial wall (Touyz RM 2005). Toxins soon begin to penetrate into the arterial wall. Inside the artery, lipids such as low-density lipoprotein (LDL) cholesterol and triglycerides accumulate and gradually become oxidized.
At this point, the atherosclerotic process has begun in earnest. In response to the oxidized lipids, the body mounts an immune response that causes more white blood cells to attack the fats, producing more inflammation within the arterial wall. In an attempt to heal the injury, smooth muscle cells begin to produce collagen to form a cap over the injury site. The mixture of oxidized lipids, white blood cells, and smooth muscle cells forms a plaque deposit. Over time, calcium accumulates on the deposit and forms a brittle cap. If this calcified plaque ruptures, a blood clot can form.
All the processes described above, in which the arterial wall is damaged and normal endothelial function is compromised, are collectively referred to as endothelial dysfunction. Risk factors that aggravate endothelial dysfunction include high blood pressure, smoking, elevated LDL and triglycerides, low levels of high-density lipoprotein (HDL) cholesterol, diabetes, elevated insulin levels, obesity, lack of exercise, and several recently identified risk factors, such as elevated levels of homocysteine and C-reactive protein. Each of these contributes to endothelial dysfunction of cerebral arteries and the subsequent increased risk of stroke.
High blood pressure, for example, is very strongly associated with stroke; in fact, high blood pressure is associated with about half of ischemic strokes. It is known that high blood pressure contributes to endothelial dysfunction. Cigarette smoke is another major risk factor because the smoke contains many toxins that contribute to endothelial injury, while homocysteine has been shown to cause the initial injury to the endothelium that begins the atherosclerotic process (Sainani GS et al 2002). Similarly, a Physician’s Health Study found that men in the highest quartile of levels of C-reactive protein (an inflammatory marker that signals inflammation somewhere in the body) had twice the risk of ischemic stroke of those in the bottom quartile (Ridker PM et al 1997). Other studies have found that C-reactive protein is a strong independent predictor of a reduced survival rate after ischemic stroke (Di Napoli M et al 2001).
If researchers can identify drugs or supplements that support healthy endothelial function, it may be possible to slow the relentless advance of atherosclerosis and reduce the risk of the most common kind of stroke. One common therapeutic focus is nitric oxide, which causes arteries to dilate and improves blood flow. A nutrient or drug that improves the production of nitric oxide may have the potential to reduce the risk of stroke or other atherosclerotic insults.
It also makes sense to modify as many other risk factors as possible, including high blood pressure, cholesterol, and even infection. Studies have linked certain common infections to increased stroke risk, including Chlamydia pneumonia, Helicobacter pylori, cytomegalovirus, and C Pneumonia (Winkelstein JA et al 2001; Meier CR et al 1999; Nieto FJ et al 1999). The first National Health and Nutrition Examination Survey (NHANES) found that periodontal disease, though treatable, is a risk factor (Wu T et al 2000). Other studies indicate that patients hospitalized with bacterial and viral infections had increased risk of stroke within one week of the infection, highlighting the importance of infection, even in younger people (Grau AJ et al 1995, 1998, 1999).”
I began taking Arginine and Pine Bark Extract after reading about clinical experiments with those two supplements and their impact on endothelial health in Life Extension Magazine. It thus comes as a surprise to me when I checked whether Life Extension produces an endothelial health supplement, the do indeed have one, but its active ingredients do *not* include either arginine or pine bark extract.
Instead, their product recommends “Endothelial Defense™ with Full-Spectrum Pomegranate™ supplies standardized pomegranate and an orally active form of superoxide dismutase to support endothelial health. Both of these components (pomegranate, SOD) have been clinically shown to help with blood flow and age-related changes in endothelial function.2-8
- Pomegranate supports healthy blood flow. In a group of aging humans with risk factors for cardiovascular events, pomegranate or placebo was ingested on a daily basis. After 12 months, the mean intima media thickening improved 44% in the pomegranate group, whereas carotid blood flow worsened by 9% in the placebo group.2 Both groups continued taking conventionally prescribed medications. In another study on patients with ischemic coronary heart disease, pomegranate or placebo was ingested daily. After only three months, coronary artery blood flow improved by 18% in the pomegranate group, but worsened by 17% in the placebo group.2 A standardized pomegranate extract is one of the active components of Endothelial Defense™.
- SOD protects against nitric oxide degradation. Aging results in a reduction of our body’s production of the critical antioxidant called superoxide dismutase (SOD). One consequence of SOD depletion is excess degradation of endothelial nitric oxide. An orally active superoxide dismutase called GliSODin® has been clinically shown to support healthy arterial function and structure … while boosting levels of the body’s most powerful antioxidant enzymes (SOD and catalase).4-7 Studies show that carotid artery thickness increases by 0.04 mm every 10 years. However, a 2007 GliSODin® study suggested that 2.8 years of supplementation may turn back the clock on 10 years of age-related changes due to carotid artery wall thickening.6 Endothelial Defense™ contains the patented GliSODin® in the identical dose.
- Pomegranate flower extract and seed oil blend. This blend of pomegranate flower extract and seed oil contains potent polyphenols that provide support for youthful lipid and glucose metabolism and help with inflammatory factors.8″
What is your opinion about the importance of taking a SOD supplement? Also, how could I rank the relatively importance of arginine, pine bark extract, SOD, pomegranate, DIM, and folinic acid to endothelial health?
Mike
P.S. I’m sure you already know daily ejaculation promotes prostate health. Did you know the supplement Icariin found in Horny Goat Weed Extract is a phosphodiesterase type 5 inhibitor?


