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Long before there were the erectile dysfunction pills Viagra, Cialis, and Levitra, the herbal chemical yohimbine was prescribed by doctors to treat erectile dysfunction. Recent research finds that it may be useful for both men and women who have diabetes.

Diabetes is a stressful disease, but some diabetics are uniquely sensitive to stress. Anything that stirs up emotion, or aggravation, or worry, also raises their blood sugar levels. Even when these diabetics are extremely careful about diet, insulin, medication, and exercise, their blood glucose levels are hard to control, and in times of extreme stress, medication and even insulin hardly work at all.

These unfortunate men and women suffer a form of type 2 diabetes partially caused by a mutation in a gene called alpha(2A)-AR. This gene causes insulin-producing beta cells in the pancreas to be covered with an unusually large number of receptor sites for the stress hormone adrenalin (epinephrine). When adrenalin binds to pancreatic receptor sites, beta cells release less insulin. Swedish diabetes researcher Dr. Anders Rosengren, head of the translational diabetes research group at Lund University Diabetes Center in Malmo, compares the phenomenon to driving a car with the parking brake on. No matter how hard you press on the gas pedal, the brakes keep you from going forward. Surprisingly, Rosengren and his colleagues have found a remedy for this condition in the herb-derived erectile dysfunction helper yohimbine.

Yohimbine, an Almost-Forgotten Treatment for ED

Before there were Cialis, Levitra, and Viagra, yohimbine was a preferred natural treatment for erectile dysfunction. Derived from the bark of the African yohimbe vine, yohimbine hydrochloride is a standardized, reliably dosed form of the active chemical of the herb that works by binding to receptors in the blood vessels supplying the penis, causing a localized increase in blood pressure that powers an erection and a generalized sensation of excitement that piques interest in sex. (In overdoses, however, the drug can bind to different receptors causing a generally lower blood pressure affecting the entire body.)

Yohimbine in the Pancreas

Yohimbine can also bind to the adrenalin receptors on the insulin-producing beta cells of the pancreas. This blocks the effects of adrenalin itself, so the pancreas is free to release insulin more normally. Most diabetics who have mutations of the alpha(2A)-AR gene also have other genetic mutations that contribute to diabetes, so yohimibine is not a complete cure for diabetes, but the effect is large enough that blood sugars become easier to manage with small doses of other medications.

A Downside to Yohimbine Treatment

The problem with using yohimbine to treat diabetes is that can lower systemic blood pressure. In the same way that too much Viagra can cause a man to pass out (or, in combination with blood pressure lowering drugs called nitrates, even enter a fatal cardiac arrest), too much yohimbine can cause both male and female users to have unacceptably low blood pressure. There can be orthostatic hypotension, a sudden lowering of blood pressure when moving from a seated position to a standing position that can cause loss of consciousness. There can be extreme fatigue, or just a general loss of energy that makes getting about one's daily routine very difficult. Also, men who take yohimbine are subject to having erections at inappropriate times and in inappropriate places.

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