Please discuss everything with your doctor first.
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2. L-Arginine Dosage. Several studies have shown that L-Arginine is debatably effective with middle-aged male erectile dysfunction and the reason is that this pathway is impaired as we age. L-Arginine was added in small dosages to the Pycnogenol study to make sure there was adequate substrate for nitric oxide increase. However, the danger is that they might add too much L-Arginine to the product.
One study showed that too much L-Arginine increased cardiac events in heart attack survivors patients and the study was actually cut short for that reason. [2] In other words, too much L-Arginine may actually be dangerous. It also may increase the risk of cancer and superbug overgrowth. See my link on Basic L-Arginine Information for more details.
3. Shisandra Root. Is this safe? Shisandra Chinesis has a long term history of use in Chinese Medicine and has even been used as a food. However, there is one under-studied concern: it has a mild phytoestrogenic effect. [3] This mild estrogenic quality is probably good: as I mention in my link The Dangers of Low Estrogen, some of this "female hormone" is beneficial for men as it relaxes arteries and will allow more blood to flow into the penis.
Of course, Shisandra has many good properties, including liver protection and a high antioxidant capacity. It reminds me of soy, which has many pro-erection properties, but it is poorly understood. In the meantime, it should probably be tabled for men until additional studies can be completed and we gain a better understand of these phytoestrogens on male physiology.
REFERENCES:
1) Am J Hypertens, 1995, 8, 565–571; "Yohimbine effects on blood pressure and plasma catecholamines in human hypertension"
2) JAMA, 2006 Jan 4, 295(1):58-64, "L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial"
3) http://www.raysahelian.com/schizandra.html, Biol Pharm Bull. 2004, "Extracts from Schizandra chinensis fruit activate estrogen receptors: a possible clue to its effects on nitric oxide-mediated vasorelaxation"
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