Go with the flow Q: I've been having trouble urinating. My urologist says it's most likely caused by prostate enlargement, but since I don't have any other symptoms yet, he prescribed a drug just to help me with urination. I'd prefer a natural approach, though, if there is one. Dr. Wright: The medication your urologist likely prescribed is called isosorbide dinatrate, which is a synthetic formulation that works by improving the production of nitric oxide, a substance that relaxes vascular and other smooth muscles. But there's no need to use a space alien molecule when there's a natural substance that does the exact same thing. It's an amino acid called L-arginine. I've written about L-arginine many times over the past few years. Admittedly, one of its more "attention- getting" benefits is that it improves erectile dysfunction (ED). But it's also useful for all sorts of vascular diseases since it dilates blood vessels and improves blood flow. There are two types of L-arginine -- "time release" and "regular." Time-release is preferable for urinary problems because, although it has a lower peak, it lasts longer. For men having difficulty urinating, I generally recommend taking 3 g of L-arginine daily in addition to other nutrients and botanicals that help improve prostate health (such as zinc, essential fatty acids, and lycopene). You can find regular L-arginine at most natural food stores. However, time-release L- arginine (sold as a product called Perfusia) is available primarily through compounding pharmacies. To find a compounding pharmacy near you, contact the International Academy of Compounding Pharmacists at (800)927-4227 or visit their website, www.iacprx.org. | 
