A Prescription Pre-Workout?! The Maximus Blood Flow Protocol by Dr. Cameron Sepah | Episode #124

After a 50+ episode hiatus, Maximus founder and CEO Dr. Cameron Sepah is back on the PricePlow Podcast for the first of two new episodes to give us the update on what’s going on in the pharmaceutical world of performance enhancement.

Dr. Cameron Sepah: The Maximus Blood Flow Protocol on PricePlow Podcast Episode #124

Dr. Cameron Sepah of Maximus re-joins the PricePlow Podcast for Episode #124 to talk about their Blood Flow Protocol, a “prescription pre-workout” with Tadalafil and Vardenafil, two synergistic drugs to massively increase blood flow beyond what dietary supplements can ever do.

For Episode #124, we talk about the Maximus Blood Flow Protocol, which is a potent synergistic combination of Tadalafil and Vardenafil to boost blood flow in ways that dietary supplement formulators could only dream of.

Dr. Cam was previously on episode #062, where he introduced Maximus and talked all things testosterone, and episode #070, where he introduced us to the science behind tadalafil. The “Maximus Lover Protocol” discussed in #070 has been upgraded to the Blood Flow Protocol that’s discussed today, however, which is why he’s back to talk about the reformulation.

We joke that this is a “prescription pre-workout”, and while that phrase can be used, but the science is showing that there’s a lot of data supporting cardiovascular improvements and potential longevity plays with the drugs used in this protocol.

You can listen to it below on your platform of choice, or watch the YouTube video beneath that:

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https://blog.priceplow.com/podcast/dr-cameron-sepah-maximus-blood-flow-protocol-124

Video: Dr. Cameron Sepah Combines Two Drugs for a “Prescription Pre-Workout”

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The Maximus Blood Flow Protocol: Show Notes with Dr. Cameron Sepah

  • 0:00 – Re-Introductions

    In Episode #124 of the PricePlow Podcast, Dr. Cameron Sepah returns to discuss the evolution of what was initially introduced as the “Maximus Lover Protocol” in episode #070 into the world’s first “prescription pre-workout”, now focused on blood flow and performance enhancement.

    Maximus Blood Flow Protocol

    Dr. Sepah explains how bodybuilders have used drugs like Viagra or Cialis off-label to enhance workouts, sexual, and cognitive functions.

    The conversation highlights a shift from the previous use of Tadalafil and PT-141, the latter of which was aimed at boosting libido, to a new formulation that includes Tadalafil (commonly sold as Cialis) and Vardenafil (commonly sold as Levitra) for an improved synergistic effect on blood flow.

    This reformulation is part of the company’s R&D efforts to better satisfy client needs for enhanced gym performance, leading to its rebranding as the Maximus Blood Flow Protocol.

    Tadalafil and vardenafil are both members of a class of drugs known as PDE5 inhibitors, which inhibit an enzyme named cyclic guanosine monophosphate-specific phosphodiesterase type 5 (PDE5), leading to greatly increased blood flow.[1]

  • 3:15 – The Maximus Blood Flow Protocol

    Dr. Sepah discusses the Blood Flow Protocol, detailing a sublingual tablet combining Vardenafil and Tadalafil for enhanced workout performance. This formulation offers the advantage of rapid onset, with Vardenafil peaking in plasma concentration within about 36 minutes, contrasting with Tadalafil’s slower peak but longer half-life, providing all-day benefits. This dual-action approach caters to both immediate workout enhancement and longer-term effects, such as improved sexual function.

    Dr. Cameron Sepah Maximus PricePlow Podcast

    In Episode #062 of the PricePlow Podcast, we meet Dr. Cameron Sepah, founder of Maximus, who’s here to help you boost testosterone in a clinically-meaningful way without TRT. Prepare to learn a ton about enclomiphene in this episode!

