Insulin Resistance and Peyronie's

In my short book, on page 20, I made a statement about causes of Peyronie's, and the higher incidence occurring in men with insulin resistance. Since that time I have not elaborated on this issue, so it is time to look into this issue a little deeper.

Detailed Description and Insulin Resistance Bood Testing:
It is well known that diabetes often leads to erectile dysfunction. Because insulin resistance occurs before diabetes, it is possible that erectile dysfunction may occur in some individuals while they have insulin resistance, but before they develop diabetes. If this is true, it might be possible to use erectile dysfunction as a sign of insulin resistance, which may lead to more timely treatment of insulin resistance and may delay or prevent the development of diabetes, and the other problems mentioned above.
Insulin is a hormone produced by the body that lets sugar into the cells, where it is used for energy. Insulin resistance occurs when the body’s cells have a decreased ability to react to insulin. This leads to an increase in insulin secretion. Over time, insulin resistance can lead to higher levels of sugar in the blood (diabetes), and can also contribute to obesity, high blood pressure, high cholesterol levels and heart disease. There are no simple tests to actually diagnose insulin resistance. Currently, the glucose tolerance test is used to diagnose IR, but it involves several blood draws over a 2-hour period. Another purpose of this study is to compare a blood test involving only one blood draw to the 2-hour glucose tolerance test, which involves several blood draws over a 2-hour period.

There is a very well thought out forum post about Insulin resistance, and Diabetes and their relationship to Dupuytrens, which has a very similar etiology to Peyronie's.  Many men develop both of these conditions simultaneously, since they may be predisposed genetically.
The post is well worth reading and gives some great dietary advice.  You can read it by going to this website:

The post was written in 2005, but I just came across it,  it has some very good advice and valuable information about insulin resistance, diabetes and the way proteins may accumulate and build up.

Natural Alternatives for Treating Erectile Dysfunction

Viagra Alternatives and Penis Enhancement Pills

Sildenafil Citrate, Taldenafil, and Vardenafil are all prescription brands for treating erectile dysfunction.  They are classed in a group of drugs that are PDE5 inhibitors.  To read more about how they work, side effects, and safety, click on this link:  

 What is Viagra and Generic Viagra

For men suffering with erectile dysfunction, it can be be very distressing.  Many men do not want to take a prescription drug for this problem or add another drug to those they are already taking.  It has been shown through surveys, and clinical studies, that the more prescription drugs a man takes, the more likely he is to suffer with erectile dysfunction.  Consumer Reports on causes of ED

There are a host of supplements out there that make some pretty wild claims like; 

Works in less than one hour,  Add up to 4 inches in length to your penis.

I haven't heard of any documented cases of men taking a pill and their penis magically growing longer, but it doesn't keep men from spending loads of money and the scammers from taking advantage.
Remember Smiling Bob? In 2005 the CEO of Enzyte went to prison for fraud.  Still many men still swear by Enzyte and its' effectiveness for increasing size and treating ED.
Let's take a look at some of these "Miracle Penis Pills ."
Enzyte, VigRX, Zyrexin, Longinexx, Extenze, Penatropin, and Magna RX, all have something in common.  That ingredient is L-Arginine.

L -Arginine:  
L-Arginine is an amino acid that is responsible for increasing Nitric Oxide in the blood.  It is not always well absorbed by the body, so it is most effective when taken along with Nitric Oxide precursers, such as Pychnogenol or L-Citrulline.  Nitric Oxide relaxes the veins of the penis, allowing increased blood flow, which is critical for erection.

Saw Palmetto:  
Saw Palmetto is also a common ingredient that is a part of most of these pills.  The fruits of    the saw palmetto are highly enriched with fatty acids and, beta phytosterols and extracts of the fruits have been subjected to loads of research for the treatment of prostate enlargement symptoms. Saw Palmetto is widely used and recommended for Prostate health.  Its' effect on erection quality is unknown.

Tribulus Terristris:

Commonly known as puncture vine extract, which many of us may be painfully aware(ouch) if you ever stepped on them with bare feet.  Tribulus Terristris is found in some of the pills.  Animal studies in rats, and primates have demonstrated a mixed bag. One study found that Tribulus terrestris extract can produce statistically significant increases in levels of testosterone, dihydrotestosterone and dehydroepiandrosterone, and also there was an effect that suggested aphrodisiac activity.


