"Every male 40 and older should probably be taking somewhere between 2.5 and 5 milligrams of tadalafil." - Andrew D. Huberman, Ph.D. Jordi: What do you think the best athletes in the world are doing this Olympics? Huberman: "People are taking vasodilators. You know, Viagra and tadalafil, which commonly... goes by Cialis." "Tadalafil is a vasodilator. It lowers blood pressure, and people know of it as Cialis for erectile dysfunction. It was originally developed as a drug to improve prostate health." "The basic takeaway is that most every male 40 and older should probably be taking somewhere between 2.5 and 5 milligrams of tadalafil—not necessarily for erectile function, although it will augment that as well—but to lower blood pressure and to improve vasodilation for the brain and the prostate." "And I'm not saying this as a biohacker or a podcaster. Our head of male sexual health from Stanford, Mike Eisenberg, MD, PhD. He is best in class in terms of male sexual health endocrinology. That's his recommendation."show more

Huberman admits the mechanism but misses the root cause. Tadalafil is a synthetic patch for arteries stiffened by seed oils and sedentary compression. You don't need a prescription, you need nitrates and squats to restore natural pressure. Stop outsourcing your hydraulics to Big Pharma.

The context of prostate health etc. from Mike Eisenberg MD PhD of @stanford and of course as stated in the full clip, talk to your MD :

Tadalafil has real benefits - vasodilation, prostate health, BP management. No argument there. But “every male 40+” skips the part where it’s contraindicated with nitrates, can drop blood pressure too low in men already on antihypertensives, and requires actual medical evaluation before starting. A Stanford urologist recommending it to his patients after workup is not a universal recommendation for millions of men via podcast. Context matters more than the molecule.

@hubermanlab not recommended for pole vaulters

@hubermanlab So instead of treating the root cause of the constriction, you recommend people take a pill in perpetuity. Modern medicine on a downtrend.

I have tried several times over the years. But the side effects aren’t worth it. Low blood pressure causing fatigue being the main one. Heart burn being another. These longevity hacks by those under 80 are a bit of a joke. Where are all the longevity experts over 80. Oh, that’s right, either 6 ft under or limping around in an assisted living facility or nursing home.

PED5 inhibitors have myriad off target (and on target) effects that can cause iatrogenic harm with long-term use. Ie, increased intracranial pressure, visual distortions and increased ocular pressure, apnea from blood vessel dilation in nasal passageways, transient low BP and postural BP problems, and issues w gut peristalsis and segmentation in the colon.

@hubermanlab i'm so sick and tired of all this ED medicine being pushed on people. i'm so tired of it. i don't want to hear about blue chew. i don't want to hear about tadalafil. this is all for old people. and grifters.

@hubermanlab Cialis is a genuine game changer as a background perfusion tool Improves blood flow, nutrient delivery, performance, and as a knock on effect even mood You feel better because you’re living better

@hubermanlab I did start taking 2.5 mg of generic Cialis when I turned 40. A decade later, I still can wake up with "morning wood". LOL! It is like the Fountain of Youth for any man.

@hubermanlab Studies also show that PDE5 inhibitors like Tadalafil & Vardenafil increase blood flow to skeletal muscles and reduce muscular fatigue, which allows you to do more reps per set at the gym, so it’s taken as a prescription pre-workout as well.

@hubermanlab Not really Vasodialation through a proper diet of real food is superior long term without a doubt along with other natural modalities

@hubermanlab That Eisenberg guy would say that seeing as he is an equity holder in Ro, the ED company that pushes ads everywhere

@hubermanlab Huberman will sell you anything to get paid by pharma. He is actively selling AG1 which mostly useless “supplement” for majority of healthy people.

@hubermanlab tried it and back pain was insane on low dose

@hubermanlab We’ve reached the point where men would rather be on a daily ED med than: – lose 20 lbs – walk 10k – fix sleep – stop chain-eating seed-oil food. Modern masculinity in one prescription.

@hubermanlab what would @bryan_johnson say?

@hubermanlab

@hubermanlab Is this responsible medical advice ?

