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You shouldn’t be surprised to know that many of your patients are struggling more than usual to maintain good eating habits. Your patients who already have underlying health issues are the most vulnerable in response to a worsening diet. Even your patients who normally are very good about eating a well balanced diet may find themselves giving in to the temptation to be overly strict with their diet routines, which can lead to missing out on key nutrients such as L-arginine and L-citrulline.

A 2020 survey of more than 800 adults, published in the European Journal of Investigation in Health, Psychology and Education, breaks down the details of how the effects of long term stress in response to this current pandemic are showing up in terms of increasingly poor dietary habits.1 More than 30% of survey respondents reported that their diet had worsened during the COVID-19 pandemic, as well as unhealthy eating practices, including overeating (39%), fasting (16%), restricting eating (20%), and skipping meals (25%).

Unfortunately, following these types of unhealthy eating habits can have adverse effects, as it means that the body may not be getting certain types of essential nutrients. The amino acids L-arginine and L-citrulline are two such nutrients that help regulate the cardiovascular and circulatory systems by increasing nitric oxide levels.


Natural sources of L-arginine and L-citrulline

Dairy products and animal proteins, particularly turkey breast, are excellent sources of L-arginine and L-citrulline. Plant-based sources can include leafy green vegetables, lentils, chickpeas, and soybeans.

However, it is important for you to carefully monitor your vegetarian or vegan patients, as well as those who have medically based dietary restrictions, to be certain their intake is at sufficient levels and they may require supplementation.

L-arginine, L-citrulline, and nitric oxide

L-arginine and L-citrulline increase production of nitric oxide, which is a type of molecule that acts as a vasodilator. This means that they allow blood vessels to expand, letting more oxygen flow through the circulatory system.2

Increasing blood flow improves cardiac health and lowers blood pressure. Furthermore, higher nitric oxide levels can also improve oxygenation in the peripheral circulatory system, which can benefit other conditions, such as diabetic neuropathy in the feet and erectile dysfunction.2

Combining L-arginine and L-citrulline

One of the more interesting research findings regarding L-arginine and L-citrulline is that combining them can significantly increase efficacy, even at a lower dose than from either amino acid alone. A number of animal and human studies appear to show this effect.3-6

A 2019 review article in the journal Nutrients reported on the state of research regarding the use of L-arginine and L-citrulline to improve blood pressure.3 In pooling together the findings from smaller papers, the authors noted that oral L-arginine supplementation can lower blood pressure by 5.39/2.66 mmHg, which is comparable to that from changes in diet and exercise. The pooled data also showed that L-citrulline may be able to lower blood pressure by 4.1/2.08 to 7.54/3.77 mmHg, although results were somewhat mixed.3

A 2017 article in Bioscience Biotechnology & Biochemistry presented the findings from a study comparing the effects of combining oral L-citrulline and L-arginine supplements on plasma L-arginine levels.4 For this study, 42 healthy Japanese men received 2g of L-citrulline or L-arginine per day, a 1g combination of the two, or placebo. The researchers found that those study subjects who took the combination of L-citrulline and L-arginine had higher plasma L-arginine levels than just L-arginine by itself.4

A 2014 article in Biochemical and Biophysical Research Communications reported on an animal study using rats and rabbits to determine if the combination of L-citrulline and L-arginine improved plasma nitric oxide levels better than each amino acid individually.5 Similar to Suzuki’s study,4 the combination of L-citrulline and L-arginine resulted in higher plasma levels of nitric oxide levels at a dose lower than for either amino acid alone. Furthermore, blood circulation similarly showed more improvement with the combination supplement than with each one individually.

Asking about your patients’ eating habits during this current pandemic is important, as it can alert you to whether or not they are getting all the crucial nutrients they need. If they are falling short, particularly in foods that are high in nitrates, a combination supplement containing L-citrulline and L-arginine could be just is needed to improve cardiovascular health.


Khubchandani J, Kandiah J, Saiki D. The COVID-19 pandemic, stress, and eating practices in the United States. European Journal of Investigation in Health, Psychology and Education. 2020; 10(4):950-956.McRae MP. Therapeutic benefits of l-arginine: An umbrella review of meta-analyses.Journal of Chiropractic Medicine. 2016;15(3):184-189.Khalaf D, Krüger M, Wehland M, et al. The effects of oral l-Arginine and l-Citrulline supplementation on blood pressure. Nutrients. 2019;11(7):1679.Suzuki T, Morita M, Hayashi T, Kamimura A. The effects on plasma L-arginine levels of combined oral L-citrulline and L-arginine supplementation in healthy males. Bioscience Biotechnology & Biochemistry. 2017 Feb;81(2):372-375.Morita M, Hayashi T, Ochiai M, et al. Oral supplementation with a combination of L-citrulline and L-arginine rapidly increases plasma L-arginine concentration and enhances NO bioavailability. Biochemical and Biophysical Research Communications. 2014 Nov 7;454(1):53-57.

The post Combining L-arginine and L-citrulline to Improve Circulation appeared first on Chiropractic Economics.

By: Tina Beychok
Title: Combining L-arginine and L-citrulline to Improve Circulation
Sourced From: www.chiroeco.com/combining-l-arginine-and-l-citrulline-to-improve-circulation/
Published Date: Wed, 19 May 2021 20:53:15 +0000