Is a larger single dosage better than smaller divided dosages for Peyronies treatment?

Dr Herazy,

Does taking the Peyronie's treatment at irregular intervals disrupt the efficacy of the supplements? I'm not referring to dosage.  I mean, still taking the recommended dosages per day, every single day (or whatever dosage the body needs to self correct) but, for example, instead of 2 Nattokinase twice a day, if someone took 4 of them all at once. Is this wrong? There are quite a few pills and given peoples' schedules and such, it seems unlikely they would be able to 100% of the time be able to take them right on schedule at regular intervals.

Also, when deciding to up the dosage of one of the therapies, how does one go about choosing which therapy to increase? Is it literally random, a best hunch? Or is there more of a science to choosing which one to increase?

Thanks for your time and information



Greetings A,

Thank you for the interesting question.

There are two ways of looking at what you propose in your example of taking four Nattokinase once a day instead of taking two Nattokinase twice a day.  The question is, since both methods deliver four Nattokinase to the body at the end of the day, is a larger single dosage more effective than a smaller divided dosage?

One of the methods that I suggest to men who wish to alter their Peyronies treatment dosage is to try to bundle up their dosages (especially the systemic enzymes like Neprinol, Nattokinase and Fibrozym) if the divided approach does not seem to be working as expected. 

The concept with the larger single dosage of systemic enzymes is that it would perhaps be more beneficial to flood the body with a large mass of enzymes all at once for maximum effect on fibrous scar material.  The concept of using smaller divided dosage of systemic enzymes is that it would perhaps be more beneficial to keep a relatively steady and constant application of the systemic enzymes working for maximum benefit.  Either approach could make a difference in treatment outcome and would only have to be used for a short time to determine the effectiveness. All treatment is judged by how it affects the size, shape, density and surface features of Peyronie's plaque – not what you or I think.

There is a third alternative approach that I often suggest that could be thought of as a combination of both approaches to dosage that you mentioned.   Let us say in the case of someone who is using nine Neprinol daily, it is often effective to alter the dosage during the course of the day by taking two Neprinol mid-AM, three Neprinol mid-afternoon, and four Neprinol before bedtime, since this will also flood the blood at a time when it will be most effective.  This altered approach totals to the same  nine Neprinol, but they are used so that there is a greater dosage available during the night hours when the blood is less likely to be carrying protein that might otherwise be attacked by the enzymes found in Neprinol, so they are more likely to do the good you hope for.  This strategy makes a lot of sense and often turns things around for a lot of people who are not getting the result s they want.   

Getting back to your example, I must admit that any serious Peyronie's plan usually involves use of much more than just four Nattokinase daily.  That is a relatively low dosage on the scheme of things.

Most increase of oral therapies involves working with Neprinol, Nattokinase, Fibrozym, PABA, Vitamin C, and Acetyl-L-carnitine, in that order.  

I cannot be more specific with information about what element(s) of our plan you might want to consider increasing since that is based on the specifics of the entire plan, not just looking at one small portion of it.  If you want help getting your plan in a more effective mode, contact me and we can work together.  TRH

Geting help for Peyronie’s disease and mild penis curvature in South Africa

Hi Dr Herazy,

We live in South Africa and my hubby has Peyronies. It is all very new to us and would like to know if there is a treatment or any equivalent medications here in South Africa. At the moment he is taking 1000mg of Vitamin E as prescribed from the urologist. His penis curvature is not all that bad and he has some exercises that he does.

Many thanks.



Greetings Belinda,

PDI ships to South Africa several often, because I am not aware of anything available in your country like what is offered here.

Taking vitamin E by itself is seldom effect; it has to be combined with a broad supply of other nutrients and enzymes to really do any good.

Please make sure he stays as diligent with his treatment as possible even though his curvature is not currently presenting a problem since it is common for even mild cases of Peyronie's disease that are a few years to suddenly worsen for little apparent reason.  