On the other hand, one recent study found that T. terrestris caused no increase in testosterone or LH in young men

Butea Superba:
This ingredient is in Longinexx and Penatropin.  These two pills are marketed as enhancement pills and Butea Superba is a herb from Thailand that is thought to be an aphrodisiac.  There are no double blind clinical studies to support this aphrodisiac effect, but many men claim it works.  Ingesting large amounts 10-16 grams a day resulted in decreased testosterone levels, probably due to the phyto-estrogens found in the herb, which some believe can cause men to grow larger breasts .

DHEA (Dehydroepiandrosterone) is a hormone/steroid that is made by the human body. It can also be made in the laboratory from chemicals found in wild yam and soy. However, the human body can't make DHEA from these foods, so simply eating wild yam or soy does not increase DHEA levels. Don’t purchase wild yam and soy products labeled as “natural DHEA”  it won't be effective in raising your levels.

DHEA is used by men for erectile dysfunction (ED), and by women  who have low levels of certain hormones to improve well-being and sexuality.

DHEA is Probably Safe for most people when used for just a few months in doses that do not exceed 50-100 mg. daily. It can cause some side effects which include acne, hair loss, stomach upset, and high blood pressure. Some women  have noticed changes in menstrual cycle, facial hair growth, and a deeper voice after taking DHEA

 The best selling natural Viagra alternative is Zyrexin.  You can even buy it at Walmart, which  has one of the lowest prices for this product.  
If you really want to make a difference, lose some weight, it will make your penis look longer, because you reduce the fat that surrounds and conceals your natural length.  To increase erectile quality lose weight and stop smoking.  Smoking is a leading cause of vascular disease and smokers are twice as likely to develop ED than non-smokers.  

Doctors for the most part do not think that penis enhancement pills work.  Those that do are less than enthusiastic, gains are almost always temporary from taking enhancement pills.  The most noticeable gains are achieved from enhanced erections, which temporarily lengthen the penis.

The best natural supplements for increasing erections quality should contain L-Arginine and a percurser like pychnogenol or L-Citrulline.  Many men are happy with the results of Zyrexin and it is readily available.  You can try DHEA for a short duration to increase testosterone and boost your libido and sex drive.  If these options do not work out, then consult with your doctor for other available options.  

When purchasing supplements beware of SCAMS.  Buy your products from reputable sources, like the Vitamin Shoppe, Amazon, Walmart, GNC, etc.  Avoid getting roped into "Free Trials" or "Autoship" products.  They can get very expensive, very quickly. 

If you go to 10 different websites promoting penis enhancement pills, you will get 10 different opinions on a multitude of products.  Much of the information is conflicting, so be careful and do your research before parting with your hard earned money.

L-Arginine how does it work for Peyronie's

L-Arginine keeps coming up as a treatment supplement for Peyronie's

I see L-Arginine being recommended for Peyronie's a lot lately.  What is the story, and why is it getting so much attention?
L-Arginine has been tested in clinical studies, and it has been found to be very effective for treating erectile dysfunction.  In one study after 3 months of combination therapy using pychnogenol and L-arginine, 92.5% of the patients acheived normal erections, which is a significant and amazing statistic.

What is it that L-arginine and Viagra have in common?  Nitric oxide (N.O.) is the answer.   N.O. is essential for a penile erection.  It works by sending a message to the smooth muscles of the corpus cavernosum (erection chambers in the penis) to relax.  When the muscles relax blood flows into the corpus cavernosum, causing the penis to become erect.  The idea of supplementing with L-arginine for Peyronie's is not to directly remove the plaque, but to allow increased blood flow to the penis.  The increased blood flow is thought to aid in the healing process.

Many doctors and urologists recommend L-arginine supplements for conditions from Peyronie's, Erectile dysfunction, to regulate blood pressure, reduce inflammation, cardiovascular health, and improve sleep quality.  It also is thought to increase endurance and strength. 

