(290) L-CITRULLINE AND BEET ROOT SUPPLEMENT IMPROVES NIGHTTIME ERECTIONS
Authors: Brandeis J , Justin E 
Published: December 2024

Abstract

Introduction
Nitric Oxide boosting supplements are known to increase circulation. L-Citrulline is converted into Arginine in the body, producing nitric oxide that relaxes blood vessels and improves blood flow. Beetroot extract potentially improves erectile function due to its high nitrate content, which the body converts into nitric oxide which helps dilate blood vessels and improves circulation. Nighttime erections can be measured and can provide an excellent indicator of erectile health.

Objective
We sought to determine if ingesting a Nitric Oxide boosting dietary supplement 1 hour before sleep can improve nighttime erectile function by using a device that measures penile pressure while sleeping.

Methods
Ten men completed the study. Average age 52. Average SHIM score 18. A single tablet of the Nitric Oxide boosting dietary supplement contains 750 mg L-Citrulline, 65 mg Muira Puama Extract 4:1, Red Beet Root extract 45 mg 4:1, Panax Ginseng Root Extract 35 mg 4:1. This supplement is commercially available as AFFIRM. Participants wore the TechRing by FirmTech during sleep to measure nighttime erectile function. The TechRing uses 2 sensors and an AI interface to measure on a 1-10 scale the firmness of erections and their duration. The data has been validated by independent researchers, and it's safety has been affirmed in a large study presented at the recent AUA meeting in 2024. The research protocol was a 2-day washout period with no ejaculation, ED medications, or supplements. Day 1 and Day 2 participants did not ejaculate and did not take any ED medications or supplements and they wore the TechRing while sleeping. On day 3 and Day 4, participants took 2 supplement tablets 1 hour before sleep and wore the TechRing while sleeping. To standardize the results between patients and between days, we calculated the area under the curve per hour of sleep as a measure of erectile activity.

Results
The area under the curve per hour of sleep (AUC/hr) of the men with no dietary supplement was 11.9 mean and the AUC/hr on the two days when participants took the supplement was 15.8. The mean difference was 3.89 and the p-value was 0.0001. 95% Confidence Interval was (-5.6 to -2.2). The number of erections per night on average was 4.05 with no dietary supplement and 4.45 with dietary supplement. There was no significant difference in the number of erections per night and the p-value is 0.42. No side effects were reported from taking the dietary supplement. AUC/hr mean AUC/hr median Number of Erections NO Supplement 11.9 11.5 4.05 Yes Supplement 15.8 15.2 4.5 Mean Difference 3.89 3.7 0.45 p-value 0.0001 0.428

Conclusions
A Nitric Oxide boosting dietary supplement consisting of L-citrulline, Red Beet Root Extract, Ginseng, and Muira Puama increased the duration and intensity of nighttime erections but did not increase the number of erections in men. A Nitric Oxide boosting dietary supplement with L-Citrulline, Beet Root Extract, Panax Ginseng and Muira Puama taken before sleep improves genital circulation at night without negative side effects. This supplement may also improve genital circulation during sexual activity and may be synergistic with PDE-5 inhibitors. Additional studies are ongoing to study this issue further.

Disclosure
Yes, this is sponsored by industry/sponsor: BrandeisMD.
Clarification: Industry initiated, executed and funded study.
Any of the authors act as a consultant, employee or shareholder of an industry for: AFFIRM Science.