Episode 95 – Why Viagra May Not Work
Speaker 1: 00:00 This is Dr Chad Edwards and you’re listening to podcast number 95 of against the grain – this episode is about Erectile Dysfunction
Speaker 2: 00:06 This is Diana Edwards, your host on this amazing journey where we are going against the grain. I’m here with Dr Chad Edwards, who is our navigator for this journey. His focus is going to be to identify the underlying causes for illness or disease. That’s what we do at revolution health and wellness. Tulsa. Uh, we’re continuing to discuss our cardiovascular disease, uh, issues. Uh, kind of what is causing these, what we’re missing. We’ve talked a little bit about endothelial function, vascular health in general. We talked in depth about nitric oxide and we kind of left a little nugget a couple of podcasts ago about ed causing Ed. So tell me why don’t some people respond to Viagra for their Erectile Dysfunction?
Speaker 1: 00:59 Great question. This was actually something that came up somewhat recently with a patient that came in. Um, we, and it’s not uncommon, you know, the, the easy thing, you know, my traditional. Before I started doing functional medicine and we open revolution health in my traditional training, patients would come in and they would say, doc, I’m having an issue. In fact, I used to say that patients, men only came to the clinic because I want two things. They would come because they’re the woman in their life, their wife, their significant other, whatever made them come or because something was wrong with their private parts. Well that would definitely cause them to come in and get some help. Erectile Dysfunction. Yeah, and I used to, I mean we said it tongue and cheek, but there’s some truth to it. When men came into the clinic and they were like, you know, just want to check up or it’s my blood pressure or you know, fill in the blanks and you go through your appointment.
Speaker 1: 01:47 At the very end when they’re getting ready to walk out, they’d be like, oh, hey doc, by the way, can I get a prescription for Viagra because they have erectile dysfunction? And like, just drop the nugget and then walk out of Pandora’s box there. It’s hilarious how often that happens and that we shouldn’t be afraid to discuss that, but as we’ve said in the last several podcasts, when you have erectile dysfunction, meaning that you cannot get an erection when you want. Now to be clear this, this podcast is not necessarily on erectile dysfunction specifically because there are several causes for erectile dysfunction. I can’t. Did we, I don’t remember if we did a podcast on erectile dysfunction, I think we’d have, but when you have erectile dysfunction caused by a vascular problem, so let’s clarify that you can have with diabetes, you can get erectile dysfunction because of both vascular problems and neurogenic problems.
Speaker 1: 02:40 Uh, you can get, have hormone issues and certainly you can have psychological issues. But in this case, we’re talking about the vascular issues. And so when you can’t get erections because of a vascular problem, you know, you, you don’t wake up with morning wood, you don’t have erections really at any time, just because the plumbing is not a prime. You can’t have the normal physiologic mechanisms that stimulate an erection. And so that means that there is a high probability that you have, that your ED (erectile dysfunction) is caused by ED (Endothelial dysfunction), meaning your erectile dysfunction is caused by endothelial dysfunction. And if that’s happening in your penis and you cannot make and can, you can have an erection, then you probably have endothelial dysfunction everywhere else in your body as well. So it’s important to keep that in mind. So we talked a little bit before about the, um, you know, these PDE-5 medications, PDE-5, which stands for phosphodiesterase-5 inhibitors.
Speaker 1: 03:45 So what is that? That is a medication and those brand names of those medications are going to be Viagra or Sildenafil, uh, was the generic. You’ve got Cialis, which I think is to Daleville and then Levitra and I don’t remember what the generic is for that one. So we will give these medications, which basically they functioned by blocking the phosphodiesterase enzyme. And so if you’ll go back and listen to the endothelial dysfunction podcast a couple of few podcasts ago, I talk a little bit more about that mechanism in the biochemistry of that. And uh, the phosphodiesterase inhibitor basically blocks, uh, the, uh, the enzyme that’s breaking down cyclic amp, so when you break, when you’re preventing that enzyme from breaking down cyclic AMP, you have sustained effect of cyclic AMP and that means the cyclic AMP is the mechanism that allows for a vascular smooth muscle relaxation so you can have vasodilation.
