Herbal Viagra Supplements: Safe or Shady?

Lamar Odom’s case shows that taking ED supplements like sildenafil to aid in erections can do more harm than good, so check with your physician before trying them.

Full disclosure: I don’t follow professional basketball. There is something about the strategic fouling that drives the last two minutes of the game that doesn’t ring true to me. I want to yell “PLAY THE GAME!!!” But, in fact, that is exactly what they are doing, just not in the way I like.

So, up until a few weeks ago, I had never heard of Lamar Odom, former NBA star and husband of a Kardashian. Now I hear his name several times a day from many of my patients. As a urologist who specializes in sexual medicine, I’m asked questions that all focus on the so-called “natural” Viagra he consumed before going into a coma.

From reading news reports, I’ve learned that he used cocaine and consumed numerous tablets of over-the-counter (OTC) nutritional supplement designed to assist erections. I’m not going to focus on the cocaine because the danger there is obvious and well proved. The questions my patients are all focused on surround the use of nutritional supplements.

Can the purchase of a supplement at a corner convenience store cause harm? The short answer is – absolutely!

Let me be clear. I do believe that the reasoned use of high-quality nutritional supplements can enhance erectile response. The problem is that a number of enhancement supplements are tainted with counterfeit Viagra, Cialis or Levitra.

If it works, I’m taking it

Now, at $40-50 per pill for those drugs, a number of my patients have asked why it is so bad that these OTC supplement are “tainted” with prescriptive medications. As one of my patients put it, “If it works, it works. And if it works and is affordable – I’m taking it.”

Here’s the problem. Erectile dysfunction (ED) pharmaceuticals cause immediate and significant physiologic changes. These changes, when occurring in moderation and under the supervision of a physician, are beneficial.

Unfortunately, when purchased at a 7-Eleven and self-administered, they can be dangerous. This is because, (i) we don’t know the dosage of the active medication within the supplement, (ii) we don’t know the quality of the ingredients (remember, these are often counterfeit medications made by unregulated labs from overseas), and (iii) a physician is not monitoring whether there are pre-existing conditions that would place the individual at greater risk from the medication.

So, what should a consumer do? How can someone differentiate between quality nutritional supplements and those that are drug-tainted? Unfortunately, this can be challenging. The FDA keeps a list of known offenders, which they call “tainted products” because they are supplements that contain a pharmaceutical drug. But the market changes so quickly that I question whether the list is completely accurate.

Lamar Odom is reported by the Washington Post to have taken Reload and Libmax Plus. The FDA tagged Reload with a warning that it contained sildenafil, an active ingredient in Viagara. The FDA reported in 2009 that Libmax was removed from the market by the manufacturer because it contained tadalafil, another ingredient in a drug approved for ED. But the (legal) brothel in Nevada where Odom had his problems sold him the product from its store.

Rather than get into trouble assuming that a natural supplement for an erection is safe, I advise my patients to listen to their gut. I explain that pharmaceuticals like Viagra are utilized on an as-needed basis and often taken 1 hour prior to sexual relations. Quality nutritional supplements, on the other hand, work over time and require daily dosing.

With that in mind, I would avoid any supplement that promises fast action, any supplement that is sold in small quantities (1-5 pills taken in a one time dose), and any supplement that makes outrageous claims of success. ED is a condition that often times requires a specialist’s care. I offer the full array of treatment options from medications to injection therapy and, if needed, surgery.

Remember, if the claims are too good to be true then they aren’t true.

The most recent reports on Lamar are ominous. There appears to be significant and permanent brain injury. He has a long road ahead of him. I can only assume that it wasn’t cost that motivated him to utilize the particular nutritional supplements that he consumed. My sense is that he was moved, in part, by the desired results but also, in part, by the pervasive belief that something purchased over-the-counter can’t hurt you. That’s just not the case.