Men looking to improve erectile dysfunction (ED) are often ready to throw the kitchen sink at the problem. We get it – you want relief fast, and while medications like Viagra®, Cialis®, and Levitra® are all proven to work well and work quickly, guys are often prepared to make broader lifestyle changes as well.
"What vitamins can I take for ED?" is a question we hear all the time. Let's clear up a few questions around vitamins and sexual health.
Which Vitamins for Erectile Dysfunction?
The bad news is that there are few vitamins proven to alleviate ED in clinical studies. There are also very few natural cures for ED, or ED pills over the counter that are proven effective.
But many of the supplements out there may help and have decent supporting evidence to back up the case for putting them to use. In most cases, using vitamins to treat erectile dysfunction is about eliminating deficiencies that could be contributing to ED. Vitamins D and Niacin are fairly well studied culprits.
Vitamin D for ED
There's good evidence that Vitamin D deficiency can contribute to ED. What we don't know is whether taking vitamin D supplements can help with ED and improve blood flow. Confusing, I know.
The newest meta-analysis around vitamin D deficiency and erectile dysfunction was published in May of 2020 and concludes that "when patients with vitamin D deficiency only were taken into account, the international index of erectile function (IIEF) score for erectile dysfunction was significantly worse than in controls." (Source)
That supports some older studies that have shown the same thing. A study published in 2016 links lower vitamin D levels in men with ED versus men without ED, and suggests that among men with vitamin D deficiency had a higher prevalence of ED. (Source)
The rationale here seems solid. ED and atherosclerotic cardiovascular disease (ASCVD) share many common risk factors, and ED is a marker for increased ASCVD risk (some men realize they have heart issues only after suffering from ED). Low Vitamin D concentrations have been associated with increased ASCVD risk, and the study above looked at this correlation after adjusting for lifestyle variables, comorbidities, and medication use. In other words, they wanted to make sure this association wasn't about ASCVD, but about Vitamin D and ED.
Conclusion: Vitamin D deficiency could be linked to ED.
Niacin for ED (Vitamin B3)
Niacin is the more common name for Vitamin B3, and it's also commonly used to lower blood levels of bad cholesterol and lipids, or fats in the blood.
As such, some researchers have looked at its impact on ED. Men with high lipids are also known to have a higher risk of ED, and one study looked at niacin's impact on ED in 160 men with ED and dyslipidemia (high lipids). There, they found that niacin can improve penis function in patients with ED and high lipids, so long as their ED was moderate-to-severe; minor ED cases did not respond. (Source)
Here's something important though: Niacin mixed with Viagra® or other PDE5 inhibitors can be dangerous, causing a rapid drop in blood pressure.
Conclusion: Niacin and other lipid-lowering therapies like statins may help men with high lipids and moderate-to-severe ED.
L-Arginine for ED
L-arginine has been promoted as a possible treatment for ED for years. L-Arginine is a precursor to nitric oxide (NO), an important component of the sexual arousal and erection process.
Let's look at some data. One 2010 publication looked at the effects of a formulation of pine bark extract and l-arginine aspartate in men with ED. The study examined its effects in 124 men aged 30-50 years and found that after 6 months, men taking the formulation had an improvement in symptoms compared to men taking a placebo, and this finding was statistically sound. (Source)
Now, the pine bark extract could be considered confounding, since we don't know if the effect was totally due to l-arginine alone, but this is some evidence that this kind of supplement may have an impact.
A more recent 2020 publication looked at a combination of 2,500mg l-arginine taken daily with 5mg tadalafil and found that a combination of the two was superior to tadalafil 5mg alone. (Source)
Does l-arginine work in ED? There's some decent supportive evidence here.
However, we have to urge caution as l-arginine is not an FDA approved medication on its own for the treatment of ED. The FDA is the gold standard in terms of effectiveness AND safety.
Do Vitamins Help with ED?
All-in-all, there's evidence supporting that some vitamins play a role in erectile dysfunction, but most supplements are not approved for this setting by the U.S. FDA.
Given that the findings are not totally conclusive, talk to a doctor before trying anything out of the ordinary. Medications like Viagra® (sildenafil) and Cialis® (tadalafil) are approved specifically for ED, they've been used by millions of men, and their safety and effectiveness are well-understood by healthcare providers. The FDA's blessing means a lot considering the rigors required for approval, and while alternative supplements might get attention on the internet, we can't say for sure that anything else will work nearly as well.
Rex MD can help with a free virtual doctor visit and inexpensive ED meds.
