Clinically I have seen these results in doses of just 20 mg twice daily.   It is important to note that prolonged zinc supplementation can lead to lowered copper levels so it is not advisable to continue this therapy unless it is in a cyclical nature.  For those on long term zinc there are combination products with Zinc and Copper.   In cases where some prescriptions that lower zinc are given, like acid lowering meds, thiazide diuretics and ACE inhibitors, or in renal dialysis patients, this chronic monitoring of zinc may lead to longer term supplementation.
Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515

For men who do find themselves suffering from ED, the knee-jerk reaction can be to reach for the Viagra but – while ED tablets are an excellent solution in the short term – there are other treatment options to consider incorporating into your lifestyle on a long-term basis, one of the most straightforward being exercise. Below you’ll find four great ways that exercise may help to treat erectile dysfunction.
While eating magnesium-rich foods or taking a magnesium supplement at the proper dosage is safe for most men, the mineral can interfere or interact with some medications. Discuss the benefits and risks of altering your daily magnesium intake with your doctor, particularly if you take blood pressure medications, diuretics, diabetes medications or antibiotics. Men diagnosed with erectile dysfunction often require changes in other minerals and vitamins or even prescription medication. Ensuring a proper daily intake of magnesium may help maintain healthy erectile function, but magnesium alone is unlikely to cause a significant reduction in ED symptoms. Magnesium levels can also be affected by excess weight, chronic stress and excessive amounts of alcohol. These factors may also be partially responsible for erectile problems.
In the statistical analysis, the difference between the pre-test and post-test values (changed score) for IIEF score was computed. Student t-test was used to compare the mean changed score values of IIEF. All statistical analysis was performed on an IBM compatible micro computer using SPSS for window version 15.0, (Chicago IL, USA). The probability level for all the above tests was set at 0.05 to indicate significance.

A study from the University of the West in the United Kingdom found that pelvic exercises helped 40 percent of men with ED regain normal erectile function. They also helped an additional 33.5 percent significantly improve erectile function. Additional research suggests pelvic muscle training may be helpful for treating ED as well as other pelvic health issues.
Could the bark of a tree actually increase libido and improve impotence? Well yes it can… Yohimbe bark (Pausinystalia yohimbe), one of the most popular herbal remedies for male sexual dysfunction, has been shown in studies to increase blood flow to the genitals of both men and women, proving to be helpful for those with low libido. Though Yohimbe can be used by women, its actions have been shown to be extremely supportive for men experiencing erectile dysfunction due to stress or as a side effect of physiological health issues.
Green vegetables, legumes, seeds, nuts and brown rice are among the best sources of dietary magnesium. Most other foods don’t contain enough of the mineral to contribute to daily recommended levels, which is why many people choose to take a magnesium supplement or a daily multivitamin that contains magnesium. If you’re concerned about your overall magnesium level, particularly as it relates to erectile function, discuss supplement options and dietary changes with your doctor.
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.
However, the case is entirely different for Niacin, as it is not only relatively more convenient, but also it allows men to enjoy sex any time when they want even when they take Niacin for only one time in a day for erectile dysfunction. Niacin formulates in the form of various slow-release pills designed primarily to seep in a slow way within the human bloodstream during the course of one day.
Even at the higher doses of yohimbine, no changes in blood pressure or pulse were noted. This agent would appear to be safe in men with medically controlled hypertension. There was an increase in the morning cortisol levels in all men; the value was higher but not significantly so in responders. Telöken et al18 reported a high percentage (80%) of adverse events, but these authors administered a large dose (100 mg) of yohimbine. A toxic overdose of 200 mg produced only tachycardia, elevated blood pressure and anxiety of brief duration.33 Even direct intravenous dosing of yohimbine raised the mean arterial blood pressure by 12%,34 Goldstein et al35 systematically administered yohimbine and noted large hemodynamic and norepinephrine responses in both normal and hypertensive men; only the men who had a history of anxiety, depression, or other psychopathologic factors had symptoms. Oral administration of yohimbine at standard doses or even four tablets (21.6 mg) at a time has had no effect on blood pressure.4 Elevated blood pressure and heart rate were recorded when eight tablets (43.2 mg) were given at one time.3

Besides that, dyslipidemia (and hypercholesterolemia in particular), remain undertreated in many patients diagnosed with coronary artery disease. High triglycerides, a contributor to cardiovascular dysfunction by many but not all studies, are somewhat treatable with fibrates, yet there are significant limitations for their use. Elevated fasting triglyceride levels have been shown to be a strong risk factor for ischemic heart disease, independent of other known risk factors for atherosclerosis.
Yohimbe is an evergreen tree with large, leathery leaves. It is native to the tropical west coast of Africa, from Nigeria to Gabon. Natives in that region have used the inner bark of Yohimbe to treat angina, hypertension, fever, cough and leprosy. It was also smoked or snuffed to attain an altered state of consciousness. Its main use and rumored “power” was that it was an aphrodisiac. Today science recognizes it as a sensual stimulant, but Native Africans also recognized that drinking Yohimbe tea encouraged sexual arousal. It was traded with Europeans and the tales of Yohimbe’s “powers” spread, giving rise for its increased demand by Europeans.

I was impressed with the questionnaire to make sure the meds I requested were right for me and the follow up email from the prescribing doctor to see if I needed any support. The meds came promptly, were well packaged and are comfortably in date - I thought they might be very near their sell by date but I was wrong to be suspicious. If I ever need this service again I wouldn't hesitate.


Your doctor will ask you questions about your symptoms and health history. They may do tests to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate. Additionally, you may need blood or urine tests to rule out other conditions.

Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). 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(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full


"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.

