Peripheral Artery Disease

Why it works: Targets ischemic skeletal muscle metabolism. In PAD, calf muscle is energy-starved during walking. PLC increases carnitine availability, facilitates transport of long-chain fatty a...

Instructions: Form & dose used in RCTs: Oral PLC 2,000 mg/day (commonly 1,000 mg twice daily) for 3–6 months. Some trials explored 1–2 g/day titration; a few used short IV courses, but oral ther...

Warnings: Common adverse effects: Nausea, abdominal cramps, diarrhea, and a “fishy” body odor (from trimethyla...

Studies: Cochrane Review (search current to July 2021): 12–13 trials...

Why it works: Mechanism. L-arginine is the substrate for endothelial NO synthase (eNOS). More substrate can boost NO, leading to vasodilation and possibly better perfusion. This rationale comes...

Instructions: What’s been used in studies:. • Oral dosing: 3 g/day for 6 months in the pivotal NO-PAIN trial (no benefit; possible harm). Other cardiovascular studies have tested 6–8 g/day, gene...

Warnings: Do not use after a recent heart attack (post-MI). In the VINTAGE-MI randomized trial, patients given...

Studies: Key randomized controlled trial in PAD (oral):NO-PAIN Trial...

Why it works: Hawthorn extracts (especially standardized leaf-and-flower extracts like WS® 1442 and LI 132) have vasodilatory and endothelial effects (eNOS/NO), antioxidant, anti-inflammatory, a...

Instructions: There are no PAD-specific dosing instructions supported by clinical trials. If it’s used at all, clinicians typically borrow doses from heart-failure/vascular studies with standard...

Warnings: Drug interactions (major concern):. • Digoxin (Lanoxin): hawthorn may potentiate effects; avoid/coma...

Studies: I could not find high-quality randomized trials showing hawt...

Why it works: Antiplatelet/hemorheologic effects. Ginkgo’s terpene lactones (especially ginkgolides A/B) antagonize the platelet-activating factor (PAF) receptor and can inhibit human platelet a...

Instructions: There is no guideline-endorsed PAD dosing for ginkgo, because it’s not recommended. The regimens below reflect what trials used, not what’s proven to help.. • Standardized extract:...

Warnings: Bleeding risk and interactions. Because of antiplatelet activity, ginkgo may increase bleeding, espe...

Studies: Cochrane systematic review (updated searches through 2013; p...

Why it works: PAD is driven by atherosclerosis and impaired vascular function. Garlic (and extracts like aged garlic extract, “AGE”) has lab and clinical data showing it can modestly affect seve...

Instructions: Standardized garlic powder: commonly 600–900 mg/day (often 300 mg two to three times daily) standardized to ~1.3% alliin or ~0.6% allicin potential. Commercial tablets (e.g., “Kwai...

Warnings: Bleeding risk / drug interactions. Garlic supplements can increase bleeding risk, especially with wa...

Studies: Cochrane Review (2013, page updated 2025): Garlic for periph...

Why it works: Antiplatelet effects (theoretical PAD relevance). Gingerols/shogaols can inhibit platelet aggregation in vitro and in some small human studies, which is relevant because PAD patien...

Instructions: Forms: fresh/cooked ginger in food or tea; standardized capsules/powders are common in studies. The NIH NCCIH fact sheet summarizes typical uses and safety. NCCIH. Amounts seen in...

Warnings: Interactions with blood-thinners/antiplatelets (very important for PAD): Ginger may increase bleedin...

Studies: Platelets / thrombosisSystematic review of human trials: mix...

Why it works: Vasodilation & microcirculation: A CUHK team showed Danshen + Gegen (the “DG” capsule) relaxed rat femoral arteries via inward-rectifier K⁺ and Ca²⁺ channels and improved perfusion...

Instructions: Formulation & dose used in PAD RCT: Oral Danshen–Gegen (DG) capsule 1.5 g twice daily for 24 weeks, double-blind vs placebo. Population: adults ≥40 y with stable intermittent claud...

Warnings: Additive bleeding risk with anticoagulants/antiplatelets: Multiple case reports and pharmacology dat...

Studies: Randomized, double-blind Hong Kong trial (DG capsule, 95 pts...

Why it works: Lowers blood pressure (mild–moderate effect) via ACE-inhibition, nitric-oxide–mediated vasodilation, diuretic effects, and anti-inflammatory/antioxidant actions. Multiple RCTs and...

Instructions: Because there’s no PAD-specific dosing, the only defensible instructions come from hypertension/vascular-function studies:. • Tea (tisane) from dried calyces: Meta-analytic and tri...

Warnings: Additive BP lowering → dizziness/hypotension when combined with ACE inhibitors/ARBs, diuretics, othe...

Studies: There are no randomized trials showing hibiscus improves PAD...