So there is a lot of information supporting the use of L-arginine in the treatment of Peyronie's.  The next question is:  "What is the best form of L-Arginine to take?"

L-Arginine when taken in large doses was shown to increase Nitric Oxide in the blood and urine.  One of the problems with L-Arginine supplements, is the amino acid is not readily assimilated and absorbed by the body.  It is better to take a combination product, where more of the L-Arginine is absorbed.  L-Citruline is better absorbed and converts into L-Arginine in the kidneys.
I recently purchased a bottle of Source Naturals, L-Arginine, L-Citrulline Complex from the Vitamin Shoppe.  It contains 750 mg. L-Arginine and 250 mg. L-Citrullene.  Suggested Use is 1 tablet 3 or 4 times daily.  The bottle contains 120 tablets. 

L-Citrulline is a amino acid found in some foods like watermelon, and it is produced naturally in the body.

L-Citrulline is used for treating Dementia/Alzheimer's, muscle weakness, erectile dysfunction, high blood pressure and is used by body builders for increasing energy and improving performance.

Your body changes L-Citrulline into L-Arginine and also to Nitric Oxide, so it is a perfect companion to an L-Arginine supplement.  It is believed to increase and improve blood flow and reduce blood pressure.

If you are suffering from Peyronie's, ED, or just feeling run down and want to increase your performance level, then you might want to consider taking this supplement.  Click on the Vitamin Shoppe tab in the right hand column to go to their website and order your own bottle.  L-Arginine was found to be effective in raising Nitric Oxide levels and improving sexual performance and erectile quality in many medical studies. 


