I'm sure you know that Calis is great for third member gains and engorgement and monstrous pumps as well as blood pressure management as a secondary beneficial effect but did you know that sealas also causes fat loss and acts as a performance ening drug if you didn't then keep watching to find out why sealas is an excellent trt add-on for perfect hardons figure Steve here to Al better known as Calis is a phospho Diest type 5 inhibitor which increases n oxide as well as cylic Quine monophosphate levels within the smooth muscles of the Corpus cavernosum which increases penal blood flow resulting in monstrous tions to put it mildly I'm sure that many of you are already aware that the Dell is an ever so popular trt or HRT or full-blown steroid cycle add-on it's been used recreationally by the people in the fitness Community for decades now but it's also used medically as a blood pressure medication and that's initially what it was investigated for most people use it for both reasons and kill two birds with one stone but there's actually a lot more benefits to toil that we can get into in this video Let's Start by briefly discussing the FDA approved medical applications of talil these treatments are stemming from the latest revision of the ell Lily Calis medical insert which was published on the 28th of May 2020 you can find the direct link down below this insert contains a bot of warnings and contraindications especially for people with pre-existing medical conditions if you're thinking about running branded Calis or generic theophil yourself then you would be wise to read through it all for example there might be sudden Vision or hearing loss or persistent erections lasting over four hours which require blood aspirations from the penus or injectable Alp adrenergic receptor agonists to relieve the pressure built up in the penis which is all very serious stuff so without further Ado let's get into the medical applications of the dapil better known as Calis there's four separate dosage formul ations you have Calis once per day that's 2.5 Mig or 5 migs per tablet and then Calis on demand that's 10 milligrams or 20 milligrams per tablet for the treatment of erectile dysfunction sealas once per day at 2.5 milligrams to 5 milligrams once daily at the same time every single day because the halflife is approximately 17.5 hours for sealas on demand that's 10 milligrams to 20 milligrams 30 minutes prior to expected sexual activity once daily for maximum of three times weekly in the treatments of the signs and symptoms of benign prostate hyperplasia Calis once per day 2.5 milligrams to 5 milligrams once daily and in the treatment of pulmonary arterial hypertension this is prescribed as needed usually it's seal once per day 2.5 to 5 milligrams again once daily but this is considered an off label prescription and I tried my absolute best to find the medical applications which are FDA approved to relieve symptoms of depression in which the pump is the cure and of course an enhanced pump would relieve those symptoms even better than before but you're going to have to wait to the end of this video because I don't think that pump enhancement by the use of the dofil is FDA approved in any country in the world not yet at least since the Dell is a well studied and commonly prescribed medication there are a ton of established drug interactions I've included the most relevant interactions for enhanced Fitness enthusias on the screen right now and you see here that theophil interacts with Alpha energic receptor antagonist better known as alpha blockers which includes yohimbine rolin telosin and other benign prostate enlargement medications as well as a car vidol which is a beta blocker that's not very selective it interacts with a Denine monophosphate and a Denine triphosphate um formulations either orally in the form of muscle tech muscle builder which is oral ATP or injectable pre-workout formulas that contain either or both amp and ATP right very potent vasel dilators and again Calis is also a very potent vasodilator by itself it interacts with chromosome p453 A4 enzyme Inhibitors that includes epigon fluvoxamine grapefruit which contains bergamottin nine and ningin in Kono and other Inhibitors it interacts with nitrates found in over the counter pre-workout formulations and no surprise here it interacts with other phoso sras type 5 Inhibitors including cenil better known as Viagra and venil better known as Levitra but there's also a couple other pd5 Inhibitors on the market it interacts with beta adrenergic receptor antagonist better known as beta blockers which includes like I mentioned before carvol metoprolol nebivolol propanolol Etc it interacts with Angiotensin converting Inhibitors like Lino for example or angot tensor receptor blockers like tasaran or volaran and calcium channel Brockers albeit that phase three clinical trials show that there's no adverse effects when combining to data fill with either beta blockers ACE inhibitors arbs or calcium channel blockers but I would still suggest you to do additional research and proceed with caution because blood pressure management medication with another blood pressure management medication might drop your blood pressure too severely there are close to 3,000 studies when you search for talil over on bumet and even pbet doesn't have all available Publications onto delil so I wasn't able to go through all of these studies for the sake of this deep dive my sincere apologies a good amount of these Studies have been performed in the context of the medical treatment in which the dalil is prescribed