Horny Goat Weed benefits, dosage, and side effects

Commonly referred to as Horny Goat Weed, Epimedium is a traditional Chinese medicinal herb recognized for its tonic, aphrodisiac, and antirheumatic properties. Also known by names such as Herba epimdii, yin yang huo, fairy wings, and rowdy lamb herb, this plant boasts over 200 compounds, with flavonoids like icariin being the most extensively researched. Icariin serves as the key active component in horny goat weed supplements.

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Horny goat weed exhibits various properties, including anti-atherogenic, anti-inflammatory, antiviral, and immune-modulating effects. However, these mechanisms have primarily been explored in animals and in vitro studies.

Erectile dysfunction (ED) can trigger a range of emotions in affected men, such as anxiety, shame, and diminished self-esteem, making it challenging to seek help. A survey conducted with 600 respondents revealed that 43 percent delayed seeking professional ED treatment for years, and over a third initially resorted to over-the-counter (OTC) ED supplements. Jonathan Davila, a urologist at Northwell Health of Staten Island in New York, warns that OTC supplements can be both risky and costly.

"Some men deny their erectile dysfunction," Davila says, "thinking they merely lack a specific nutrient."

While certain ED supplements can be effective for some men, not all are created equal. Many claim to enhance the body's natural testosterone or nitric oxide production—two critical neurotransmitters for erection. However, the FDA does not regulate these claims, and current literature indicates that the efficacy of OTC ED supplements requires more robust research.

The urologists we've spoken to echo this sentiment. "There's anecdotal evidence behind many of these supplements, but their safety and effectiveness haven't been thoroughly evaluated," says urologist Wesley Yip. Conversely, naturopathic doctors—who employ a more holistic and personalized approach to health—suggest that herbs, vitamins, and amino acids may improve male sexual health when used under professional guidance.

We consulted Hannibal Miles, a naturopathic doctor based in New York City and Stamford, Connecticut, to further explore the benefits and risks of ED supplements. Miles acknowledges the potential benefits but advises caution.

"Many people don't realize that herbs function like drugs. Combining them with prescription medications may amplify effects you don't want," says Miles.

Therefore, it’s crucial to consult a healthcare provider before starting any ED supplements to avoid compromising your health or wasting money on unsuitable treatments. Here, we delve into the science behind ED supplements to help you prepare for your next medical appointment.

Warning

Before embarking on a regimen of supplements to alleviate ED symptoms, consult a healthcare provider. Herbs, vitamins, and amino acids can pose risks based on your health history and current medications.

HelpGuide Handbook’s Erectile Dysfunction Testing Methodology

To conduct research on OTC supplements for erectile dysfunction, the Handbook Team consulted Hannibal Miles, an experienced New York City-based naturopathic doctor specializing in ED supplement treatment. We also interviewed traditional urologists about the safety of prescription ED medications and the use of herbs in treatment. Moreover, our research team reviewed numerous studies examining the effectiveness of specific ingredients for treating ED.

Multiple focus groups were held with actual users to gain candid feedback regarding the effects of erectile dysfunction treatments.

The Handbook for Erectile Dysfunction Supplements

ED Supplements

Consult your doctor before starting any supplements to avoid dangerous interactions and side effects.

ED supplements primarily enhance testosterone or nitric oxide (NO) production.

The underlying cause and severity of your ED impact how effective supplements may be.

Ensure safe manufacturing practices by looking for the GMP or cGMP seal.

Understanding Nitric Oxide Boosters

Nitric oxide (NO) is the primary neurotransmitter responsible for an erection, initiating the chemical reactions that widen penile blood vessels and enhance blood flow to produce an erection. Insufficient NO production is a major cause of erectile dysfunction.

The body obtains NO through:

• Breaking down the amino acids L-citrulline and L-arginine.
• Extracting NO from food, facilitated by gut bacteria.
• Direct NO intake via pharmaceuticals known as NO donors (such as nitroglycerin).

Although NO donors should be used under medical supervision, dietary supplements can provide NO through the other two methods.

"Most think of L-arginine for ED, which is good, but I prefer L-citrulline," says Miles. "For those with compromised immune systems, viruses may feed on arginine."