Non Invasive Treatment Studies for Peyronie's

  Non Surgical Peyronie's Studies

I will start this article about Medical studies with Drugs and Supplements that have been studied and the results, and also cover some other products that have not been tested.  If you wish to take the time to go through these studies, you will see the reasoning behind the 3 step program that I developed and used to successfully treat my Peyronie’s disease.
Colchicine is a drug that is mainly used to treat Gout due to its’ anti-inflammatory qualities.  It is also known to reduce the production of collagen and increase the activity of collagenase. (the enzyme that breaks down collagen)  Colchicine is extracted from the “Meadow Saffron” plant.  It is a toxic drug and its’ toxic qualities are amplified or multiplied when combined with cholesterol lowering drugs. (statins)
Adverse Reactions to Colchicine include nerve damage that causes numbness and tingling in the hands and feet, in advanced cases this effect can be permanent along with an increased risk of dementia.  Large doses can result in respiratory failure and death.  Colchicine is not FDA approved for treating Peyronie’s Disease and the toxic side effects really are not worth the risk, since study results have been mixed.
An uncontrolled group study of 24 men took Colchicine in 1994.  The results of the study were, 26% of the men reported a marked decrease in curvature, 11% reported a slight decrease, 63% were unchanged, and 50% of the men reported plaque size reduction.  I do not have the duration or dosage taken in this study.
The next study in 2004, involved 78 men broken into two groups.  One group took .5mg-2.5mg. colchicine per day for 4 months.  The other group took a placebo.  There was no difference in curvature reduction reported between both groups.  There was another study undertaken using 84 men with the same protocol above.  All of the men were screened to make sure they had similar duration of disease – 15 months.  The results were no difference between Colchicine group and placebo group.
Pentoxifiylline works by changing the shape of red blood cells in the body, thus reducing the viscosity (thickness) of the blood.  This allows blood to circulate more freely, especially to the bodies extremities.  Pentoxifylline acts as a mild stimulant and is in the same family as caffeine.  Men that are allergic to caffeine should not take Pentoxifyllline without medical observation.  Brand names are Pentoxil and Trental.
A study by the University of California at San Francisco treated 71 men with Peyronie’s Disease.  62 men took Pentoxiffyline for a year and 9 men received no treatment.  The calcifications stabilized or improved in 57 of the 62 men who took Pentoxiffyline compared to 4 of the 9 men in the no treatment group.  I found no reports of curvature improvement in the study, so that part is unknown.
Another larger study with 228 men participating was don at Ahahid Beheshti University in Tehran, Iran.  114 men took 400 mg. Pentoxifylline twice daily.  The other 114 men took a similar regimen of placebo.
Results: 35.9% of the men in the PTX group reported a positive response with only 4.5% in the placebo group.  Improvement in measured curvature on average was between 11.4 – 11.7% in the PTX group.  In the placebo group curvature improvement was .2 to neg.4.2%
11% of the PTX group still have disease progression compared to 42% in the placebo group.
In a study using Tamoxifen VS. Placebo there was no significant improvement VS. the placebo group so this study is a non-story.
Tamoxifen VS. Acetyl-L-Carnitine:
Results: Acetyl-L-Carnitine was significantly more effected and safer to use in the treatment of early acute Peyronie’s Disease.  Tamoxifen induced significant undesirable side effects.
The body produces carnitine in the liver and kidnesy and then stores it in the heart, brain, sperm and muscles.  It acts as an anti-oxidant and helps restore cells damaged by inflammation.  Only one study has been done on L-Carnitine for treatment in Peyronie’s Disease.  Acetyl-L-Carnitine significantly reduced penile curvature and plaque size. (Biagiotti, 2001, Turin, Italy)
The suggested dosage of carnitine for Peyronie’s Disease is 1 gram (1000 mg.) twice daily for three months.
L-Arginine is a popular supplement for Peyronie’s but studies are very limited.  In 2003 a study found arginine given to rats in mixed in their water.  L-Arginine was effective in reducing plaque building components. L- Arginine was also used in an another study, but it was combined with other drugs, so the reports would be mixed and not statistically significant.  There are other studies with L-Arginine in treatment of erectile dysfunction and the results are significant.  I will be posting a separate article on L-Arginine soon.
L-Arginine should not be taken with sildenafil (Viagra), or with blood pressure lowering medications.
PABA: Para-Aminobenzoic Acid
PABA (Para-Aminobenzoic Acid) is a popular Peyronies remedy. It is best known as a sunscreen in topical lotions, since it blocks UV light.  The reviews are mixed on how effective PABA is for treating Peyronie’s. A typical safe dose of PABA for therapeutic use is 400 mg. daily. Most of the studies using PABA are very old, dating back to the early 1940′s.
There is only one double blind placebo study that I could find, that used a control group of over 100 men with Peyronies. The trial enrolled 103 men and for one year they ingested 3 grams, 4 times daily. The progression of their Peyronie’s was significantly slowed, but it did not reduce any pre-existing plaque. Doctor’s consider 400 mg. a day a safe dose, but the men in this study were ingesting 12,000mg. or 12 grams daily. This is far beyond the safety threshold, and should not be done except under strict medical supervision.
In 1959 a study was undertaken with 21 patients and another study in 1997 included 32 patients, but since they were not double blind placebo studies there was not a control group to compare the results with. These studies used from 12 grams daily to a maximum of 20 grams daily. Because it takes such high doses of PABA to get a positive response, and it causes significant gastrointestinal side effects, PABA for Peyronie’s Disease often is not recommended as a treatment. Other more uncommon side effects include nausea, reduced appetite, fever, and rash. PABA can also interact with some medications, including sulfa antibiotics.
Vitamin E
Vitamin E as an oral supplement has been extensively studied, and shown to have no impact on Peyronie’s Disease.  Vitamin E may be effective in combination with other supplements and treatment combinations.  One possible medical regimen is 100 mg of vitamin E taken three times a day for a minimum of four months. Theoretically, this antioxidant will prevent further development of plaque, although studies have suggested that it is no more effective than placebo.
Gotu Kola 
Use of Gotu Kola, which is also called Centella asiatica, Indian pennywort, and other less known names is believed to contain certain chemicals that seem to decrease inflammation and also decrease blood pressure in veins.  Gotu Kola is used to treat various conditions in which fibrous scar tissue causes problems, and for that reason it has been advocated for Peyronie’s disease. However,  there are no studies with evidence to show that it is effective.
Some of the comments about Gotu Kola at the Peyronies’ forum can be read  here:
The verdict is out on Gotu Kola’s effectiveness in treating Peyronie’s, but it does seem to have many other health benefits, and is generally accepted as safe.
Omega 3 Oils
The data from a study of 224 patients with chronic Peyronie’s Disease was divided into two groups.  The results of the study did not show any data that would support Omega 3 supplements to be beneficial in treating chronic Peyronie’s Disease.
One of the problems with this study in my opinion, was the low dosage of Omega3 that was given to patients, and the questionable quality of the products administered.  There are all types of Omega3 oils, and many brands are so processed, that their effectiveness is in doubt, and questionable at best.