Good luck to you both.  TRH

What is cause of mild pain in penis and urge to urinate at night?

Hi Doc,

I've been experiencing a mild pain in the urethra when the penis is erect and also the opening (tip) of the penis seems to a little swollen or may be I am just thinking that way..I've undergone all the tests (HIV, Herpes,Vdrl, Hepatitis B) everything came back normal..The doctor said no need for the Gonorrhea and Chlamydia test as the urine routine didn't show anything..Also I've developed a bumpy scar on the line of circumcision to which the urologist said it's a hypertrophic scar.. I have an urge to urinate frequently at night please advise as to what I am going through..

Thanks in advance!!!!!!


None of what you describe sounds like it is related to Peyronie's disease, even the penis pain you describe is nt characteristic of Peyronies.   The Peyronie's scar or plaque is not external and cannot be seen from the surface of the shaft; it is internal and must be palpated.  I doubt you have Peyronie's disease.  Beyond that I could not venture a valid opinion about what is happening to you because I would need to examine you and get a lot more information than what you have provided here.

I suggest you get a second opinion at an institution that is not associated with the first you went to so that you will get a more candid and unbiased tendency to not just rubber-stamp what the first doctor told you.  Good luck.  TRH 

Question about a mistaken idea about the Peyronie’s plaque

Dr Herazy,

As I'm sure you're aware, the Copenhagen City Heart Study suggested that patients who drank wine had half the risk of coronary heart disease or stroke, primarily due to the reduction of plaque.

Has any of your research indicated that drinking alcohol in moderation, 1-2 drinks a day, can have a positive effect on removing the plaque that causes PD?


Ken Francois


Greetings Ken,

Your question is based on a misunderstanding about the nature of the Peyronie's plaque which is not remotely related or associated with a blood vessel plaque formation; they are two different animals.    

I invite you to read the post I wrote some time ago, Peyronie's plaque or scar that will explain this subject better.  Part of the post will tell you that this plaque is not a vascular problem of blood vessels, but is a problem of the tunica albuginea of the penis.  Besides that its cellular structure is vastly different.  TRH

Questions abouty protein intake in a Peyronie’s treatment plan

Dr. Herazy,

I bought and have been reading your "Peyronies Disease Handbook" (which I think is excellent!) and am focused right now on modifying my diet per your advice in Chapter 5—-Diet and PD.

I have two questions:
1. When you make the suggestion to eliminate or reduce the intake of "meat", are you talking mostly about red meat or are you saying to also eat less chicken, fish, lean pork, other types of seafood, etc.?

2. I notice that most of the foods to eliminate are high protein types and the ones to add hardly have any protein at all. It looks like the same can be said about bad fats, which makes a lot of sense to me and will make my cardiologist happy with these changes in my diet. But in your opinion is it OK to add or keep additional sources of high protein foods not on the list that are low in bad fats and have mostly good fats, such as salmon, tuna, chicken without the skin, etc.?

The protein question is especially interesting to me because I developed my PD when I started doing a lot of protein shakes with muscle builder and fat burner type additives at my gym and also used protein shakes as meal substitutes at home. Your thoughts on these two questions asap would be greatly appreciated as I want to move forward as quickly to get accustomed to my diet before starting the enzymes and rest of my treatment plan.

Thanks for all that you are doing to help people like me and giving us hope!




Greetings Scott,

Thanks for the kind words about PD Handbook; I get a lot of compliments about both books. 

I appreciate you trying to do this correctly.  The more disciplined and exact you are the better the PDI treatment plan will work for you.

Red meat is especially important to be reduced in your diet if you can manage it.  Some people so suffer physically when they eat a low protein diet that they give up entirely to treat Peyronie's disease.  I find most people have a better tolerance of fish and chicken protein sources.  So do your very best to greatly reduce red meat, and cut back moderately on chicken and fish, as a general rule.  The world will not come to an end if you eat either red or white meat protein but you are going to get better results the stricter you can be, OK?   TRH 

Can I substitute Neprinol of the nattokinase and Fibrzym in my Peyronies treatment plan?

