Take the assessment
45-min intake with your dedicated health coach. A free health-score quiz is available before the paid intake.
How it works
Marek's Guided Optimization® Program combines advanced lab testing, a dedicated health coach and medical provider, and a personalized treatment plan, all built around your data.
Resources
The process
1
Start your assessment
Complete your 45-min intake assessment
2
Get your labs drawn
4,000 partnered lab locations nationwide
3
Review with your coach
Screen-by-screen lab review
4
Receive your protocol
Treatment delivered to your door
Why Marek
The only program pairing you with a dedicated health coach and medical provider, built on precision diagnostics, with no subscription required.
Resources
Meet our co-founder
Derek
Co-Founder · MPMD Podcast
"Over time, I found it incredibly difficult to get medical oversight for myself and my family that reflected the latest research, and that was preventative. That's why I started Marek Health."
Excellent on Trustpilot
What we test
Every client's lab panel is hand-selected from 1,000+ available biomarkers, built around their specific goals.
Panel categories
Resources
Treatments
700+ medical provider-prescribed therapies built from your labs. Browse by category or explore the full formulary.
TadalafilTadalafil
Long-acting PDE5 inhibitor with 17.5-hour half-life enabling daily dosing for continuous erectile function support. Beyond ED, demonstrates cardiovascular, endothelial, and pulmonary vascular benefits making it increasingly relevant in longevity medicine.
HSA/FSA eligible · No commitmentHSA/FSA eligible · No commitment
Sexual Health · PDE5
Marketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
Marketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
How it works
From sign-up to treatment.From sign-up to your first dose.
Get your labs drawn
Complete lab panel ordered by your provider, drawn at any of 4,000 partnered lab locations nationwide. Results typically return within 14 days.
Provider reviews your results
A licensed medical provider reviews your labs and history to evaluate whether Tadalafil is appropriate for you. Eligibility and any prescription are determined at the provider's discretion.
If eligible, treatment ships to your door
If your provider prescribes Tadalafil, it ships from a licensed pharmacy. Your coach supports you through follow-up labs and ongoing monitoring.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
The science
How Tadalafil works.
Selectively inhibits PDE5, preventing cGMP degradation in vascular smooth muscle. Increased cGMP causes NO-mediated vasodilation in penile corpus cavernosum, pulmonary vasculature, and systemic endothelium. Daily dosing provides continuous endothelial NO support.
Erectile dysfunctionBPH/LUTSPulmonary arterial hypertension (Adcirca)Raynaud's phenomenonEndothelial function optimization
Eligibility, dosing, and outcomes vary. Any prescription is at the discretion of a partnered licensed medical provider based on your labs and medical history.
Clinical evidence
The research behind Tadalafil.
Daily Tadalafil for BPH: Phase III
Journal of Urology (2012)
5mg daily significantly improved IPSS and IIEF scores vs placebo in men with BPH and ED.
PDE5 Inhibitors and Cardiovascular Outcomes
BMJ (2021)
Meta-analysis found PDE5 inhibitor use associated with 39% reduction in all-cause mortality and 36% reduction in cardiovascular events in men with T2DM.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Headache
- Dyspepsia
- Back pain
- Myalgia
- Nasal congestion
- Flushing
Less common but serious risks
- Hypotension with nitrates (contraindicated)
- Priapism (rare)
- NAION, non-arteritic anterior ischemic optic neuropathy (very rare)
- Hearing loss (very rare)
Generally not appropriate for
- Concurrent nitrate therapy (absolute)
- Alpha-blockers (caution, hypotension)
- Severe hepatic impairment
- Recent stroke or MI
Typical monitoring
- Blood pressure
- Erectile function (IIEF scores)
- Visual/hearing symptoms
- Prostate symptom scores (IPSS)
FAQ
Quick answers.
Long-acting PDE5 inhibitor with 17.5-hour half-life enabling daily dosing for continuous erectile function support. Beyond ED, demonstrates cardiovascular, endothelial, and pulmonary vascular benefits making it increasingly relevant in longevity medicine.
Long half-life enables daily low-dose use. Improves erectile function and spontaneity. BPH symptom improvement. Endothelial and cardiovascular protective effects. Blood pressure reduction (~3 to 5 mmHg).
Common side effects include: headache, dyspepsia, back pain, myalgia, nasal congestion, flushing. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
Long-acting PDE5 inhibitor with 17.5-hour half-life enabling daily dosing for continuous erectile function support. Beyond ED, demonstrates cardiovascular, endothelial, and pulmonary vascular benefits making it increasingly relevant in longevity medicine.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.