Proteolytic Enzymes
Serrapeptase is a potent proteolytic enzyme that contains 470 amino acids and a zinc atom, which is essential for proteolytic activity.  Medical studies have not been done for treatment on Peyronie’s Disease specifically, but other medical studies have proven this enzyme to be more effective in anti-inflammatory activity on collagen than the other proteolytic enzymes that were used in the study.  It was also shown to have a synergistic effect with aspirin.  (2008 Dept. of Pharmacology, J.N. Medical College, India)
A study conducted in Jordan in 2008,  found Serrapeptase to offer significant reduction in swelling and pain, with oral surgery, and no negative side effects.  It has been used in numerous studies from Breast engorgement to acute inflammation in chronic ear, nose and throat disorders, with significant symptom reduction.  These double blind placebo studies found that Serrapeptase was well tolerated and its’ anti-inflammatory, anti-oedemic and fribrinolytic activity, acts rapidly on localized inflammation.
Serrapeptase/Nattokinase blends have been found to be very effective in the reduction of Fibroid tumors, and Endomitriosis in women.  Serrapeptase also has the ability to digest non-living tissue that is a by-product of the healing response without harming living tissue. Serrapeptase is used to dissolve non-living tissues to include: scar tissue, fibrosis, blood clots, cysts and arterial plaque. It is also used as an anti-inflammatory agent against Sinusitis, and as a thinner for mucous secretion.
Bromelain is a powerful proteolytic enzyme that has anti-inflammatory effects and is known to increase fibrinolytic activity in the blood.  Bromelain is derived from pineapples. Bromelain is a popular enzyme used in the treatment of Peyronie’s Disease.  It is a candidate for studies, because of its’ link to promoting the enzyme collagenase, which digests collagen.  Bromelain has many of the qualities of Serrapeptase but it is not as well tolerated.  Common side effects include diarrhea, increased heart rate, nausea, stomach pain and vomiting.  Avoid Bromelain if you are allergic to bee venom, carrots, celery, papaya, pineapple, rye, wheat and pollen.
Bromelain by itself is effective as a blood thinner.  When taken with blood thinners it can raise the risk of bleeding.  Bromelain for health maintenance is generally deemed safe at 50 mg. a day with little risk of side effects.  The recommended dose for treating Peyronie’s is 500 mg. a day.  This high of a dose should not be maintained on a long term basis.
Topical Gel Applications
DMSO with Serrapeptase was studied in use for a transdermal topical gel to treat subcutaneous inflammation.  It was found that DMSO concentrations had to be  unacceptably high in order to transfer the enzyme beneath the skin, due to Serrapeptase having a large molecule weight, it would not readily permeate the skin.  Indian J Pharm Sci. 2010 Jan-Feb
DMSO with iodine was found to reduce infections and increase the effectiveness of iodine alone in hospitals where Staphylococcus epidermidis was causing increased infection, mortality, and health care cost. (J Clin Microbiol. 2012 May)
An article by Dr. Jonathan Wright of the Tahoma Medical Clinic discusses the use of Iodine and DMSO
DMSO may be an important stimulator of the tumor suppressor protein HLJ1 through AP-1 activation in highly invasive lung adenocarcinoma cells. Targeted induction of HLJ1 represents a promising approach for cancer therapy, which also implied that DMSO may serve as a potential lead compound or coordinated ligand for the development of novel anticancer drugs. (Published online 2012 April 17)
DMSO in the treatment of Scleroderma.  Scleroderma is a baffling disease in which the body begins manufacturing collagen, where it begins collecting in the extremities.  Scleroderma often will go into remission, but can be fatal if it continues its’ progression, unabated.  Dr. Jacobs is well known for treating Scleroderma with DMSO.  The following is the conclusion of this study.
The relief of pain, stiffness and, to a lesser extent, weakness in these patients who have been treated with DMSO is impressive, and most of the patients are continuing maintenance treatment. It appears that DMSO, as administered at present, has no effect on the internal manifestations of scleroderma. Of 26 patients who had good to excellent improvement, 16 had minimal, and eight had moderate disease, according to our criteria for classification of the severity.
It should be emphasized, however, that the results seen in treating patients with scleroderma with DMSO have never been observed with any other method of therapy. It is the first time we have observed evidence, both clinical and histological, that the collagen is undergoing definite change.
Verapamil GEL has been falling from favor as a viable treatment option of Peyronie’s.  A survey of 236 practicing urologists in 2008 found that only 10% selected Verapamil gel as their first treatment choice.  In 2002 Loyola University Medical center came to the conclusion in their study that the use of transdermal verapamil has no scientific basis.  Transdermal Verapamil does not infiltrate into the Tunica Albuginea.  Wish I had known this before spending $1,000.00 on Verapamil.
 Intralesional Injection and Iontophorisis
Verapamil VS. Saline – Iontophorisis, electromotive drug administration.  This placebo study has 23 men in the Verapamil group and 19 men in the saline placebo group.  Results:  The Verapamil group achieved greater decrease in curvature, but the results were not statistically significant.  The results concluded this option was effective in patients complaining of pain and with mild curvature.
Verapamil Intralesional injection, (Long term study 1994-1996 Dept. of Urology, Montefiore Medical Center, Bronx, NY)  Conclusions:  The study suggests that intralesional injection may be a reasonable approach in some selected patients with non calcified plaques and penile angulation of less than 30 degrees.
A placebo controlled study involving 80 patients in Iran, actually showed more curvature decrease in the saline control group, than in the Verapamil group.
Corticosteriod injections VS. Saline Placebo:  Placebo was more effective in curvature correction than the cortisol group . . . enough said?
Another reason that steroid injection has become less popular is that we know that steroids can result in tissue atrophy, and thereby may cause thinning and weakening of the penile tissues. Therefore, with rare exceptions the use of intralesional steroids have been completely abandoned.