Beetroot powder and red spinach powder are other viable NO sources, but optimal gut bacteria health is crucial for maximum benefit. Consider probiotics to maintain sufficient “good” bacteria that release NO. Miles notes that these powders need long-term consumption for results, and whole beets or spinach leaves aren’t as effective as concentrated powders.

Vitamin B6 plays a critical role in NO production, so check for B6 deficiencies. NO supplements typically include B6. Studies also indicate that vitamin C and Panax ginseng aid NO production, although Panax ginseng could be hazardous for individuals on medications for high blood pressure and diabetes. Consult your healthcare provider before starting any NO supplements.

Exploring Testosterone Boosters

Low testosterone (T) is the underlying cause of ED in approximately 5–18 percent of men with erectile dysfunction. Testosterone replacement therapy (TRT) can improve erectile function and libido but has drawbacks like reduced sperm count and testicular shrinkage.

Unlike TRT, testosterone-boosting supplements stimulate the body to produce more T, maintaining balance with hormones like luteinizing hormone, which is responsible for testicular size and sperm count. However, these boosters are not guaranteed to improve ED, especially if your ED isn’t due to low T.

"Testosterone has various effects," notes Miles. "It should theoretically help, but it might boost arousal rather than have a direct biochemical effect."

Common testosterone-boosting herbs include:

• Tongkat Ali (Eurycoma longifolia)
• Yohimbe (Pausinystalia johimbe)
• Fenugreek (Trigonella foenum-graecum)
• Ashwagandha (Withania somnifera)
• Asian ginseng (Panax ginseng)
• Horny goat weed (Epimedium sp.)
• Puncture vine (Tribulus terrestris)
• Maritime pine (Pinus pinaster)
• Maca (Lepidium meyenii)

Each herb may lead to different side effects, drug interactions, or allergic reactions, which can compound when combined. Consult a healthcare provider before taking any testosterone boosters.

Other popular ingredients like diindolylmethane (DIM) and boron increase the levels of “free” T in the bloodstream, participating in the biochemical reactions needed for an erection. Testosterone boosters may also contain vitamins and minerals that support T production, including vitamin B3 (niacin), vitamin D3, and zinc.

Miles advises patience with testosterone boosters, as their effects accumulate over time and require long-term usage. Additionally, have your testosterone levels checked before starting any supplements. If your levels are healthy, testosterone boosters likely won’t improve ED. Men with hormone-sensitive benign prostatic hyperplasia (BPH) should avoid testosterone supplements.

Icariin: “Natural Viagra”

Icariin, a PDE5 inhibitor found naturally in horny goat weed, has shown promise in animal studies for treating ED caused by poor blood flow, albeit not as effectively as Viagra (sildenafil) or Cialis (tadalafil).

While human studies on icariin are limited, research indicates that rats need approximately 10 milligrams of icariin per kilogram of body weight to improve erectile function. Another study found that doses up to 100 mg/kg continued to show benefits by enhancing testosterone and sperm count.

Warning

Horny goat weed should be avoided by individuals with estrogen-sensitive cancers. It might slow blood clotting, cause respiratory issues or low blood pressure, and increase anxiety if consumed with caffeine. If you're taking medications metabolized through the liver, consult your doctor before using horny goat weed.

According to FDA guidelines for estimating safe starting doses in healthy adults based on animal studies, this 10–100 mg/kg range translates to approximately 110–1,098 mg for a 150-pound man and 182–1,829 mg for a 250-pound man. However, many horny goat weed supplements have lower icariin content than believed to be therapeutic, and some brands don’t disclose icariin amounts.

Vitamins and Minerals for Sexual Function

Essential vitamins and minerals required for testosterone production include:

• Vitamin B2
• Vitamin B3
• Vitamin B6
• Vitamin D3
• Vitamin K
• Zinc

Proper testosterone production is only one part of improving erectile health. Testosterone needs to be “bioavailable” to interact effectively with other molecules, such as NO, and reduce PDE5 levels. Minerals like folate and magnesium support testosterone bioavailability.

