For SURGERY RECOVERY, L-arginine increases blood flow and oxygen delivery to healing wounds, by helping the body to make nitric oxide. Better circulation enhances protein formation, especially collagen. L-arginine also reduces excessive inflammation. It improves the output of growth hormone and insulin, leading to stable glucose levels needed for energy and cellular healing, and supporting tissue repair.
Where is L-arginine found?
L-arginine is a semi-essential amino acid, necessary for protein synthesis, and a building block for making nitric oxide. It becomes essential when the body is exposed to trauma, stress, chronic disease, or a poor diet. Adult bodies make some arginine, but its production depends on many different factors such as age, mental or physical stress. Because a number of health situations require higher amounts, L-arginine can be classified as a conditionally essential amino acid, depending on the developmental stage and health status of the individual. Though small amounts of arginine are found in nuts, seeds, and legumes, it needs to be consumed through supplementation to reach adequate levels to benefit anyone undergoing surgery.
“Only a few decades ago, the primary focus of nutritional supplementation was prevention of deficiencies. It is now recognized that, at higher levels, many well-known nutrients such as L-arginine can shift body chemistry to prevent or treat disease.”
Dr. Rachelle Herdman, Custom Health Guide
How does L-arginine impact surgery recovery?
- It accelerates insulin secretion, a hormone that moves glucose from the blood stream into cells, and thus allows the body to convert glucose into energy. Better insulin levels, thanks to L-arginine, can boost the body’s ability to heal surgical wounds.
- Arginine stimulates protein regeneration, which is essential to build and repair muscle, skin, and other body tissues. This especially includes increased collagen formation for knitting tissues back together. Protein also helps fight infection, balance body fluids, and carry oxygen throughout the body.
- Arginine boosts nitric oxide, which increases blood flow and oxygen delivery to the healing wound.
- Nitric oxide also plays a major role in antimicrobial activity and thus cuts the risk of post-operative infections.
- L-arginine is an effective nutrient for reducing excess inflammation. A healthy level of inflammatory activity brings fresh white cells into a wound area to remove dead tissue and debris, but too much inflammation impedes healing.
- L-arginine stimulates the release of growth hormone, as well as insulin-like growth factor 1, also known as IGF-1, both of which can improve wound healing.
What is L-arginine?
L-arginine was first recognized in the extract of a lupin plant seedling in 1886 by a Swiss chemist, Ernst Schultze. As one most metabolically versatile amino acids, L-arginine serves as a precursor for the synthesis of urea, nitric oxide, glutamate, and important amines in the body. These key metabolites replenish the Krebs Cycle, a biochemical pathway which is the main source of energy for cells and an important part of aerobic respiration, that is profoundly important during surgery recovery.
Partly due to its protein building ability, L-arginine can cross the blood-brain barrier and reach the brain tissues and hypothalamus–something that many other nutrients cannot do. L-arginine can improve dopamine levels, offering a calming influence. L-arginine is made up of 32% nitrogen. Studies indicate that L-arginine does this via a nitric oxide synthase-dependent mechanism.1
Nitric oxide is a natural blood vessel-opening molecule for mammals. For surgery recovery, it improves perfusion of wounds by making more oxygen available, and supports new protein and scar formation. It also occurs in the cells of almost all types of organisms, ranging from bacteria to plants, fungi, and other animals. Nitric oxide is made within human cells from L-arginine, oxygen, and a compound called NADPH. Each nitric acid molecule lives for only a few seconds, so a steady supply of L-arginine is needed.
The research behind L-arginine and surgery recovery
Research confirms that L-arginine helps with surgery healing and reduces infection risk.
Of special interest are several studies which have demonstrated that arginine may favorably influence outcome during sepsis. In one 2003 study, arginine or placebo was given to subjects for 10 days before sepsis was induced. The group receiving arginine supplementation had improved activity of phagocytes, white blood cells that clear foreign material, and as a result, their bacterial counts diminished and improved.2
Recent advances in 2014 have shown data that arginine has profound effects on wound healing and post-operative infections. When taken at ample doses, it can also reduce the incidence of and improve outcomes for cardiovascular disease, diabetes, organ transplant rejection, and inflammatory conditions. The 2014 publication Advances in Wound Care laid the groundwork for more research to clarify optimal combinations of immune supportive nutrients. L-arginine is identified as a key molecule for wound healing and infection prevention and treatment. Its timing of administration and optimal dosing warrants further in-depth pre–clinical and clinical studies.3
Our patients’ experience with L-arginine
Dosing of L-arginine varies in clinical practice, and safety studies have found that amounts up to 20,000mg have no adverse effects. L-arginine is best in a sustained-release form because of its short action. Plain L-arginine is rapidly metabolized and used up by the body, so unless it is taken frequently throughout the day, blood levels drop fast. We therefore recommend a sustained-release L-arginine formula, in a base of methyl cellulose. This can maintain ample tissue levels of L-arginine over 24 hours at doses of 500 to 1,000mg taken twice daily.
Our patients undergoing surgery generally start taking L-arginine about 5 days before their procedure, then resume afterwards as soon as they are able to eat, and continue for another 4 weeks. They report that post-operative wound healing is often faster than expected, with less pain and more ability to be active in a shorter time. They also notice a lower rate of infection than expected and stable blood sugar levels.
Recommendation: L-arginine in a base of slow-release methyl cellulose, 500 to 1,000mg two times daily, with or between meals; or as directed by your healthcare provider.
- Volz, Trent J., and James O. Schenk. “L-arginine increases dopamine transporter activity in rat striatum via a nitric oxide synthase-dependent mechanism.” Synapse 54.3 (2004): 173-182.
- Wang Y-Y, Shang H-F, Lai Y-N, and Yeh S-L: Arginine supplementation enhances peritoneal macrophage phagocytic activity in rats with gut-derived sepsis. J Parenter Entearl Nutr 2003; 27:235
- Alexander, J. Wesley, and Dorothy M. Supp. “Role of arginine and omega-3 fatty acids in wound healing and infection.” Advances in wound care 3.11 (2014): 682-690.
- Sukhotnik, Igor, et al. “Oral arginine improves intestinal recovery following ischemia-reperfusion injury in rat.” Pediatric surgery international 21.3 (2005): 191-196.
- Nishizaki, Kanae, et al. “Effects of supplementation with a combination of beta-hydroxy-beta-methyl butyrate, L-arginine, and L-glutamine on postoperative recovery of quadriceps muscle strength after total knee arthroplasty.” Asia Pacific journal of clinical nutrition 24.3 (2015): 412.