1. Increased Blood Flow in Men with Lower Niacin Levels.  Of course, there is a lot to an erection, but I think just about everyone would agree that the #1 goal is to increase something called endothelial function.  The endothelium is the delicate lining of the arteries that pumps out nitric oxide and relaxes the arteries.  And, of course, a relaxed, i.e. more open artery is one that allows more blood to flow into your arm, your leg or your brain.  And I'm sure I don't need to explain why increased blood flow into your penile arteries is critical for erectile strength.

It’s important to note that high levels of zinc can reduce available copper in the body and affect iron levels. High levels of zinc can also interfere with different kinds of medications. Though it is estimated that 40 milligrams of zinc supplement are safe for men to take daily, there is no long-term research into the effects that this practice could yield.

A number of nonprescription products claim to be herbal forms of Viagra. Some of these products contain unknown amounts of ingredients similar to those in prescription medications, which can cause dangerous side effects. Some actually contain the real drug, which should be given by prescription only. Although the Food and Drug Administration has banned many of these products, some potentially dangerous erectile dysfunction remedies remain on the market.
All hormone determinations were performed by radioimmunoassay using kits provided by commercial suppliers. All blood samples were drawn between 8 am and 1 pm, quickly spun down, frozen, and then stored. All determinations were performed at the same time after the end of the study. The serum LH kit was obtained from Nichols Institute (now Quest; Tarzana, CA, USA) (normal male range, 1.4–11.1 mIU/ml). The serum free testosterone kit was obtained from Diagnostic Products Corporation (DPC, Los Angeles, USA) (normal male range, 15–40 pg/ml). The serum cortisol kit was bought from DPC (normal morning range, 10–24 mcg/dl; normal afternoon range, 5–12 mcg/dl). The serum dehydroepiandrosterone sulfate kit was obtained from DPC (normal range, 150–350 mcg/dl from adolescence to the peak at age 50 y, with a progressive decrease with advancing years).
Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.

The Enlightenment proved itself to be an intellectual movement in 18th Century Europe that mobilized the power of reason to advance knowledge and reform society. It promoted intellectual transaction and opposed intolerance and abuses by both Church and State. This constituted a challenge to and disparagement of the heavy-handedness of the State. Thus, society was lifted and enlightened.
Zinc therapy (5 mg/day) improves sexual competence by increasing penile thrusting and prolonging ejaculatory latency without disturbing arousability and motivation of male rats. Increase in the T levels observed with zinc supplementation is beneficial in this regard. However, increase in PRL is responsible for the reduced libido index. Further studies on pigs and monkeys are needed to evaluate the possible therapeutic use of zinc in sexual dysfunction.
Vitamin B5 (Pantothenic acid) is irreplaceable if you wish to increase life expectancy. Vitamin B5 has a positive impact on the nervous system and intestinal motility. Calcium pantothenate is a form of vitamin B5 that has a powerful anabolic effect, enhances the synthesis of steroid hormones, and takes part in the synthesis of coenzyme A. In addition, calcium pantothenate helps release energy from foods. So, to a large extent, it improves your body’s endurance and stamina, as well as increases human tolerance to different loads.
Also to be considered, patients were not using PDE5 inhibitors during the study period. Therefore it wasn’t determined whether the combined use with niacin can enhance the response of PDE5 inhibitors. Another limitation on the study results was the exclusion of the partner’s assessments. This would help to provide a more comprehensive assessment of the efficacy of niacin.
When men are given supplemental testosterone it can have positive effects on erectile dysfunction as well as the “grumpy old men” syndrome of low energy, loss of drive, low libido, and loss of endurance as well as “man boobs”.  Zinc has a direct effect on the two main enzyme systems that act on testosterone: conversion of testosterone to estrogen via aromatase and the conversion of testosterone to DHT by 5 alpha reductase.   Zinc blocks the testosterone to estrogen pathway leading to more testosterone.  It turns out that only at really high zinc levels does zinc inhibit the 5 alpha reductase enzyme so when we give mild to moderate zinc supplements, DHT actually increases because there is more testosterone to feed into this pathway.   This actually benefits things because DHT has 2-3 times the times the androgen receptor affinity than testosterone.  In any case, we see an increase of testosterone and androgenic activity from DHT with zinc supplements and whether a guy has low or normal T to begin with, there is a positive change in erectile dysfunction and libido in some men due to the increased androgenic activity and less estrogen pulling in the opposite direction.  Conversely we see testosterone levels drop when a diet is low in Zinc as well as a drop in DHT.  It is important to note that this effect of increased testosterone with zinc supplementation, while well established, does not always lead to an improvement of ED and increased Libido.

There is no guaranteed, permanent way to ‘cure’ ED – partly because, age is a factor that affects ED the older you are, the more likely you are to get ED symptoms. This might mean that even if you have successfully kept your erectile dysfunction under control in the past, you may get ED symptoms again as you get older. Also, there are lots of factors that cause ED. So, one factor that doesn’t affect you right now might do in the future. 
In addition to getting helpful nutrients from your diet, you can also consider supplementing. Many of these are also on my list of top five supplements to increase sex drive, so they’re helpful for overall sexual health. It’s a good idea to check in with a practitioner, particularly one with knowledge of your individual health issues and medications, before taking anything. Here are some I recommend:
We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]
Talk with your doctor about going to a counselor if psychological or emotional issues are affecting your ED. A counselor can teach you how to lower your anxiety or stress related to sex. Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a doctor can focus on treating the physical causes of ED.
Acupuncture. Acupuncture has been used for centuries to treat ED and impotence in China. A recent review of studies on acupuncture for erectile dysfunction was published in the British Journal of Urology International. After reviewing four studies, the authors concluded that there was not sufficient evidence to say that acupuncture worked. However, some experts believe it's worth trying. "Acupuncture can work," says Gilbert. "It probably works best to treat the psychological component of ED. There is very little downside to trying it."
The endothelium is vital to the maintenance of vascular health. It is a critical determinant of vascular tone and patency, reactivity, inflammation, vascular remodeling, and blood fluidity. (9, 10). Nitric oxide (NO) is the most potent vasodilator and is secreted by the endothelium. It is synthesized from Larginine by the endothelial enzyme NO synthase (eNOS). NO released in response to sexual stimulation relaxes penile vascular smooth muscle by increasing intracellular cyclic 3′, 5′-guanosine monophosphate (cGMP) concentration. Vasodilatation of erectile tissues allows the sinusoidal spaces to fill with blood resulting in the attainment and maintenance of an erection (5).
Much of the evidence shows high rates of vitamin D deficiency in patients with erectile dysfunction. In fact, one study of 3,400 participants found that men with vitamin D deficiency were 32% more likely to have trouble with erections when all other risk factors were controlled for. It’s a little on the nose that you need vitamin D for your “D,” but hey—science can be funny too.
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