Hello Dr. Herazy,

I am currently on the first phase of my Peyronie's treatment using the PDI medium plan and need to re-order my Fibrozym, Nattokinase, and Fundamental Sulfur. I noticed that Neprinol has multiple enzymes. Can I order just Neprinol to replace all three items I am currently getting ready to order?


Greetings Chris,

Sure, you can do it that way especially if you have not noticed any problem with diarrhea while taking the Fibrozym and Nattokinase. Mild diarrhea sometimes happens as a result of the systemic enzymes causing so much breakdown of fibrous matter that it irritates the gut lining.

We do not put Neprinol in the primary plans because for many men it is better to start with Fibrozym and Nattokinase as the enzyme source since they are easier to take initially. If you really want to use Neprinol it can help even better than the lower dosage products that are in the initial plans. TRH

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Questions about straightening a congenital penis curvature

Hi Doc.

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My Name is Tomas and i am a 25 year old male from Sweden. We have spoken on the phone previously but i am afraid that my written English is better then my spoken. I have also, very recently, submitted a question but i am not sure it got registered correctly so i take the opportunity of writing a new one and adding some additional information and text if that is alright with you.

My penis, who i am overall pleased with, have always had a slight downward curved. Probably less then an average banana. It is not Peyronies disease but what you call Congenital curvature. Although this is yet to cause me any problems while having intercourse (i believe some of the girls i have been with have not even noticed it), i can't help to feel a bit self conscious about it. I think it looks unattractive compared to a completely straight penis and since i am quite of the 'ladies man' if i may say so my self, i thought to my self that it's time to get it straight. It would feel really good to just relax and enjoy sex without having to worry about my appearance.

First of all, i have to praise your dedication to the subject. I believe such attitude and respect as yours towards the patients are rare and something i hold in a very high regard.

Now, i know that your programs are generally more directed towards treating Peyronies disease – but i'm also of the impression that it can help a congenital curved penis as well. While searching the Internet, i have stumbled upon countless of alternative treatments but yours is the first which i feel confident might help me and feels “serious”.

So, my question is.

What is recommended for treating a congenital downward curve as effectively as possible? Should you add some supplement or is stretching enough? If so, what program?

And i also wondered what videos are possible to be sent to me by email and how that is arranged. The shipping costs to Sweden was really expensive – and i would also like to keep my little project a secret from my roommates.

Kind Regards
(And sorry for possible bad grammar)

Sweden 🙂

Greetings Tomas,

Your English is wonderful and in fact better than some of native English speaking people I sometimes encounter. You are to be congratulated. And thank you for the kind words about the work I do with PDI.

When the Peyronie's Disease Institute Manual Penis Stretching Method was developed and researched in 2006 it was intended to be used for PD, not correction of birth or congenital penis curvature. However, since there are apparently many men like you with a slightly to moderately curved penis they would like to make straighter, we have had perhaps 40-50 men over the years who have used this particular Peyronie's treatment method and have reported success when used according to the detailed instructions found on the CD. What you will find is that on the CD there are several different techniques, a variety of pivot points, as well as different angles and lines of traction to use depending on your particular penis curvature.

In the past I have recommended that these men who want to change a congenitally bent penis use at least Neprinol as the follow the PDI manual penis stretching method. This should work to increase the effectiveness of treatment. A bit more information is available on the PDI website at “Peyronie's Disease Institute Manual Penis Stretching Method.”

The information you want is available only on the CD and has not been made to be downloaded as an attachment to an email. Sorry.