for but I was still able to find a good amount of evidence-based unique characteristics which are relevant for people into health and fitness or performance enhancement which let's be honest performance enhancement isn't entirely about health and fitness if you feel I left a particular study out in this deep dive post your citations down below if there's a lot of citations and it's worthy of a follow-up video I'm happy to make it for you guys so here are a good amount of the evidence-based unique characteristics of talil it relieves symptoms of erectile dysfunction which is further enhanced with vigorous exercise so if you compare studies between trained men and untrained men both taking sealas at various dosages the trained men taking Calis have more resolvement of the symptoms of their erectile dysfunction so you go to the gym you get pumps in all of your body parts when supplementing with tadalfil tadalfil improves sexual performance and orgasmic function and also confidence during intercourse that you know that you're not going to lose your erection tanil has a slight reduction in sperm concentration without affecting sperm morphology sperm motility and serum seone level so that's shbg testosterone Etc but this slight reduction in sperm concentration is accredited to the increased ejaculation frequency because well if um confidence in sex goes up then you probably have sex more o often and thus more ejaculations occur reducing sperm concentration without affecting the morphology or the IM morality talil relieves symptoms of benign prostate hyperplasia and it lowers blood pressure and relieves symptoms of pulmonary arterial hypertension so these are basically all of the Medical Treatments in which talil is prescribed for talil improves total and free testosterone to estral ratio and it does so by lowering serum estral levels this has actually been shown in a multitude of different studies again you can f all of the stations down below and there's no significant impact on testosterone levels albeit that some studies do show that testosterone levels reduce slightly might be for another reason which we'll get into the downfall increases skeletal muscle Androgen receptor messenger RNA content so if there's more Androgen receptors in skeletal muscle maybe that's binding to all of the testosterone lowering serum concentrations anal induces lipolysis improves glucose homeostasis increases glucose consumption of skeletal muscle and approves inent sensitivity stemming from Human subjects animal models and in vitro studies and this is stemming from The increased intercellular cyclic adeny monophosphate and nitric oxide concentrations tedl alter post exercise di testosterone to Total testosterone ratio in humans it appears that TL blunts Max effort 5 Alpha reduction and Di testosterone release from skeletal muscle so maybe there's some sort of impact on how testosterone aromatizes or 5 Alpha reduces into estrad or D testosterone when the dalil is used around the workouts again this is all stemming from healthy individuals who are trained so if you have issues with high esile or high D testosterone levels then maybe talil is a valid option to keep those metabolites under control and you don't have to result into aromatized Inhibitors or F reducti enzyme Inhibitors like fastrite or dast which might alter your libido I mean again if the downal is increasing your confid to have a great sexual performance and thus heightens your libido by increasing the ratio between testosterone and estr or D testosterone then maybe everything is perfectly balanced as everything should tedl increases exhaustive post exercise [ __ ] phosphokinase CPK and lactose deogenz LDH levels while maintaining Redux status in human subjects Al be that other studies show that there is an increase in oxidative stress when supplementing with dofil before the workout and this might insinuate improved skeletal muscle metabolic effects albe it that the scientific evidence regarding performance-enhancing effects of the dalail are a little bit wishy-washy but we'll get into that a little bit later on talil might prevent high altitude edema and sickness and this might be a valid combination with hypoxen which I discussed in the optimized inurance Deep dive video series if you take hypoxen you also prevent altitude sickness by um lowering your body's threshold to hypoxia basically and maybe tadil can help with that right but additional research needs to be performed tanil is not lethal not carcinogenic not mutogenic not genotoxic not teratogenic not embryotoxic and not fetotoxic stemming from animal models and in vitro studies using very very very very high dosages I believe that the downfill has been studied in human subjects in single dosages of 500 mams and consecutive dosages of 100 milligrams I would not suggest you to attempt such high dosages because the flushing in add dizziness in the acid reflux and basically all of the side effects commonly associated with the dofil would be way too severe so don't even get started we're not going to go into the high do studies here because I don't believe in high do the dalil that would be absolutely insane but the 500 milligram study did show that there's no significant change in cardiac output or hemodynamic response to exercise so again with talil the established dosages are the way to go tadalfil improves depressive symptoms and reduces memory impairments stemming from animal models so even though the pump is the cure for depressive symptoms obviously um that was not entirely studied in this animal model still interesting read