    Sepah emphasizes the scientific basis for using these PDE5 inhibitors, highlighting their vasodilatory effects that increase blood flow to muscles without the risk of unintended erections unless stimulated. The discussion also covers how these inhibitors can delay muscle fatigue, enhance muscular endurance, and potentially double muscle protein synthesis,[2] similar to the effects of injectable testosterone, but with fewer side effects due to the lower doses required, especially with Vardenafil’s potency. There’s even evidence of reduced cognitive decline.[3]

  • 13:00 – Enhancing overall circulation with Tadalafil and Vardenafil

    Dr. Sepah addresses the misconception that increased blood flow to muscles might reduce flow elsewhere, clarifying that PDE-5 inhibitors enhance overall circulation, including to the brain, without detracting from other areas. Sepah discusses research indicating improved cognitive performance and a possible reduction in Alzheimer’s risk due to enhanced cerebral blood flow.

    Additionally, he critiques the overuse of caffeine for its vasoconstrictive effects, contrasting it with the vasodilatory, non-stimulatory nature of PDE-5 inhibitors which offer advantages like reduced blood pressure and potential cardio protection. Sepah argues for the broader health benefits of PDE-5 inhibitors, including prostate health and enhanced sexual function, suggesting these could play a role in improving overall quality of life and health span without the side effects associated with stimulants like caffeine.

    Why tadalafil over sildenafil (commonly sold as Viagra)? Because tadalafil has a longer half-life (17.5 hours vs. ~4 hours).[4] Additionally, food doesn’t affect the absorption of tadalafil, but it does for sildenafil.[5] This provides far more flexibility.

  • 19:30 – Performance benefits and consistency

    Male Function Reporting

    Due to an onslaught of endocrine-disruptions, men’s hormonal systems aren’t working like they used to. Maximus has a three-pronged solution called the Testosterone Protocol. Image courtesy Maximus.

    Ben highlights the lifestyle and health benefits of using low doses of Tadalafil for prostate health and blood pressure management, complementing its efficacy as a pre-workout supplement for enhanced gym performance. Cam supports this view, emphasizing the importance of minimal effective dosing over high doses, which can have detrimental effects. He explains the combination of Tadalafil and Vardenafil in low doses not only boosts gym performance but also provides cognitive and sexual benefits.

    Cam advises daily intake, regardless of workout frequency, to maintain steady serum levels for consistent benefits and enhance recovery, even on rest days. This approach is contrasted with traditional ED medication usage, which is typically on an as-needed basis, illustrating the broader health and recovery advantages of consistent, low-dose PDE-5 inhibitor use.

    Interestingly, a double-blind, placebo-controlled randomized study found that men taking Cialis had higher testosterone levels after exercise compared to placebo![6] Another study that non-obese men with mild ED given tadalafil had increased abdominal muscle mass, likely due to its supportive effects on insulin secretion, estrogen levels, and of course endothelial function.[7]

  • 25:30 – Aspirin Synergy

    Dr. Cam clarifies that while baby aspirin is not part of their protocol due to its minimal risk reduction in heart attacks and its blood-thinning effects, it can synergize with PDE-5 inhibitors to potentially enhance erectile function. However, he doesn’t see it as a necessity for their regimen.

    Enclomiphene

    Enclomiphene: The Maximus Test-Boosting Drug that is a better alternative to TRT

    Addressing the combination of their prescription pre-workout with over-the-counter supplements, Dr. Sepah notes the safety of amino acids like L-citrulline for mild pump effects but cautions against combining nitrates with PDE-5 inhibitors due to the risk of excessive blood pressure drop.[8]

    He argues that the prescription blend offers sufficient potency without needing additional over-the-counter muscle pump enhancers. Cam advises against polypharmacy, recommending monitoring one’s blood pressure when stacking supplements and drugs to avoid hypotensive side effects and suggesting a more conservative approach to supplement use to assess individual effects and maintain health.

  • 32:00 – PDE-5 inhibitors in bodybuilding

    Ben and Cam discuss the use of Cialis among bodybuilders, particularly in untested federations, where it’s regularly included in their regimen not just for its blood pressure-lowering effects due to exogenous hormone use but also for the significant muscle pumps it provides. This practice has turned Cialis into a staple for many, allowing them to focus on other fitness aspects like hydration and nutrition without overemphasizing pump supplements.

