Does NAD+ increase testosterone? Right now, there’s no evidence from human clinical trials showing that it does. No published clinical trial has shown that NAD+ or its precursors raise testosterone in people. The research that exists comes from animal models, and almost all of it involves restoring testosterone that something else had suppressed rather than raising it in healthy subjects.
NAD+ and Testosterone: Key Takeaways
- There’s no human clinical evidence showing that NAD+ increases testosterone. Research hasn’t established NAD+ or NAD+ precursors as a way to raise testosterone levels in people.
- Animal research is more promising, but it has important limitations. Studies in mice have found that NMN can help restore testosterone levels after certain types of injury or metabolic dysfunction. That doesn’t mean it will boost testosterone in otherwise healthy people.
- There is a biological connection worth studying. Testosterone production depends in part on healthy cellular and mitochondrial function, and NAD+ plays an important role in those processes. But a plausible biological mechanism isn’t the same as a demonstrated benefit in humans.
- Low testosterone requires proper testing. Testosterone levels can change with age and for many other reasons. Diagnosis is based on symptoms along with appropriately timed blood testing, not on whether you feel different after taking a supplement.
- NAD+ shouldn’t be viewed as a testosterone treatment. If you’re experiencing symptoms that could be related to low testosterone, talk with a healthcare provider who can evaluate what’s actually causing them.
Why Researchers Are Looking at NAD+ and Testosterone
NAD+ is a coenzyme your cells use for essential processes including energy production, mitochondrial function, and DNA repair. So what does that have to do with testosterone?
Testosterone production requires healthy, functioning cells in the testes, and those cells rely on mitochondria for energy. Because NAD+ plays an important role in mitochondrial function, researchers have questioned whether changes in NAD+ levels could also affect testosterone production.
That’s where the potential connection comes from, but so far, most of the evidence comes from animal research. A biological reason for NAD+ to influence testosterone doesn’t mean that taking an NAD+ precursor will raise testosterone levels in people.
It’s also worth separating the research from the marketing. In Canada, some NMN products are licensed as natural health products for general health and energy-metabolism claims. They are not licensed to increase testosterone or treat low testosterone.
How Testosterone Is Actually Produced
Understanding this makes the NAD+ hypothesis easier to evaluate.
Testosterone is made mainly in the Leydig cells of the testes. The pituitary gland releases luteinizing hormone, which signals Leydig cells to convert cholesterol into testosterone through a series of enzymatic steps. Several of those steps happen inside mitochondria.
That last detail is the whole basis for the NAD+ and testosterone idea. Making steroid hormones is partly a mitochondrial job, and mitochondria depend on NAD+. Research also shows that Leydig cell function deteriorates with normal aging, driven partly by oxidative stress, reduced mitochondrial function, and lower expression of the enzymes involved.
So the reasoning runs like this. NAD+ supports mitochondria and antioxidant defences. Leydig cells decline partly because those systems fail. Raising NAD+ might therefore help. That is why the question gets asked.
Does NAD+ Increase Testosterone? What the Evidence Shows
What Do Human Studies Show?
So far, no published human clinical trial has shown that NAD+ or NAD+ precursors such as NR or NMN increase testosterone.
One placebo-controlled trial gave 250 mg of NMN daily to healthy older men for 6 or 12 weeks and found it raised blood NAD+ and altered some measures of muscle function. Testosterone was not among the endpoints reported.
That’s an important distinction if you’re considering NAD+ specifically for hormone health. While there are biological reasons researchers are interested in the connection, we don’t currently have human evidence showing that NAD+ supplementation raises testosterone.
What Do Animal Studies Show?
This is where the NAD+ and testosterone connection gets more interesting, but also where context really matters.
Several studies in mice have found that NMN helped restore testosterone levels after the animals experienced conditions that damaged the testes or disrupted normal hormone production. These have included radiation exposure, heavy-metal exposure, diabetes, and interrupted blood flow to the testes.
In other words, these were largely recovery or protection experiments. Researchers were studying whether NMN could help protect damaged tissue or restore testosterone that had already been suppressed.
That’s very different from showing that NMN can boost testosterone above normal levels in a healthy person.
Animal research can help scientists understand how NAD+ may be involved in reproductive and hormonal health, but the results don’t automatically translate to humans. Until well-designed human trials specifically measure testosterone, NAD+ shouldn’t be considered a proven way to increase testosterone.
Understanding Low Testosterone and What Actually Helps
Both NAD+ and testosterone decline with age, so the correlation exists. Correlation across a whole population is weak evidence for a causal link in an individual, because dozens of things decline with age simultaneously.