if you're looking for a little bit of depression relief citations down below as usual and then a couple numbers for the sake of completeness the dalil has between 14 fold to 10,000 fold selectivity for the phosphodiesterase type 5 enzymes compared to all of the other phosphodiesterase enzyme types moving over to the acid reflux which is the most commonly occurring side effect of the dapil especially we combine that with oral steroids in the clinical trials it appears that there's do dependent instances of dyspepsia with continuous Toopy administrations dispepsia includes acid reflux as well as gastric esophagus refluxes is better known as Girt at the 2.5 to 5 milligram dosages about 2 to 4% of the patients experience dyspepsia where 7% got the side effects at the 10 to 20 milligram dosages instances of headaches are about 3 to 6% and 11% respectively now bodybuilders usually experience acid reflux at any dose of theophil probably because we take a multitude of different performance enting drugs as well as ancillary medications all could have an overlapping effect on stomach acidity and allow the esophagus the mouth of the stomach to open as acidity levels in the stomach drop causing acid reflex right this little bit of acid that's now lift in the stomach is slowly coming up giving you terrible heartburn and acid reflux and maybe over time a gastric esophagus reflux disease yeah if I were to have to put a number on it I would say 75% of the bodybuilders experience acid reflux while using tadil whether they take oral steroids or not and of course I'm pulling the statistic out of my completely but based on all of the anecdotal reports and all of your comments that I see on my multitude of different sealas videos on this YouTube channel I would say three out of four 75% of the bodybuilders experience acid reflux on Calis and combining oral steroid or trimone with the dapil probably increases the instances of acid reflux among bodybuilders to 100% now there's various over counter supplements and best practices you can put in place to combat the a reflux keep the mouth of the stomach closed and not get a terrible heartburn in the process while running to dalil anavar and tremone all the same time but I already have a separate video on this topic I'll link it at the end of this one as well and it brings us to the fat loss part of this video starting with a study performed by sesy at all published on 2017 titled acute tadalfil Administration increases plasma fatty acids without changes in the inflammatory response in healthy men in this study 12 healthy men with normal physical and sexual development consuming a standard Mediterranean diet did not take any medications steroids or over the counter supplements for that matter received 20 milligram sedal Orly after fasting from food for 10 hours and from caffeine for 24 hours again caffeine might have some fat loss benefits as well 14 days later the experiment was repeated with either tadil or PBO uh serum free fatty acids and glycerol levels were elevated for 2 hours and 6 hours post ingestion with the most significant increase occurring around 6 hours serum free fatty acids and glycerol levels fill back to baseland within 24 hours after dosing so this would mean that with continuous dosages of theophil as high as 20 milligrams that a free form fatty acids in the bloodstream and glycerol concentrations should stay continuously elevated the researchers note that the delil had no change on serum glucose levels but in F gear one you can clearly see that glucose levels decreased 2 hours after dosing to dofil and it remained lower compared to the placebo even 24 hours after the last dose and there's a b lot of other studies that show that the dofil actually improves insulin sensitivity and improves glucose uptake and like I mentioned before since the dofil has a 17.5 hour half life it would still be active at the 24-hour Mark in the discussion the researchers mentioned that the dofl increases intercellular nitric oxide concentrations and it's a nitric oxide that regulates nutrient metabolism by stimulating glucose uptake and oxidation and stimulates lipolysis and fatty acid oxidation as well so I feel that there's already a butload of beneficial effects from the data fill and we're only one study in and these effects are further confirmed in other studies which are cited down below where the was shown to improve insulin sensitivity increase glucose transporter type four translocation similar to how insulin or vigorous exercise does it regulates lipid homeostasis within skeletal muscle and even increases Androgen receptor content of skeletal muscle in inv vitro studies so let's move over to that study particularly which is stemming from this study performed by AV Versa at all published on June 2017 so it's probably a little bit later than the previous study titled tadalfil improves lean mass and endothelial function in non obese men with mild erectile dysfunction or a lower urinary tract symptoms in Vivo and in vitro characterization in this study they administered 5 milligram Calis daily or 20 milligram Calis on demand for two months so apparently that's up to the patient how many times they dosed 20 milligrams Calis to 43 healthy adult men with normal body mass index suffering from mild erectile dysfunction or other lower urinary tract symptoms prolonged administration of mams talil improves body composition on healthy non-obese men so it's very promising and a valid excuse to run talil at a low and effective dose for longer periods of time especially during a cutting phase after two months