A well-formulated men’s multivitamin can help prevent deficiencies that lower testosterone production or reduce its bioavailability. Numerous options are available; choose one without iron if taken in excess, as it can reduce testosterone production.

If you haven’t recently checked for vitamin deficiencies, consider a blood test. Your doctor might recommend higher doses of specific vitamins based on the results.

Our Research Experience

Herbs have been integral to traditional medicine worldwide for centuries, although their healing properties often lack modern scientific research. This might explain why urologists have limited experience recommending ED supplements. Herbs, commonly used in ED supplements, usually fall outside a urologist’s area of expertise.

To provide a balanced perspective, we spoke with Hannibal Miles, who uses herbs to treat his patients. He explained why some people prefer supplements over prescriptions, how to choose safe supplements, and what ingredients he recommends for ED.

We also reviewed studies supporting the information Miles provided and read journal articles reporting inconclusive results regarding natural supplements for ED. The consensus is to consult a healthcare professional before taking any supplements, as they can evaluate risks based on your health, medical history, and current medications or supplements.

Pros and Cons of ED Supplements

Supplements may work where traditional treatments have failed: "People come to naturopathic doctors after traditional treatments haven't worked," says Miles. Western medicine often treats symptoms rather than the root cause, whereas supplements can be one tool in holistic treatment.

ED supplements don’t work quickly: Miles advises that herbal supplements need time to build effects, requiring consistent, long-term usage.

Effectiveness depends on your ED’s cause: Supplements won’t help if your ED isn't related to poor blood flow or low testosterone. ED due to anxiety or nerve damage needs different treatments.

Davila advises seeking medical advice rather than using supplements. "Corporations exploit men with ED by charging high prices for basic amino acids, vitamins, and random ingredients," he says.

Be wary of side effects and interactions: Herbs, vitamins, and amino acids can cause adverse effects or interact with other medications and herbs.

"Interesting that most ED supplements are unsafe for those on hypertensive or diabetic meds," Davila notes. "75-90% of men with ED have diabetes, hypertension, or metabolic syndrome, which means most shouldn't take these supplements."

Beware of hidden ingredients: The FDA has found hidden sildenafil (generic Viagra) in OTC ED pills, posing dangers for those who can't tolerate it due to side effects or interactions.

"Difficult endorsing these products," says Davila. "I always tell patients they take them at their own expense and risk."

Are ED Supplements Safe?

The safety of an ED supplement varies by product and individual. It's best to consult a doctor before starting a new supplement. Even "all-natural" products can have unanticipated side effects. A doctor can assess your medical history and current medications to weigh a supplement’s potential benefits and risks.

Look for the cGMP (or GMP) seal for safe manufacturing practices. GMP stands for “good manufacturing process,” referring to the regulations in the Federal Food, Drug, and Cosmetics Act. A cGMP seal indicates the manufacturers meet governmental quality standards.

Our Final Verdict

Many ED supplements enhance your body’s ability to produce nitric oxide and testosterone. If your ED stems from low testosterone or poor blood flow, these supplements may address the root cause, leading to better erections over time.

Even with natural ingredients and OTC availability, supplements aren’t inherently safe for everyone. Seek medical approval before starting a supplement regimen. Though a doctor may prefer traditional ED treatments, they can at least evaluate whether a supplement poses health risks.

Frequently Asked Questions

To an extent, yes. Certain vitamins and supplements can support erectile health by boosting nitric oxide and testosterone production. However, they don’t benefit men who already produce sufficient nitric oxide and testosterone. Herbal supplements like horny goat weed may help by inhibiting PDE5, a chemical that reduces penile blood flow.

Research suggests two natural alternatives to Viagra: saw palmetto extract and icariin from horny goat weed. Similar to sildenafil (Viagra’s active ingredient), they inhibit PDE5. However, most studies on these supplements have been conducted on rodents, so their effectiveness for people with ED remains uncertain.

An ED treatment's safety and effectiveness depend on individual factors. Your overall health, current medications, and lifestyle choices impact the safety of prescription or OTC treatments. To minimize serious side effects, discuss your options with a healthcare provider.

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