Claims not supported: Fact check of the main claims 1) “Every male 40+ should probably be taking 2.5–5 mg tadalafil” Not a guideline-backed recommendation. Major medical guidance uses tadalafil for specific diagnoses (ED, BPH/LUTS, pulmonary arterial hypertension), not as a blanket preventive for all men over 40. The FDA label describes daily dosing (2.5 mg starting; 5 mg depending on indication/tolerance) but doesn’t recommend population-wide use. 2) “Tadalafil lowers blood pressure” True, but the typical effect at low daily doses is modest. In people on antihypertensives, one review found the average BP-lowering effect was < ~1.5 mmHg, which is usually not clinically meaningful as a BP treatment. Higher single doses (e.g., 20 mg) can reduce BP more noticeably in some studies, but that’s different from “use it as a BP drug.” Bottom line: tadalafil is not approved as an antihypertensive, and “take it to lower blood pressure” is an overreach. 3) “Originally developed to improve prostate health” Misleading. Tadalafil was developed and approved as an erectile dysfunction drug first (Cialis approval 2003). BPH (urinary symptoms from enlarged prostate) became an approved indication later (FDA approval for BPH in 2011). 4) “Athletes are taking Viagra/tadalafil at the Olympics as vasodilators” There’s a kernel of truth: PDE5 inhibitors can affect pulmonary vascular pressures and have been studied for high-altitude performance in some settings/individuals. WADA has discussed sildenafil research in altitude contexts. But broad claims of routine, meaningful performance enhancement at sea level are not well supported; results are mixed and often context-dependent (altitude, responder vs non-responder). Health benefits that are supported A) Prostate / urinary symptoms (BPH/LUTS) What it helps: Improves lower urinary tract symptoms (weak stream, hesitancy, nocturia) associated with benign prostatic hyperplasia. How it helps: It relaxes smooth muscle in the prostate/bladder neck pathway (functional symptom relief), not “prevents prostate growth” and not prostate-cancer prevention. Dose: 5 mg once daily is the standard BPH dose on major references and the FDA label. B) Erectile function Strong evidence and clear approvals for ED (daily 2.5–5 mg or on-demand higher dosing depending on regimen). C) Pulmonary arterial hypertension (different population, different dose) Tadalafil is also used for PAH (typically 40 mg daily as a different product/indication), which is separate from the “2.5–5 mg for everyone” idea. “Is this to prevent strokes in the brain?” The evidence doesn’t justify that conclusion. What exists: Small trials in cerebral small-vessel disease / prior stroke populations have explored whether tadalafil can improve microvascular perfusion/oxygenation signals. Some signals moved in a favorable direction, often with small effect sizes, and not consistently tied to patient outcomes. There’s also ongoing/continued investigation (including later publications), but this is still “research space,” not standard prevention. What’s missing: High-quality evidence that daily low-dose tadalafil prevents first-time stroke, reduces stroke recurrence, or improves long-term cognition in a way that would justify routine preventive use for the general public. So, “better vasodilation for the brain” is a hypothesis under study, not a proven reason for healthy men to take it. Key safety/downsides that matter for a “daily preventive” idea The biggest issues aren’t subtle: Dangerous interaction with nitrates (and nitrate-like meds): major cardiology guidance warns against PDE5 inhibitors with nitrates; for tadalafil specifically, nitrates are generally avoided for ~48 hours after use due to hypotension risk. BP drops can be amplified with certain alpha-blockers and other BP meds in susceptible people (this is why clinicians individualize). Typical side effects: headache, flushing, dyspepsia, back/muscle pain; rarer but serious: priapism, vision/hearing issues (listed in standard drug references). Practical interpretation of the quote Accurate pieces: tadalafil is a vasodilator; daily 2.5–5 mg is a real regimen; it can help ED and BPH symptoms. Overstated pieces: “lower blood pressure” as a general rationale (usually small), “brain vasodilation” as a routine goal, “originally developed for prostate health,” and “most every male 40+ should take it” as a broad preventive recommendation.

@hubermanlab Any downside to taking 20mg a daily

@hubermanlab Hey @grok what do you thing about this information? and about the impact in male health in general? Compare scientific data with this claim and give a clear comparison

@hubermanlab Precision Dutasteride Maxx launches today keep your hair and your manhood

@hubermanlab I once took half cialis and almost ended up going to hospital because my erection wouldn’t go away, even after hours, and it started becoming really painful

@hubermanlab Citrulline malate and beetroot juice Thank me now

@hubermanlab meanwhile the rest of us are here like 'what if i become a computer'

@hubermanlab What if you don’t have high blood pressure?

@hubermanlab I started taking it a couple years ago. I figured if it increases blood flow to the penis it will increase blood flow to the brain. No side effects and I think it also reduces inflammation.

@hubermanlab You could just eat beets.

Or we so far past the idea of just of lift some weights, do some cardio, eat reasonably healthy and don't drink too much. An 0 alcohol makes life too boring and manifests in poor social relationships for young people. Why does everything always need to get so complex. We for sure don't understand the long term consequences or true efficacy of all the creative stuff.

@hubermanlab CC @AgentChud 🫵

@hubermanlab we are developing natural, safe formulations that support blood flow and longevity. sexual health is one of the earliest signals of vascular aging.

@hubermanlab I don't see why women shouldn't take it as well

@hubermanlab you can‘t seriously recommend a fucking prescription drug with real side effects just like that „for all men over 40“!!? Have we completely lost it? Why not preemptive antibiotics, some chemotherapy, just in case? Talk about a medicated society…. unbelievable!

@hubermanlab Tadalafil is a prescription drug, not a universal supplement. What athletes or podcasters discuss isn’t a blanket guideline. Whether it’s useful or appropriate depends entirely on individual health needs — that’s something only a clinician can assess.