Dont forget to take your vitamin C
I'm not talking about orange juice..
As a man, you should be taking your vitamin C.
I’m not talking orange juice.
Or those weirdly tasty chewable vitamin C pills from the store.
Im talking Cialis. Tadalafil.
The literal wonder drug that is criminally undersold as just a “boner pill”.
Which is such a disservice to what this drug is, and what it can do. It’s scope reaches far, far beyond turning your dick into weapon of mass destruction. That’s just the generally accepted favourite side effect. The real sauce is in the other health benefits.
I remember when my heart diagnosis came back. It was bad. I was down bad. Barely above heart failure levels, feeling like a shell of a human. I had no idea what to do, or where to go. The pills prescribed to me barely made a difference for me in that first year. My low ejection fraction had barely budged. I was stressed. I was young. I had fucked up, and I had to figure it out quick.
I had started to incorporate more cardio.
Joined a Muay Thai gym.
Taken a step back from bodybuilding.
Dropped down to true TRT dosages.
Leaned out, lost weight and shed the bulky frame.
But that wasn’t enough. I had to optimize every single fucking area. The supplements. The food. Any additional medicine. I had to do everything within my power to improve this mess. It was a legitimate threat to my life.
I had sporadically used Cialis as a preworkout here and there. It was often thrown in as a freebie in my larger steroid orders. Had a bit of a surplus built up. Definitely liked the stuff, but had no idea how beneficial it could be. To me, it was just better boners and really solid pump in the gym. Made the veins pop a bit more..
One of the beautiful things about it is that it doesn’t just increase blood flow to your dick.
It increases blood flow to your entire body.
Okay, maybe thats not 100% correct. Thats a bit of a bro science tier explanation. Lets break it down a bit more accurately here..
Cialis and other drugs like it are referred to as PDE5 inhibitors.
While I dont take the FDA seriously, its worth mentioning that Cialis has received FDA approval for erectile dysfunction, benign prostatic hyperplasia (a.k.a prostate issues), and pulmonary arterial hypertension (high blood pressure in the lungs). No other PDE5 inhibitor accomplishes this. But it’s health benefits still have a much larger scope. From cardiovascular protection and remodeling, to neuroprotection, metabolic improvement, and effects on body composition that have nothing to do with the bedroom...
You could almost describe this as the best multivitamin for men ever formulated.
To understand Cialis, you really just need to to understand one enzyme (PDE5) and one signalling molecule (cGMP).
PDE5, phosphodiesterase type 5, is an enzyme whose job is to break down cyclic guanosine monophosphate (cGMP). cGMP is a secondary messenger that tells smooth muscle to relax. When smooth muscle relaxes, blood vessels dilate, blood flow increases, and tissues downstream get more oxygen and nutrients. PDE5 is not always acting in our best interests. This is where Cialis comes in to help out.
Cialis inhibits PDE5, the enzyme responsible for degrading cGMP. This increases cGMP concentrations, resulting in vascular smooth muscle relaxing and vasodilation. This is what we want, and where the benefits are found.
The key here is that PDE5 isn’t just in your dick.. Smooth muscle exists throughout the body, which means PDE5 inhibitors like Cialis can improve endothelial function systemically. The enzyme is found in the blood vessels in the lungs, the prostate, the bladder, the coronary arteries, blood vessels in the brain, the kidneys, and skeletal muscle. Block PDE5 anywhere it’s found, and you get improved blood flow and oxygen delivery in that region.
This is why Cialis gives you great boners, helps with prostate symptoms, lung hypertension with a ton of other systemic benefits on the side.
Hopefully now you can see why calling Cialis a “boner pill” is simply underselling it, by a large margin.
Now that we have a better understanding, lets dig a bit deeper..
THE SYSTEMIC BENEFITS
This is what really took me down the Cialis rabbit hole when I was trying my absolute best to manage that dilated cardiomyopathy diagnosis. Cialis is something much bigger than what’s on the label and what its typically prescribed for.
