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Herbal Impotence Pills Get Some Scientific Scrutiny

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While the theory about L-arginine "could conceivably work," says Catalona, "I'm not sure there's any practical evidence to show it really does this. ... Even though [Ito's] studies look positive, there's not absolute proof at this point. With Viagra, it's been through the FDA, so we know it's definitely effective. As for its safety, the safety guidelines are pretty good.

"What you see in some advertising for herbals [is] they jump all over the fact that Viagra is said to cause deaths," he adds. "So I have a lot of patients who [don't have heart disease] or anything else that would make Viagra dangerous to them, but their wives won't let them take it. ... So some people who are afraid of Viagra take these things."

Those who want to go the natural route sometimes turn to naturopathic physicians like Seattle-based Don Brown, ND, who tells WebMD, "L-arginine is pretty safe; there aren't a lot of concerns. Nitric oxide has a mild [blood vessel expanding] effect. We know it does that." Still, he says, "I would consider the research on L-arginine at this point to be very, very preliminary with regard to its effect on erectile dysfunction."

The problem is that dietary supplements are unregulated, Brown tells WebMD. "Mechanism of action becomes the way that it's promoted to the public, and yet there aren't any good clinical trials to back up their claims."

From the offices of the American Botanical Council, Blumenthal takes issue with that. "One of the biggest myths about the entire botanical/herbal medicine industry is that it is unregulated." Although these supplements are not regulated as drugs, he says, "any claims must be truthful and not misleading. They have to be backed by scientific evidence." The Federal Trade Commission recently obtained large financial settlements from two supplement companies whose advertising made unsubstantiated claims.

The FDA is expected to issue some new, more stringent regulations for the manufacturing of herbal supplements later this year. The quality control of supplement manufacturing will then be required to meet the same standards as that for foods -- "somebody that makes tomato paste or tomato sauce or apple juice," Blumenthal says.

His organization has been trying for seven years to push the supplement industry toward higher standards, by testing 500 commercial ginseng products. "We have done it by the book and done it very fair, tested everything twice to make sure everything is accurate, contacted the manufacturer once we found a negative finding, and gave the opportunity to rebut our claim or explain the situation," Blumenthal says.

"Many manufacturers have told us that either ... because they knew we were testing ginseng or because they got an adverse finding from us, that they totally overhauled their operation. Now, not only is their ginseng better, but everything else they produce has a higher degree of reliability of the quality because they learned a lesson from us on the ginseng.

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