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Additional antioxidants like ascorbic acid (vitamin C) help release the NO that was bound to glutathione, recapturing the NO that the body has already produced.[52] This may be one mechanism by which antioxidants and natural substances like pomegranate and quercetinwhich provide high levels of polyphenols, which are natural antioxidantsalso have a positive effect on ED of a vascular etiology.[53],[54],[55] Antioxidants are also important for the formation of the NOS enzyme as well as maintaining it in its active, coupled state.[56],[57] When NOS becomes uncoupled, it reduces molecular oxygen to superoxide (a damaging free radical) instead of NO.[58] This may be one means by which the French Maritime pine bark [CD2] also has a positive impact on erectile function

L-carnitine does this by interacting with both the membrane phospholipids and their proteins, thus preventing the loss of mitochondrial membrane integrity

Berberine has a relatively short half-life, which is why divided dosing throughout the day is often recommended