of treatment and after two months after Seal's discontinuation among other parameters the researchers investigated the subject body composition of the male subjects and they also investigated endogen receptor expression in C2 C12 skeletal muscle in an initro study now when you scroll down to table one and you start comparing the Baseline to the two months of treatment to the two months after withdrawal of Calis treatment you see that body weight initially shot up from Baseline to uh two months of Calis treatment in the 5 mgram lowd do study and then uh came down after withdraw two months later lower than Baseline and the body mass index did the exact same thing right it from Baseline it went up during seala Street M and then after discontinuation it came down but the waist circumference went down during the treatment so that's a little bit better indication of what's going on if body weight goes up that could be skeletal muscle bone mineral density um increased intestinal Mass from eating more foods but if your waist comes down in size that is a net positive outcome indicating that body fat of the abdomen and lower back is going away you see here that the lean total body mass went up during the 2 months of Calis treatment and then uh stayed slightly elevated compared the Baseline and bount fat percentage came down within two months of Calis treatment and then recovered slightly after two months of discontinuation so I would say that this is a win-win your weight goes up your body mass index goes up your fat-free Mass goes up but your weight circumference and body fat percentage comes down isn't that great at a low dose of sealas of 5 milligrams daily for 2 months consecutive ly very very very promising results and you see here that total testosterone levels went down slightly could be due to an upregulation of the Androgen receptor which we'll get into um but total estrogen levels had a significant reduction which is repeated in many other studies looking at total testosterone free testosterone and Ester levels during a talal treatment so here it went from an average of 35 pigr per milliliter to let's say 21 p per milliter that's a steep reduction and it came back to Baseline two months after discontinuation of the tadalfil treatment um so I would say that that's a very good way to control serum eser D levels going forward and none of these results are repeated in the 20 milligrams on demand groups right here you see that uh a baseline compared to two months treatment of two months withdrawal everything is pretty much the same and there's no steep reduction in serum Ester levels so load those every single day for longer periods of time that's the way to go based on this study and in the invitro study of this publication Androgen receptor messenger RNA content was significantly increased at the higher concentrations of the calist treated cells but the levels were highest around the 24-hour Mark and fell down to Baseline at the 24-hour Mark after adding Calis to these cells so again that insinuates that you would need to dose sealas basically every day if you want want to have somewhat reduction in body fat levels and waste circumference while keeping Androgen receptor content of skeletal muscle somewhat ulated very interesting results and this might explain why libido in some individuals also goes up when they start supplementing with tadil right by changing the ratio between total and free testosterone and estr right skewing this ratio having more testosterone relatively to your estrogen and as estrogen comes down shbg might also drop even though this study showed that there was no real changes in shbg levels amongst the different groups the other studies did show that shbg levels declined slightly so free testosterone comes up estral comes down and that is a needle mover for you to have better lito including this increased blood flow to the penis and maybe you even get additional anabolism by up ulating Androgen receptor content in skeletal muscle you feel better you look better but you also perform a lot better whether that's in the gym or in the bedroom win win so besides the increased blood flow that most bodybuilders experience when they dose 5 milligrams 10 milligrams or even 20 milligrams to dofil pre-workout The increased pump might also come from the Improvement in insulin sensitivity the absorption of glucose and this U regulation of Androgen receptor content and if this effect is acute and seala starts to work within 30 minutes and oral steroids when you take them sublingually starts to work within well let's let's say 30 minutes as well maybe even sooner so it makes logical sense to stack your tadalfil with oral steroids whether that's anavar Anadrol or whatever oral steroid you prefer take that all sublingually for the maximum and super fast effects systemically of course the increase blood flow to the skeletal muscle that you're going to train enhances the pump locally and then consider taking some intw workouts with essential amino acids and hyber cyclic dextrin to take that pump to the next level and while there's a good amount of studies that show that Exercise capacity in patients suffering from pulmonary hypertension is quite significantly increased during T downi treatment when these studies are repeated in athletes the results are a little bit lackluster I would say both talil and selenop have been investigated as possible performance anancy drugs that should be included in the world anti-doping agency prohibited list as there are some clear indications that pd5 Inhibitors attenuate symptoms of hypox