A yohimbine HCL dosage of 0.2 milligrams per kilogram of bodyweight taken on an empty stomach immediately upon waking or in-between meals ramps up fat oxidation without causing undesirable side effects like high blood pressure or racing heart. [3] The table below provides a guideline on how many 2.5mg capsules of yohimbine HCL you should take based on your weight and the recommended dosage:


Your doctor will ask you questions about your symptoms and health history. They may do tests to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate. Additionally, you may need blood or urine tests to rule out other conditions.


If you bike a lot and have a very narrow saddle on your bicycle, consider switching to a "no-nose seat" which is wider at the back than a conventional saddle, allowing more of your weight to be distributed to the sitting bones. Make sure the seat is level or angled slightly downward and at a height that allows your knee to be just slightly bent at the bottom of the pedal cycle. Raising the handlebars on your bike so that you're sitting upright may also help.
Intermountain Healthcare is a Utah-based, not-for-profit system of 23 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.
Yohimbine also helps to increase levels of the coenzyme NAD (or nicotinamide adenine dinucleotide). This affects metabolism, cognitive processes, and detoxification of drugs in the body. NAD is not currently used to treat cognitive or mood-related disorders on its own, but has been shown in some studies to potentially have uses for preventing neurodegenerative diseases including Parkinson’s disease or Alzheimer’s. However on the other hand, studies have found that because it can increase anxiety in some patients, yohimbine may actually worsen mental illness in some patients, including those with Parkinson’s. (15) For this reason, it’s important for anyone taking mood-altering medications, or who has a history of any cognitive or mood disorder, to work with a professional while taking or starting any new herbal treatments.
Researchers at Johns Hopkins University last year looked at 3,400 healthy Americans and found that men who were vitamin D deficient were 32% more likely to have trouble getting it up than those with sufficient levels, even after adjusting for other ED risk factors. In fact, the connection is so common, Walker says D levels are something he always checks in ED patients. Why? The sunshine vitamin is crucial for keeping the endothelial cells that line blood vessels healthy. Without enough of the stuff, blood flow is inhibited, affecting everything from your heart to your hard-on.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
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For example, contracting your PC muscle at the wrong time during sex can actually cause you to ejaculate early! Specific thoughts and actions are required in order for your brain to respond with the correct muscle program. Learning this doesn't take away from the spontaneity of sex. In contrast, a start to end procedure for sex provides you with the total confidence required to satisfy yourself AND your partner.
Your doctor will ask you questions about your symptoms and health history. They may do tests to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate. Additionally, you may need blood or urine tests to rule out other conditions.
Zinc affects different aspects of mammalian reproduction. Testicular disruption, impaired spermatogenesis and subsequent poor semen parameters are found in males with zinc deficiency. Testicular concentration of zinc was lower in male sheep fed with zinc deficient diets. The same animals showed smaller seminiferous tubules and less lumen development than the controls.[1] Similarly variable degrees of maturation arrest in different stages of spermatogenesis with reduced diameter of seminiferous tubules were noted when rats were fed with zinc deficient diets.[2] Zinc deficiency causes a reduction in the structural parameters of seminiferous tubules influences serum levels of testosterone (T) and prolactin (PRL) in rats.[3,4]

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Those consuming yohimbine lost nearly 30% more fat and experienced 31% greater reductions in body fat percentage compared to those in the placebo group. Neither group reported negative side effects from a twice-daily dosing of 10mg of Yohimbine HCL. These findings indicate that the powerful fat loss effects of yohimbine apply to even the most seasoned athletes with already low levels of body fat.
Ginkgo biloba. Ginkgo is an herb that is used in Chinese medicine that’s thought to improve blood flow. "Any ED treatment that improves blood flow may help," explains Dr. Harris. "An erection is just blood in and blood out." However, the evidence that ginkgo can improve blood flow in ED is limited, and most experts say the jury is still out. In addition, ginkgo can increase the risk for bleeding problems if combined with certain medications, such as warfarin (Coumadin).
But researchers emphasize that immediate-release niacin should remain as a treatment option for high cholesterol. "The point of our study is not that niacin should be avoided, but that the immediate-release preparation is the preferred form, and that medical supervision and evaluation are necessary for people taking this drug," said James McKenney, professor and chairman of the division of clinical pharmacy at the Medical College of Virginia.
Exercise lowers blood pressure – a consistently high blood pressure (hypertension) can damage your arteries and cause them to harden, limiting the flow of blood to the penis and leading to cardiovascular problems. Exercise works to reduce the force required to pump blood around your body, protecting your artery linings as a result. You should aim to have a blood pressure less than 140/90mm Hg.
Many studies have been conducted on this topic; their results have been challenged by lack of controlled groups and non-randomization. Randomized controlled trials (RCTs) are generally accepted as the most valid method for determining the efficacy of a therapeutic intervention, because the biases associated with other experimental designs can be avoided.Non-randomized controlled trials, can detect associations between an intervention and an outcome. But they cannot rule out the possibility that the association was caused by a third factor linked to both intervention and outcome. Random allocation ensures no systematic differences between intervention groups in factors, known and unknown, that may affect outcome. Randomized controlled trials are the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome and for assessing the cost effectiveness of a treatment (45, 22).
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).
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.
Much higher doses have been used in certain studies, sometimes up to 100 milligrams daily. However, this is considered a very high dose that is potentially dangerous and likely to cause some side effects. Overall, it’s best to start with small doses while monitoring your reaction. Speak to a doctor or herbal practitioner before increasing your dosage to high levels.

Health benefits and risks of copper Copper is an essential trace mineral that occurs in all body tissues. It is vital for a range of body functions including the production of red blood cells and energy, and the maintenance of nerve cells and the immune system. A copper deficiency can be harmful, but too much can be toxic. Learn more about copper here. Read now
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