Does NAD+ Increase Testosterone Levels?

Understanding the complex relationship between cellular health, hormones and longevity is key to optimising wellbeing. In this article, we explore whether NAD+ supplementation has an impact on testosterone levels, a question that is increasingly relevant to men seeking natural ways to support energy, vitality and healthy ageing.

The insights provided in this article are by Vivere's Head of Nutrition, Yusra Serdaroglu Aydin, a registered dietitian with a background in nutrition, food engineering and culinary arts. Her approach is grounded in science and shaped by a strong understanding of personalised nutrition and the human microbiome.

• NAD+ plays a central role in energy production, DNA repair and cellular resilience, which may indirectly support healthy hormone regulation.

• Current research does not confirm a direct increase in testosterone levels from NAD+ supplementation, but studies highlight promising indirect links.

• Lifestyle factors such as diet, sleep, stress management and microbiome health are crucial in maintaining both NAD+ levels and testosterone balance.

• While NAD+ is not a replacement for testosterone therapy, it can be safely combined with hormone replacement therapy (HRT) or testosterone treatments.

• NAD+ may support sexual health by helping to address erectile dysfunction, low libido and overall reproductive health.

Nicotinamide adenine dinucleotide (NAD+) is a molecule found in every cell of the human body. It is essential for turning nutrients into energy and supporting critical processes like DNA repair, inflammation control and cell survival. NAD+ levels naturally decline with age, which has been linked to fatigue, reduced resilience and impaired metabolic health [1].

Because NAD+ supports the proper function of mitochondria, the powerhouses of the cell, its role in ageing and longevity has gained significant attention. Declining NAD+ levels may contribute to age-related conditions, including reduced hormonal balance, which makes the question of its effect on testosterone and men’s health particularly relevant [2].

Testosterone regulates muscle mass, bone density, mood, sexual function and overall energy. For men, testosterone plays a central role in reproductive health, sperm quality and fertility [3]. Men often experience a decline in testosterone after the age of 40, referred to as andropause, which can lead to reduced vitality, decreased libido and performance, fatigue and changes in body composition [4].

Maintaining healthy testosterone levels depends on a range of factors including diet, sleep quality, stress regulation, physical activity and underlying health conditions. Because both NAD+ and testosterone are deeply linked to cellular health and men’s hormones, researchers are exploring potential interactions between them.

At present, scientific evidence does not establish a direct causal link between NAD+ supplementation and a measurable rise in testosterone levels. Most clinical studies on NAD+ focus on energy metabolism, DNA repair, inflammation and age-related decline, rather than hormones.

However, there are promising mechanisms to consider that NAD+ supports:

• Mitochondrial function, which influences hormone production in the testes and adrenal glands [5].

• Sirtuin activation, a family of proteins linked to ageing and metabolic regulation, which may support hormonal balance [6].

• Reducing oxidative stress, a known factor in impaired testosterone production [7].

These pathways suggest that optimising NAD+ could support the environment in which healthy testosterone levels are maintained, even if the molecule itself does not directly boost hormone production.

NAD+ therapy can be taken alongside other treatments, including hormone replacement therapy (HRT) and testosterone supplementation. This combination may provide additional support for men’s health, particularly when addressing symptoms of low energy, reduced recovery or declining sexual health. As always, professional medical guidance is recommended before starting combined therapies.

Through its role in regulating hormone levels, NAD+ may help lessen symptoms of erectile dysfunction and low libido. It also supports vascular health and helps decrease inflammation, which can reduce pain or discomfort during sexual activity [8]. While more human studies are needed, these findings highlight the potential of NAD+ as part of a broader strategy for improving sexual health.

The most effective strategy for supporting testosterone is not found in supplements alone but in a holistic lifestyle that nurtures cellular and hormonal health together.

• Diet: A nutrient-rich diet that includes lean protein, healthy fats, colourful vegetables and polyphenol-rich foods supports hormone production and protects cells. Foods such as oily fish, nuts, seeds and olive oil can provide building blocks for testosterone [9].

• Sleep: Restorative sleep is critical for both testosterone synthesis and NAD+ replenishment. Poor sleep is linked to reduced hormone production and faster cellular decline [10].

• Exercise: Strength training and high-intensity activity are particularly effective at boosting testosterone. Exercise also improves mitochondrial function, which relies on NAD+ [11].

• Stress management: Chronic stress raises cortisol, which can suppress testosterone and drain cellular energy. Practices such as meditation, deep breathing and nature exposure help maintain balance [12].

• Gut microbiome health: An often-overlooked factor, the microbiome plays a role in nutrient absorption, fertility, sperm quality and hormone regulation. Supporting gut health through fibre-rich foods, probiotics and balanced nutrition helps sustain both NAD+ and testosterone levels [13].

NAD+ supplementation may be most relevant for people over 30, when natural levels begin to decline more significantly [14]. Those experiencing fatigue, reduced recovery, brain fog or signs of accelerated ageing may also consider NAD+ support as part of a broader health strategy.

For men, NAD+ may contribute to better hormone balance, improved reproductive health, greater sperm quality and enhanced sexual health [2]. Individuals interested in hormone balance should view NAD+ support as one piece of a bigger puzzle. Testosterone health requires attention to diet, lifestyle, body composition and personalised needs. Consulting a healthcare professional before starting supplements is always recommended, especially if there are underlying conditions or prescribed medications.

While current evidence does not show that NAD+ directly increases testosterone, it plays a vital role in supporting the systems that influence hormone balance. Through different metabolisms, NAD+ may help create the right conditions for healthy testosterone levels. A balanced lifestyle that integrates good nutrition, restorative sleep, regular activity and microbiome support remains the most reliable foundation for men’s health, sexual health and longevity.

Vivere helps you take control of your health with personalised insights from state-of-the-art gut testing, nutritional guidance, science-backed supplements (including NAD+ injections) and expert support. Sign up today and start living better, for longer.

[1] NAD+ metabolism and its roles in cellular processes during ageing - PMC

[2] Current Insights & a Potential Role of NAD in the Reproductive Health of Aging Fathers and Their Children - PMC

[3] Benefits of Testosterone Hormone in the Human Body: A Systematic Review - PMC

[4] Male Andropause : A Myth or Reality - PMC

[5] The role of NAD+ metabolism and its modulation of mitochondria in aging and disease - PMC

[6] Sirtuins as regulators of metabolism and healthspan - PMC

[7] The Impact of Oxidative Stress on Testicular Function and the Role of Antioxidants in Improving it: A Review - PMC

[8] NAD+ and Vascular Dysfunction: From Mechanisms to Therapeutic Opportunities - PMC

[9] Manipulation of Dietary Intake on Changes in Circulating Testosterone Concentrations - PMC

[10] The relationship between sleep disorders and testosterone in men - PMC

[11] Various Factors May Modulate the Effect of Exercise on Testosterone Levels in Men - PMC

[12] Chronic stress inhibits testosterone synthesis in Leydig cells through mitochondrial damage via Atp5a1 - PMC

[13] Gut microbiota is involved in male reproductive function: a review - PMC

[14] Age-Dependent Decline of NAD+—Universal Truth or Confounded Consensus? - MDPI