    Cam acknowledges the bodybuilding community’s pioneering use of PDE-5 inhibitors for workout enhancement, crediting them for identifying the benefits long before scientific research caught up. He highlights the evolution of these drugs for better efficacy and fewer side effects, with bodybuilders now recognizing the synergistic effects of combining Tadalafil and Vardenafil for superior pumps and performance, emphasizing the importance of minimal effective dosing for optimal results.

  • 36:00 – Regulations, quality, and standards

    Maximus Blood Flow Protocol Dosage

    Maximus is a consumer telemedicine company that offers online doctor consultations and FDA-inspected pharmacy services, available in 46 states, excluding a few like Alaska and Alabama. Cam discusses the rigorous regulation in the pharmaceutical industry, ensuring precise dosages and purity of medications, contrasting with the less regulated supplement industry where quality and ingredient accuracy can vary significantly. He emphasizes the benefits of prescription-grade medications and supplements, like their prescription strength multivitamin, for their guaranteed potency and safety, highlighted by the example of pharmaceutical-grade omega-3s, which avoid the rancidity issues common in over-the-counter versions.

    The discussion touches on issues with supplement quality, citing specific examples where brands like Now Foods have pointed out inconsistencies in supplement ingredients (see our recent article on NOW Foods berberine testing). Cam advises careful selection of reputable brands to ensure product quality and safety, underlining the vast differences in regulatory standards and enforcement between pharmaceuticals and supplements.

    Additionally, Cam addresses the use of medications for BPH and nocturia, discussing the roles and effects of PDE5 inhibitors and 5 alpha-reductase inhibitors like finasteride, while cautioning against over-reliance on PSA levels as an indicator of prostate health.

  • 52:15 – Prostate issues and health markers

    The Blood Flow Protocol has shown anecdotal benefits in reducing nocturnal urination, a common issue related to prostate health. While the company doesn’t prescribe PDE5 inhibitors specifically for treating prostate or urinary issues, users have reported this as an ancillary benefit.[9] Cam emphasizes the importance of consulting with a healthcare provider for significant prostate or urinary problems to rule out underlying causes.

    Sexual Arousal Nitric Oxide Mechanism

    Cialis (tadalafil) inhibits PDE5, the enzyme that degrades cGMP to 5′-GMP, effectively increasing cGMP levels and amplifying the erectile response to nitric oxide.[10]

    A large 2019 meta-analysis analyzing 36 studies involving 2,999 participants showed that PDE5 inhibitors have a profound clinical benefit on a specific type of hypertension called pulmonary arterial hypertension (PAH).[11] They may also help with other types of hypertension as well, but it’s most pronounced with PAH.

    Additionally, Maximus has begun incorporating PSA testing as a safety measure in their new testosterone protocol, not due to a direct need but as a precaution to monitor any significant changes post-treatment. Cam also introduces a revolutionary, virtually painless FDA-approved blood collection device for home use, enhancing the convenience and accuracy of testing for their protocols, contrasting sharply with less reliable methods like dried blood spot or saliva tests. This device allows for the accurate measurement of a variety of health markers essential for Maximus’s personalized health protocols, including those for testosterone enhancement and weight loss, without the need for traditional lab visits.

  • 1:00:00 – Vitamin D

    Dr. Cameron Sepah: The Maximus Blood Flow Protocol on PricePlow Podcast Episode #124

    Maximus is adding vitamin D to their testing panel, highlighting its critical role due to widespread deficiencies, even among those with significant sun exposure. Cam shares his own experience of becoming vitamin D deficient after ceasing supplementation, underscoring the necessity of vitamin D (alongside vitamin K2 for optimal absorption) for immune function and potentially aiding testosterone levels when deficient.

    The podcast concludes with Cam inviting listeners to try the protocol for noticeable improvements in various health markers and introducing the Maximus community, emphasizing critical thinking and skepticism towards health information, even from credentialed professionals.

Where to Follow Dr. Cam:

Thanks for joining once again – get ready for the second part of this two-part series!

Until then, subscribe to the PricePlow Podcast on your favorite platform, and please leave us a great review!