Speaker 1: 04:45 So the arteries will open up at that point. You have a sustained erection. Yeah, that’s, that’s what kind of stimulate what both initiating an erection and being able to maintain an erection because it’s, you know, there’s a lot of components that go with that. But I think all of that is important. And you gotta have good endothelial function, uh, so that, so that, that can work. Does that make sense? Yeah. Okay. Clear as mud. Alright. So that’s how these medications work. Uh, you know, and I, I get guys that’ll come in all the time and they’ll be like, dude, that was awesome. Took a Viagra and it made all the difference in the world. Uh, and their reaction, their erections were great and those kinds of things. And the other day I had a patient that came in a, he’s in his mid forties and was having shortness of breath and would have occasional chest pain and in fact, he’s so short of breath with activity that he’s had to really alter his lifestyle and can’t do some of the things that he used to do.
Speaker 1: 05:44 I gave him a Viagra because he had erectile dysfunction. Now he didn’t tell me about the shortness of breath before this, so we gave him the Viagra. And in followup he called and said, man, that was absolutely amazing in my shortness of breath, went away and he was able to like, run up six flights of stairs and do all kinds of things. And so my thought is, Whoa, we’ve got a blood vessel problem. He has some significant endothelial dysfunction, which is causing some cardiovascular problems, resulting in symptoms outside of just erections. So it’s important from a functional medicine perspective that we think about the entire concept, the entire picture and what’s going on and how is this stuff working? Um, so anyway, the, the, uh, the phosphodiesterase inhibitors work by blocking that enzyme. So you have sustained a smooth muscle relaxation and what we call vasodilation.
Speaker 1: 06:39 So the arteries are opening up. So what about the individuals are the ones that it does work. So what about this percentage of people where they do take that magic blue pill and they get nothing? Yeah. So that’s a great question and we do see that from time to time because the easy thing is, you know, here’s your stuff, here’s your Viagra ad and just go about your, your business and hopefully, you know, date night will go well for you. Um, and by the way, for, for those patients that we need to use a medication like Viagra and I would argue that there are multiple things from a functional medicine perspective that we can do to enhance erectile function. Um, and I would approach this from a comprehensive package, you know, neo 40 that we’ve talked about that has the beet root powder and all of these kinds of things.
Speaker 1: 07:26 We have the professional version at revolution health. Um, I would look at a number of different things as far as antioxidants and things to improve vascular health and reduce inflammation. And improve liquids and all of these kinds of things. And I think it’s important that we do address all of those components. But if you need one of those pde five medications, let us know. We can get them for a fraction of the cost. I don’t quote me on this, but I think you can get 40, uh, of the 20 milligram Viagra or sildenafil capsules, so 40 or 50 of those for $40. That’s a lot of date nights. So when you think about that, and so some guys are going to need more than more than one. So that’s 20 milligram, relatively low dose. You can go up to 100 milligrams. Um, so even if you needed to take five of them, that’s still 10 doses for $40, $4 a dose, it’s less than half and more like probably about a third of what the prescription costs for erectile dysfunction.
Speaker 1: 08:26 So if you need one of those medications, come see us, we can help you out and we can get you a prescription for a much less expensive cost. But again, we’re also going to address it from that functional medicine perspective where we’re looking at everything. So going back to the question, why do these not work for everyone? So remember if you go back to the endothelial function and the nitric oxide podcasts, I talked about how nitric oxide works, so we make a nitric oxide by the endothelial nitric oxide synthase enzyme that then when we have nitric oxide that works to increase cyclic gmp, which increases cyclic amp. So that’s Kinda how, how it works. And then Viagra works by prolonging the effect of cyclic amp. So if you don’t have enough nitric oxide to make cyclic gmp to subsequently make cyclic amp, there’s nothing to prolong so it doesn’t work because there’s nothing there to begin with.
Speaker 1: 09:29 Got It. You got to have enough of that foundational. Exactly. So we’re, what we’re trying to do with Viagra is prolong what’s already there, but it’s kind of on this, uh, on this little to teeter totter kind of thing. And we’re trying to tip the scales so that we get good results and prolong the activity at this point. If they take the Viagra and it doesn’t work, that means that they did not have enough nitric oxide to begin with. To start that at chain reaction. Yeah. That there’s a high probability that that’s the case and you need, if that’s you and your, you know, as a listener or you know, if you know, if you’re the spouse or a family member or a friend of, um, of someone that’s having this issue, then we need to dig deeper, number one, because we want to fix the erections because we believe that’s a gift from God and you need to be able to capitalize on those things.