improve overall glucose metabolism and glucose homeostasis in the bloodstream alter the post exercise hormonal balance potentially improving overall endurance and stamina in athletes but unfortunately all of these studies are high dose with single Administration studies not lowd dose long-term Administration studies and I would say that the latter goes a very long way especially in the context of improving one's pump as many bodybuilders and other Fitness and duas can ATT test to when they dose a very low dose of 5 milligrams 10 milligram or 20 milligrams to dofil pre-workout and this last study is a great read in case you're interested in a full meta analysis of all the studies performed up until 2017 regarding to dail's beneficial effect as a performance- enhancing drug performed by du Luigi at all published on November December 2017 titled phoso dester type 5 Inhibitors Sports and doping in the study probably the most comprehensive literature review on the ifs and how to DL might offer performance-enhancing effects in human athletes in the conclusion the researchers note that the dofil should be added to the wider prohibit list as there are clear signs that the dofil improves performance in athletes so um what more incentive do you need to use this compound however to this day the scientific evidence isn't very substantial and thus the DL orsel Dil for that matter hasn't been added to the prohib at list yet and it isn't even on the monitoring program even though some of the uh Russian made compounds like hypoxen for example are included in the monitoring program and M dronet has now been added so um use it while you can I would say and that finally brings us to the dosing protocols for men I would say that the sustainable and tolerable dose of the dalail better known as Calis is between 2.5 to 10 milligram Orly 30 to 60 Minutes pre-workouts take that sublingually 20 minutes pre-workout if you like to go that route in combination with oral steroids and a vable Anadrol for example or you can take it upon waking on rest days again it has a very long halflife 17.5 hours and since um it will stay active in overlap it's better to start with a low dose and continue to use that for about two weeks so you don't experience the flushing or dizziness when blood pressure drops too much I would say that the deleterious dose and it's a little bit of an overstatement again there's a lot of safety and efficacy data in the clinical trials which we're not going to highlight because everybody is well aware of the commonly occurring side effects so the delary is those where side effects start to occur is between 10 to 20 milligrams early 30 to 60 Minutes pre-workout but skipping this on rest day so that would mean four times or five times if you work out that many times um during the week right that's a little bit higher than they would recommend in the medical insert but you're probably taking more testosterone than what's recommended in the medical insert as well for women I would say that the sustainable and tolerable dose to enhance one's pump in the gym is 2.5 to 5 milligrams Orly 30 to 60 Minutes pre workout or upon waking on rest days the dosage is a little bit lower because generally speaking women are less heavy than men and the deleterious dose where side effects start to occur is 5 to 10 milligrams Orly 30 to 60 Minutes pre-workout and skipping this on rest day so that will be between four to five administrations per week so that's pretty similar to what they would recommend in the medical insert I would say that 5 to 10 migrs is my sweet spot range as a pre-workout I haven't taken Calis in a very long time because the acid reflex sometimes still occurs even though I have all of the tools in my toolbx to prevent acid reflux with various over the counter supplements and dietary practices sometimes I still get the acid reflux and then during the workout I feel very very very uncomfortable and I might have to spit some additional saliva in the well in the garbage bin so um I haven't taken sealas in a very long time but now after doing all of this uh medical research I might have to replace my telmer startan for sealas on certain days when I want that mega mega pump in the gym and later in the bedroom as well thank you guys so much for watching you can find everything that I'm associated with Down Below in the YouTube description section if you want to do your bloodwork go over to am Health if you live in the United States they can help you analyze your blood work results they have excellent Healthcare Prov iders who can guide you through the process to get super super healthy and if you qualify for trt they should be able to help you with that as well gorilla mind has excellent pre-workouts in case you want to combine nitrites with Calis and take that pump to the absolute phenomenal Next Level I took a gill mode Nitric with 10 milligram Calis many eight times yes double scooped with 10 migam Calis many eight times um I didn't die luckily my blood pressure was in range but I also supplement with plenty of sodium before I go to the gym to sustain blood volume and guess what my arteries were the width of garden hoses okay I'll leave it here thank you guys so much for watching um follow me on Instagram and Tik Tok at Viger Steve Viger crew you guys know what to do and no seis front Bas for you guys but the pump and the fullness man I might as well have been on Calis maybe I did take some Calis no I didn't take any seals but maybe the next video I will take some all right thank you guys and I'll see you in the next one around Ling Steve out