Subscribe to the PricePlow Podcast on Your Favorite Service (RSS)

About the Author: Mike Roberto

Mike Roberto

Mike Roberto is a research scientist and water sports athlete who founded PricePlow. He is an n=1 diet experimenter with extensive experience in supplementation and dietary modification, whose personal expertise stems from several experiments done on himself while sharing lab tests.

Mike's goal is to bridge the gap between nutritional research scientists and non-academics who seek to better their health in a system that has catastrophically failed the public.

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References

  1. Andersson, K-E. “PDE5 Inhibitors – Pharmacology and Clinical Applications 20 Years after Sildenafil Discovery.” British Journal of Pharmacology, vol. 175, no. 13, 25 Apr. 2018, pp. 2554–2565, 10.1111/bph.14205; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6003652/
  2. Sheffield-Moore, Melinda, et al. “Sildenafil Increases Muscle Protein Synthesis and Reduces Muscle Fatigue.” Clinical and Translational Science, vol. 6, no. 6, 29 Oct. 2013, pp. 463–468, 10.1111/cts.12121; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076819/
  3. Sanders, Owen. “Sildenafil for the Treatment of Alzheimer’s Disease: A Systematic Review.” Journal of Alzheimer’s Disease Reports, vol. 4, no. 1, 22 Apr. 2020, pp. 91–106, 10.3233/adr-200166; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242821/
  4. Coward, Robert M, and Culley C Carson. “Tadalafil in the treatment of erectile dysfunction.” Therapeutics and clinical risk management vol. 4,6 (2008): 1315-30. doi:10.2147/tcrm.s3336; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643112/
  5. Forgue, S Thomas et al. “Tadalafil pharmacokinetics in healthy subjects.” British journal of clinical pharmacology vol. 61,3 (2006): 280-8. doi:10.1111/j.1365-2125.2005.02553.x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885023/
  6. Luigi Di Luigi, et al. “The Type 5 Phosphodiesterase Inhibitor Tadalafil Influences Salivary Cortisol, Testosterone, and Dehydroepiandrosterone Sulphate Responses to Maximal Exercise in Healthy Men.” The Journal of Clinical Endocrinology & Metabolism, vol. 93, no. 9, 1 Sept. 2008, pp. 3510–3514. doi: 10.1210/jc.2008-0847; https://academic.oup.com/jcem/article/93/9/3510/2597068
  7. Aversa, Antonio, et al. “Tadalafil Improves Lean Mass and Endothelial Function in Nonobese Men with Mild ED/LUTS: In Vivo and in Vitro Characterization.” Endocrine, vol. 56, no. 3, 30 Jan. 2017, pp. 639–648, doi:10.1007/s12020-016-1208-y; https://pubmed.ncbi.nlm.nih.gov/28133708/
  8. Kloner, Robert A, et al. “Time Course of the Interaction between Tadalafil and Nitrates.” Journal of the American College of Cardiology, vol. 42, no. 10, Nov. 2003, pp. 1855–1860, 10.1016/j.jacc.2003.09.023; https://www.sciencedirect.com/science/article/pii/S0735109703012932
  9. Peixoto, Christina Alves, and Fabiana Oliveira dos Santos Gomes. “The Role of Phosphodiesterase-5 Inhibitors in Prostatic Inflammation: A Review.” Journal of Inflammation, vol. 12, no. 1, 15 Sept. 2015, doi:10.1186/s12950-015-0099-7; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570643/
  10. Márton Oroszi, et al. “Microcirculatory Effects of Sildenafil in Experimental Testicular Torsion in Rats.” World Journal of Urology, vol. 36, no. 12, 21 May 2018, pp. 2081–2087, doi:10.1007/s00345-018-2340-5; https://www.researchgate.net/publication/325269416_Microcirculatory_effects_of_sildenafil_in_experimental_testicular_torsion_in_rats
  11. Barnes H, Brown Z, Burns A, Williams T. Phosphodiesterase 5 inhibitors for pulmonary hypertension. Cochrane Database Syst Rev. 2019 Jan 31;1(1):CD012621. doi: 10.1002/14651858.CD012621.pub2; https://pubmed.ncbi.nlm.nih.gov/30701543/

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