Speaker 1: 10:20 And number two, you’ve got some severe vascular problems where there’s a high probability that you’ve got some severe vascular problems, uh, and your risk for cardiovascular disease, heart attacks, strokes, hypertension, a kidney dysfunction. All of these kinds of things are significantly more elevated. And if you don’t want to die of a heart attack, then you need to address this. And I would argue you need to address it from a functional medicine perspective because even at your, even your cardiologist, more than likely is not going to address the endothelial function in this way. All they’re going to do in general is to evaluate your five traditional risk factors for cardiovascular disease and ignore the other 400. Exactly. And move on and hope you respond. Well. Yup. We’re going to look and say, oh, your cholesterol is high. Here’s your staten, which does nothing for your erection too, by the way.
Speaker 1: 11:11 And then we might do a stress test. We know something to identify if you have a, an obstructive plaque. And then if you do, then we’re going to get you a stent. We’re going to get you a heart bypass. Uh, you know, those kinds of things. And, but we’re dealing with that on such a far end of the spectrum that we’re, we’re missing. I’m making this number up, but we’re missing 95 percent of the population that has an issue. And we will. Exactly, exactly. And we want to address it from a functional medicine perspective where we’re identifying it at its inception or as early as possible, and we’re treating it as early as early as possible using a combination of lifestyle changes using nutritional supplements or neutraceuticals and medications when appropriate, based on your risk, your family history, your labs and your vascular function. So I think it’s very important. I think this topic is a very important function or a topic because if you are having erection problems like that and you tried Viagra, I mean number one, you may have endothelial dysfunction to begin with. Right? And if your Viagra works, don’t dismiss this problem, you still have a problem that needs to be addressed. So do not dismiss that. Now is the time to address that. But if you take Viagra and it’s not working,
Speaker 2: 12:36 you’re very serious day job. Exactly.
Speaker 1: 12:38 But you have a worse problem. In general, you have the worst problem that needs further evaluation and management and you need to make an appointment right away.
Speaker 2: 12:46 So would you say if someone is good with one Viagra than day stuff, got really good nitric oxide levels kind of on the zone of maybe looking into it and then the more viagara you need a, you talked about you can take up to five. Um, so if they’re taking five is should they be more concerned than someone who’s taking one? Is that the kind of the graduation?
Speaker 1: 13:08 I don’t think there’s any study that shows the more Viagara you are taking, are there more viagara you need the worst or cardiovascular disease? I don’t think anybody’s looked at that, but I would argue that that’s probably true. If you are needing more and more of that enzyme inhibitor, then there’s, there’s more and more of an issue and we need to be more aggressive with that. If you’re fortunate enough that one of those pills works or ideally that you don’t even need that pill. You know when we addressed this from nutrition, you’re getting adequate nitrates. You’re getting, you’re converting them over to nitrites by not using mouthwash and not using ppis. If you don’t understand that concept, go back and listen to our podcast on those issues because they are big time issues backed up with scientific literature, scientific studies, so go back and listen to those things. Um, so you know, all of these interventions make a difference and improve your overall health and reduce your risk for cardiovascular disease. But those patients that take a Viagra and you’re not getting good erections and good results with your Viagra. You need to get evaluated.
Speaker 2: 14:13 So basically guys, call revolution health and wellness. If you are having erectile dysfunction issues, it’s just as important to call and tell that as the primary concern as it is to call and say your primary concern is chest pain or shortness of breath. It’s just as important,
Speaker 1: 14:30 In fact, I think now is the time to do that. So Yep. Thanks so much Diana. Thank you guys for listening. You’ll be sure to share this with anyone that might have one of these issues. Um, you know, call our clinic at (918) 935-3636. Schedule your appointment and be sure to go on to itunes. Leave us a review for what you think about the podcast. Again, thanks so much for listening and we’ll catch you next time.
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