I would be remiss if I would not advise you to be less concerned about the small penis curvature you have. Women are far more tolerant and willing to accept physical variation of the penis than what you would imagine. Attractiveness and beauty are not found in symmetry or sameness of appearance; the value and effectiveness of the penis toward good sex is not found in symmetry or someone's preconceived idea of beauty, but how it is used with kindness, gentleness, a giving spirit, passion and love. Besides that, a bend applies a bit more friction to the vaginal wall for added stimulation. You might be better off curved than straight. TRH


Can your Peyronies stretching video help me correct a downward curved penis?

Hi doc!

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Which videos are you able to email to me and what is recommended for a congenital downward curve?



Greetings Tomas,

The Peyronie's Disease Institute Manual Penis Stretching Method was not intended or tested for correction of congenital penis curvature. However, men with a curved penis that they were born with have reported success when used according to the instructions found on the CD. I have always recommended that they at least take Neprinol while following this manual penis stretching method to increase the effectiveness of treatment. You can find information by clicking on “Peyronie's Disease Institute Manual Penis Stretching Method.” TRH


Easy treatment for Peyronie's disease?

hi doc plz tell me the correct and easy way to make it straight i m soo worried doc plz help me!!! guide me with natural and easy exercise in treatment thank you…


Sorry to disappoint you but there is no easy or fast treatment for Peyronie's disease. PD is not that kind of problem.

You seem to be a young fellow who might be inclined to believe the nonsense of some of the bogus websites that promise fast and easy Peyronies cures when nothing like that exists. Mystery herbs from Pakistan or mechanical penis stretchers will not correct the curved penis that is worrying you. Everyone believes that penis stretching will work until they learn it is a painful process that many men cannot do for more than a few minutes and is not effective because having Peyronies is not like having a bent paperclip.

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You will have to do some work, maybe even a lot of work, to help and support your body's ability to recover and reabsorb the Peyronie's plaque. It can be done and it is being done daily, but always with effort and time. All you have to do is go to Start Peyronie's Treatment and start learning and reading.

If none of this sounds appealing to you, you can always come back to the Peyronie's Disease Institute website when the easy methods have failed and you might be a bit worse.

Let me know if i can help you in any way. TRH


Now that my Peyronie's disease is gone should I continue taking the supplements?

I have had Peyronie's for approximately two years. I had about a 45 degree bend upwards and about a a 15-20 degree bend to the right. I noticed that I had a large scar along the top of the shaft about 2″ and a small nodule about 1/4 inch in diameter on the right side. I obtained your gentle manual penis stretching video and started with the exercises and took PABA, Vitamin E, Nattokinase as you suggested in the instructions PDI provides. I continued with this stretching exercise and the vitamins and enzymes and have now straightened out the shaft. I do not feel any more scar tissue. I was wondering if I am going to have to continue on with the PABA? I will continue to take the other natural vitamins and supplements as I was taking before i developed the Peyronie's, but I did not ever before take PABA so i wonder if I should continue with that. Thanks for your help.


First of all, congratulations on your successful treatment of Peyronie's disease. Many people doubt that they can do what you did. I get this kind of report from people around the world several times a week telling me that they have recovered from their terrible Peyronie's problem by following the simple directions and ideas found on the PDI website. Good for you.

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I doubt you will have to continue with the PABA or continue doing the gentle manual penis stretching technique now that your Peyronie's plaque is gone. Since 2002 I have been consulting with men about Peyronie's disease and in that time we have had some really great results. In all these years I have never had anyone come back to me a year or two or five years later to report that their PD has come back when they stopped taking the PDI Peyronies treatment plan they used to recover from their problem.

However, I would say that half of the men who get over their Peyronie's disease say they will continue with certain parts of it because they believe they get general health benefits from certain products (Neprinol, nattokinase, vitamin E, acetyl-L-carnitine, etc.) I have recovered from my own Peyronie's disease now for about ten years and still take Neprinol, Omega T, and vitamin E because I am convinced of their broad health benefits.

Again congratulations on your great Peyronie's treatment story. TRH