In men without known heart disease, Cialis reduced blood pressure, both systolic and diastolic (systolic is the top number, diastolic is the bottom number) and improved how elastic their arteries were.
Stiffer arteries are one of the strongest predictors of cardiovascular death..
The fact that a daily low dose of Cialis can reverse that progression deserves far, far more attention than it gets. But it still gets better from here..
The most critical finding is that Cialis improved endothelial function. Endothelial function can be thought as the health of the inner lining of your blood vessels. And this was regardless of how bad someone’s ED was. What this means is that vascular benefit isn’t a side effect of better erections.
It’s a direct effect of the drug on your cardiovascular system as a whole.
In men taking 5mg daily for BPH, arterial stiffness markers improved at 3, 6, and 12 months. And a large study found men using PDE5 inhibitors had a 19% lower risk of cardiac events and a 44% reduction in mortality.
Read that last number again. Forty four fucking percent... Just from taking a pill that not only gives you insane pumps in the gym, but insane pumps in the bedroom as well.
There’s also some good animal data that hard to ignore.
In mice with induced heart attacks, daily Cialis cut infarct size by almost a third, reduced fibrosis by more than half, and dropped heart cell death from 6.7% to 2.1%.
In a sheep model of advanced heart failure (which is much closer and more comparable to a human heart) Cialis improved the heart’s ability to contract, reversed structural damage at the cellular level, and restored the heart’s response to adrenaline.
Heart failure progressively disconnects the heart from its own signaling system.
Cialis appears to reconnect it.
For what its worth, I saw my most significant raise in LVEF the year I started using a daily dose of Cialis. From the 40’s back into the low 50’s.
This next one most people don’t know about, I didn’t for a long a time either. I had noticed improved cardio sessions after a preworkout dose, but never really connected the dots. So Tadalafil isn’t just sold as Cialis...
it’s also sold as Adcirca, used for high blood pressure in the lungs.
Same drug. But with a different label, and different dose. For a different purpose.
When the arteries in your lungs tighten, pressure builds, the right side of your heart has to work overtime. When this happens your ability to do anything physical starts to fall off a cliff. Cialis opens those arteries back up by doing the same thing it does everywhere else:
Blocking PDE5 and letting cGMP do its fucking job.
Great for endurance athletes, runners and martial artists prioritizing cardio. While you definitely do not need to push a dose anywhere near this high to reap these benefits, the dose for lung hypertension is 40mg daily. Which is eight times the typical daily dose at 5mg. Which tells you the margin for safety on this stuff. You’re not gonna overdose.. Worst case, you have a stuffy nose and heartburn. Maybe a headache.
For the enhanced guys reading this, whether its TRT or far beyond it, prostate issues can be a legitimate health concern after a while. This can also apply to the natural guys above 40... so this next part is relevant to most guys. It’s your prostate. For some reading this it might already be making your life harder. Things like frequent urination, a weak stream, getting up multiple times a night etc.. that’s typical BPH shit.
Fortunately, Cialis got FDA approval treatment of it in 2011.
The issue is straightforward...
PDE5 is found in the smooth muscle of your prostate and bladder neck. Block it, pressure on your urethra drops, and urine flows better. Doses as low as 5mg daily significantly improve these symptoms across the board.
But here’s where it shines compared to some other prescribed methods..
Cialis is the only drug that handles both ED and prostate symptoms with one pill. Alpha blockers can help you pee, but they can kill your erections or cause retrograde ejaculation. 5-alpha reductase inhibitors shrink the prostate but can kill your libido by nuking your DHT levels systemically (i.e fina and dutasteride, please never take these, ever).
Cialis avoids all that bullshit. One pill, two problems solved, no sexual side effects, just sexual benefits.
It comes with some cognitive benefits as well. Lately I’ve seen the biohacker crowd start writing about it. Cialis also crosses the blood-brain barrier. This was debated for years, but the end result of studies was that the compound gets into your brain, and with chronic use, it accumulates there. In Alzheimer’s mouse models, chronic Cialis use improved memory performance and reduced the buildup of one of the two proteins (tau) responsible for the disease progressing. The mechanism isn’t just blood flow here... Cialis appears to reduce brain inflammation directly, lowering pro inflammatory signals and shifting immune cells in the brain toward a protective rather than destructive posture. For those that have seen the effects of Alzheimers or dementia on a family member, this is worth noting. It’s something I wouldn’t wish on any other human being.