Interferon Alpha 2B injections VS. Saline Placebo: A study of 39 men at Tulane University, New Orleans, LA,  injected Interferon Alpha 2B directly into the plaque of 19 men.  20 men received saline placebo injections.  Same protocol for each group, injections were given once a week for 12 weeks.  6 months later they received a follow up visit and evaluation.  The Interferon group showed significant improvement over the placebo group in curvature, plaque size and density, and pain with erection.
30 men in Ankara Turkey were studied using a similar protocol as the test above for management of early stage Peyronie’s.  The conclusion was that Interferon Alpha 2B was not clinically effective in treatment and management of early stage disease.
Interferon Alpha 2 B frequent side effects are fever, and mild to moderate flu like symptoms,of short duration.  Further study is currently ongoing to determine precise quantities and frequency of application to be most effective.
Xiaflex by Auxilium Pharmaceuticals  clinical studies for FDA approval have shown impressive results with intralesional injections of Xiaflex.  Phase III studies showed 67% of patients showed significant improvement.  Significant improvement was counted as a 25% improvement or better from the original measured angle.

Combination Therapy:


Department of Urology, Rush University Medical Center, Chicago, IL 60612, USA.


Non-surgical treatment of Peyronie’s disease (PD) has come a long way since it was first described in 1743. A myriad of treatment options are currently available, including oral, intralesional and external energy therapies. The purpose of this article is to review the contemporary literature on non-surgical therapies for PD, and where possible, focus on randomized, placebo-controlled trials, as well as review the latest guidelines for the management of PD from the International Committee on Sexual Medicine, which conveyed its findings in July 2009.  At this time, it appears that a combination of oral agents and/or intralesional injection with traction therapy may provide a synergy between the chemical effects of the drugs and the mechanical effects of traction. Until a reliable treatment emerges, it does appear that some of the non-surgical treatments discussed can be used to stabilize the scarring process and may result in some reduction of deformity with improved sexual function.