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Home » Mostly Wise #1 – Matt McCusker, Andrew Huberman & Tom Segura (Transcript)

Mostly Wise #1 – Matt McCusker, Andrew Huberman & Tom Segura (Transcript)

Editor’s Note: In the debut episode of Mostly Wise, host Chris Williamson brings together a powerhouse panel featuring comedian Matt McCusker, neurobiologist Dr. Andrew Huberman, and comedian Tom Segura. Over the course of a nearly three-hour conversation, the guests dive into a wildly entertaining mix of health optimizations, brain science, and hilarious personal stories. From the benefits of prostate health protocols to the subjective nature of comedy, this episode perfectly balances deep, insightful science with unfiltered humor. 

Tadalafil, Morning Routines, and Weight Loss

CHRIS WILLIAMSON: I keep seeing tweets about how everyone should be taking erectile dysfunction medication. Is that true?

MATT MCCUSKER: Low-grade, whatever. Yeah.

DR. ANDREW HUBERMAN: The low-grade tadalafil, which is the generic name for Cialis, was developed first as a prostate health drug, and then people took more of it and realized that at higher dosages it can be effective for erectile dysfunction.

TOM SEGURA: But low dose is good for prostate health.

DR. ANDREW HUBERMAN: Low dose, like 2.5 to 5 milligrams per day, is very helpful for perfusion of the prostate and also it causes vasodilation in the brain. So things like strokes, I mean, you want blood flow, right? You don’t want excessive blood flow where you’ve got a headache from it. But our chair of male sexual health and urology at Stanford, Mike Eisenberg, he came on the podcast and he said pretty much every male over 40 or so should be taking about 2.5 to 5 milligrams per day.

MATT MCCUSKER: Does it still get you pretty hard too?

DR. ANDREW HUBERMAN: It definitely will improve.

MATT MCCUSKER: Just curious.

DR. ANDREW HUBERMAN: It will definitely notch up erectile strength. But unlike some health people out there, I’m not using the calipers to measure the strength. I ask someone else to measure and she tells me that, it’s all good.

MATT MCCUSKER: I know what you mean.

TOM SEGURA: Yeah.

MATT MCCUSKER: She’s telling her to close her hand. Close her hand if you can.

DR. ANDREW HUBERMAN: Well, no, I’ve never actually subjected to the grip test. I don’t want to tempt anybody, but in all seriousness, the drug that was developed for vasodilation, which is now used for erectile dysfunction, it really was developed first as a prostate health drug. And a lot of sitting — the prostate’s weird too, because it doesn’t get a lot of blood flow compared to other tissues.

CHRIS WILLIAMSON: Speak for yourself.

DR. ANDREW HUBERMAN: Same immune system. Yeah.

MATT MCCUSKER: Well, what if you sit with the plug in?

DR. ANDREW HUBERMAN: We’re here kegeling all day. So Chris had to pull up to this little piece of tape so we didn’t catch a kegel. Kegeling, kegeling.

CHRIS WILLIAMSON: I kind of feel like it could just be a psyop to normalize erectile dysfunction medication by dudes that have got erectile dysfunction. Like by doing that, every man should be taking it, so that nobody is then on the outside.

DR. ANDREW HUBERMAN: Hmm.

CHRIS WILLIAMSON: It’s fair.

TOM SEGURA: I take it — it’s like 5 to 6 milligrams in the morning.

DR. ANDREW HUBERMAN: You do it in the morning?

TOM SEGURA: Yeah. Every morning.

CHRIS WILLIAMSON: There you go. What’s a little trochee? What’s a little mint? Is that half?

DR. ANDREW HUBERMAN: What’s like a — I don’t know. I mean, you can get like a — is that a full one?

CHRIS WILLIAMSON: Is that a full one or a half one?

TOM SEGURA: Of what?

CHRIS WILLIAMSON: The tadalafil?

TOM SEGURA: Well, it depends on the prescription that you’re given, right?

CHRIS WILLIAMSON: Yeah.

TOM SEGURA: So the 6 milligram thing is supposed to be for prostate health. But if you were to get 25, 50, obviously that’s like massive blood flow and you’re going to take note and it can draw blood.

CHRIS WILLIAMSON: Strong gust of wind.

MATT MCCUSKER: Yeah.

DR. ANDREW HUBERMAN: And it can disrupt, you know, lower blood pressure slightly and things like that. Because you gain vasodilation, so all the pipes are getting a little bigger. But let’s all take one right now and see how the broadcast —

CHRIS WILLIAMSON: Whoever gets the erection last wins.

TOM SEGURA: Yeah, I have a strong mind.

DR. ANDREW HUBERMAN: This is not the podcast I signed up for. But to your point, it probably does feel safer for guys to call up their doctor and go, “Hey, I heard this podcast. I heard some MD, PhD from Stanford — not me, but Mike Eisenberg — said that I should be getting better perfusion in my prostate and I should take 2.5 to 5 milligrams of tadalafil.” And there they just avoided all the statements about Cialis, ED, and so on. And then they call another doctor and get a duplicate prescription and now they’re taking double. You can assume that some of that happens, but it’s also cost like pennies. It’s generic now. The patent is out.

The Discovery of Viagra

CHRIS WILLIAMSON: Do you know the story about how Viagra was found?

DR. ANDREW HUBERMAN: I only know that it was very quick to market. It’s one of these remarkable discovery-to-market stories, and that just tells you how badly certain people want it on market and to use it.

CHRIS WILLIAMSON: The story was that they were trying to do something — I think it was for angina, it was more heart stuff. And they found that typically when a medical trial’s finished and they ask people to give the medication back, people don’t have any issue doing it. And no one wanted to give the medication back.

DR. ANDREW HUBERMAN: Like, no.

TOM SEGURA: Oh, this is —

CHRIS WILLIAMSON: And then they also noticed when the nurses were going in to do the checkups on the people during the trial, that the guys were sitting weird. They were all sitting cross-legged to cover themselves up.

DR.