THE GYM AND YOUR HORMONES
This is where it just continues to get better...
Daily Cialis improved lean abdominal muscle mass in non-obese men, confirmed by DEXA scan, without any changes to diet or exercise. The effect reversed when they stopped taking it. The study also found increased androgen receptor expression in skeletal muscle cells....
This tells us Cialis has a direct effect on muscle tissue that goes beyond just getting more blood to it.
Performance wise, Cialis can improve athletic output, especially under low oxygen conditions. So basically, the harder you’re pushing and the more oxygen starved your muscles are, the more Cialis helps. If you’ve ever taken it before a workout and noticed the pumps hit different, the vascularity looks freakish, and the endurance lasts longer, the research backs up what you felt. Many years of my personal use supports this as well....
Electrolytes + Carbs + Cialis + Caffeine = One hell of a workout. Would recommend, and will do you much better than any tub of overpriced Kool-Aid from a supplement store.
While I am a huge proponent to TRT and will always advise against taking supplements to boost testosterone (please dont fall for the scams), men with metabolic syndrome taking 5mg daily for three months saw testosterone levels jump 44% on average. Not bad, I will admit.
Beyond testosterone, and something important to note here for the ones on TRT or beyond, is that Cialis shifted the testosterone to estradiol ratio in the right direction, by reducing estradiol.
It appears to have a direct effect on aromatase. Thats the enzyme that converts your testosterone into estrogen. So you’re looking at a compound that simultaneously improves blood flow, raises testosterone, and blunts estrogen conversion. In one pill. Which is wild. In my experience, it does assist with this. I’ll probably discuss this further in another write up, but the use aromatase inhibitors is out of control and over prescribed in the bodybuilding and TRT world (read: parroted by people with little to no skin in the game), so a combination of staying lean and utilizing Cialis could help many men avoid the rollercoaster of dialling in estrogen levels while on testosterone.
The chart above provides a clean visual summary. As you can see, Cialis puts in some serious work, system wide.
WHY CIALIS, WHAT ABOUT VIAGRA?
Every benefit above is amplified by one fact that separates Cialis from the rest of the drugs in its class... the half life. Longer half life = longer time in the bloodstream. Cialis has been around for a minute, but when you bring up boner pills, most will default to thinking of Viagra. While Viagra is still useful in a pinch for the obvious prescribed reasons or as a preworkout additive, it still falls short of our boy Cialis who tirelessly works around the clock.
Basically, Viagra has a half-life of 4 hours.
Cialis on the other hand? It has a half-life of 17.5 hours.
The chart above makes helps map it out clearly. Viagra is essentially gone from your system by hour 12. Cialis? At hour 12 is still sitting at roughly 60% of peak concentration. Even at 24 hours, you still have meaningful plasma levels. The curves overlap. You never go to zero. You just keep reaping the benefits.
Once you hit a steady state concentration from daily dosing, the exposure is 1.6x greater than the same dose taken intermittently. Basically, this means a daily 5mg dose delivers the equivalent effects of about ~8mg around the clock, without peaks and troughs once daily dosing is established.
Cialis is also unaffected by food or alcohol in most cases, unlike Viagra which can be impaired by fatty meals. You take it, forget about it, and your vascular system (and cock) runs better all day, and into the night. And the next day.
Another win…
Okay. Lets take a step back and look at what this beautiful compound actually does...
Improved blood pressure and heart function.. I can personally vouch for this.
It crosses the blood-brain barrier and reduces inflammation in the brain.
It improves body composition and testosterone to estrogen ratios.
It gives you skin splitting pumps and insane vascularity when utilized as a preworkout.
And It does all of this with a safety profile spanning over two decades of clinical use and a half-life that allows once daily dosing at 5mg. My personal preference is 10mg.
Cialis is generic now. A 90 day supply costs less than most people spend on coffee in a month. Dirt cheap. You can find it everywhere online. And if you go straight to the source, you could order a lifetime worth of raws from China for less than $1000.
Oh yeah, I almost forgot, it gives incredible boners as well.
Your girl will love it and appreciate it just as much as you will.
Dont forget to take your vitamin C.
References, for those who care:
Drugs.com — “Adcirca (tadalafil) FDA Approval History” — https://www.drugs.com/history/adcirca.html
FDA Prescribing Information — ADCIRCA — https://pi.lilly.com/us/adcirca-pi.pdf
FDA Prescribing Information — CIALIS — https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021368s029lbl.pdf
MIMIT Health — “Tadalafil (Cialis): Anti-Aging and Pre-Workout Benefits Backed by Science” — https://mimithealth.com/blog/tadalafil-cialis-as-an-anti-aging-and-pre-workout-supplement-science-backed-benefits
Nature / Scientific Reports — “Phosphodiesterase 5 inhibition improves contractile function and restores transverse tubule loss and catecholamine responsiveness in heart failure” — https://www.nature.com/articles/s41598-019-42592-1
PMC — “A review of the use of tadalafil in the treatment of benign prostatic hyperplasia” — https://pmc.ncbi.nlm.nih.gov/articles/PMC4054509/
PMC — “Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis” — https://pmc.ncbi.nlm.nih.gov/articles/PMC5603624/
PMC — “Tadalafil and Steroid Hormones Interactions in Adipose, Bone and Prostate Tissues” — https://pmc.ncbi.nlm.nih.gov/articles/PMC9024809/
PMC — “Tadalafil once daily in the management of erectile dysfunction: patient and partner perspectives” — https://pmc.ncbi.nlm.nih.gov/articles/PMC2778425/
PMC / Cardiovascular Drugs and Therapy — “Tadalafil Prevents Acute Heart Failure with Reduced Ejection Fraction in Mice” — https://pmc.ncbi.nlm.nih.gov/articles/PMC8529582/
PMC / Frontiers in Medicine — “Efficacy and Safety of 12-week Monotherapy With Once Daily 5 mg Tadalafil for LUTS/BPH” — https://pmc.ncbi.nlm.nih.gov/articles/PMC8545998/
PubMed — “Chronic treatment with tadalafil improves endothelial function in men with increased cardiovascular risk” — https://pubmed.ncbi.nlm.nih.gov/15661417/
PubMed — “Effects of taking tadalafil 5 mg once daily on erectile function and total testosterone levels in patients with metabolic syndrome” — https://pubmed.ncbi.nlm.nih.gov/28295481/
PubMed — “Evaluation of arterial stiffness and cardiac function in patients with vascular erectile dysfunction” — https://pubmed.ncbi.nlm.nih.gov/27928151/
PubMed — “Tadalafil crosses the blood-brain barrier and reverses cognitive dysfunction in a mouse model of AD” — https://pubmed.ncbi.nlm.nih.gov/22776546/
PubMed / Endocrine — “Tadalafil improves lean mass and endothelial function in nonobese men with mild ED/LUTS” (Aversa et al.) — https://pubmed.ncbi.nlm.nih.gov/28133708/
QuickMeds — “Does Tadalafil Improve Athletic Performance?” — https://quickmeds.co.uk/blog/mens-health/erectile-dysfunction/tadalafil/does-tadalafil-improve-athletic-performance/
Shanghai Archives of Psychiatry — “Can Tadalafil Protect the Ageing Brain?” — https://shanghaiarchivesofpsychiatry.org/en/214067.html
StatPearls / NCBI Bookshelf — “Tadalafil” — https://www.ncbi.nlm.nih.gov/books/NBK603743/
Taylor & Francis / Aging Male — “Administration of daily 5 mg tadalafil improves endothelial function in patients with BPH” — https://www.tandfonline.com/doi/full/10.1080/13685538.2017.1367922