It is also worth noting that the NAD+ decline itself is less well established in humans than marketing suggests. A 2025 review in Nature Metabolism concluded that consistent human evidence for an age-related NAD+ decline comes from a limited number of studies and is not uniform across tissues.
Factors That Contribute to Declining Testosterone
Beyond age, factors that may contribute to declining testosterone include:
- Excess body weight, which is one of the strongest modifiable factors
- Poor sleep and untreated sleep apnea
- Chronic illness and acute severe illness
- Certain medications, including opioids and glucocorticoids
- Very high training loads combined with inadequate energy intake
- Disorders of the testes, pituitary gland, or hypothalamus
Testosterone also varies substantially through the day, peaking in the morning and falling by evening, which is why timing matters when it is measured.
How Low Testosterone Is Diagnosed
Low testosterone isn’t diagnosed based on symptoms alone. Because testosterone levels naturally fluctuate, healthcare providers typically look at both your symptoms and the results of blood tests.
The Endocrine Society recommends confirming low testosterone with at least two early-morning blood tests taken on separate occasions. If your levels are consistently low and you’re experiencing symptoms associated with testosterone deficiency, your healthcare provider can determine whether further evaluation or treatment is appropriate.
Symptoms associated with low testosterone include reduced libido, erectile difficulty, fatigue, low mood, poor concentration, reduced physical performance, and disturbed sleep. Most of these are non-specific, meaning many other conditions cause them, which is exactly why measurement matters and self-diagnosis does not work.
The Endocrine Society also advises against population-level screening in men without symptoms, and recommends lifestyle change as a first step for functional hypogonadism, where weight loss and exercise can improve levels.
What Can Support Healthy Testosterone Levels?
NAD+ hasn’t been shown to increase testosterone in human clinical trials. If supporting healthy testosterone is your goal, it’s better to focus on factors with stronger evidence behind them.
Depending on your individual health, that may include maintaining a healthy weight, getting adequate sleep, treating conditions such as sleep apnea, resistance training, eating enough to support your activity level, and reviewing medications or underlying health conditions with your healthcare provider.
If testing shows that your testosterone is consistently low, your healthcare provider can investigate why and discuss appropriate treatment options.
Testosterone Testing and Support in Canada
If you’re experiencing symptoms that could be related to low testosterone, testing is a better starting point than experimenting with supplements.
MyRocky’s testosterone support connects Canadians with licensed clinicians who can assess your symptoms and determine whether testing or treatment may be appropriate. If weight management is also part of your health goals, our body optimization and weight management program provides access to clinician-guided support.
You can also explore more topics related to testosterone, sexual health, and men’s health in our sexual health articles.
When to Speak with a Healthcare Provider
Book an assessment with your healthcare provider if you experience:
- Persistently low libido, erectile difficulty, or reduced morning erections
- Fatigue that does not improve with adequate sleep
- Loss of muscle mass or strength that you cannot explain
- Low mood, irritability, or difficulty concentrating that has changed over time
- Any of the above alongside a known condition or medication that can lower testosterone
Speak with a clinician before starting NAD+ if you take prescription medication, have kidney or liver disease, or are already on testosterone therapy.
Frequently Asked Questions
Does NAD+ Help With Low Testosterone?
There’s currently no human evidence showing that NAD+ increases testosterone or treats low testosterone. Animal studies have found that NMN can help restore testosterone after certain types of testicular damage, but that’s very different from treating low testosterone in people.
Can NAD+ Increase Testosterone Levels in Men?
We don’t know yet. Human trials of NAD+ precursors have looked at outcomes such as NAD+ levels, cardiovascular health, insulin sensitivity, and muscle function, but they haven’t established increased testosterone as a benefit.
Can You Take NAD+ With Testosterone Replacement Therapy?
NAD+ and testosterone replacement therapy haven’t been specifically studied together, so we don’t know whether combining them provides additional benefits or changes their safety or effectiveness. If you’re receiving testosterone therapy, talk with your healthcare provider before adding NAD+ or another supplement.
What Is the Connection Between NAD+ and Testosterone?
The potential connection comes down largely to cellular energy and mitochondrial function. Testosterone-producing cells rely on healthy mitochondria, and NAD+ plays an important role in mitochondrial function. Animal research suggests NAD+ may help protect testosterone production when these cells are damaged, but this hasn’t been demonstrated in humans.
Concerned About Low Testosterone? Start With Testing
NAD+ and testosterone are an interesting area of research, but right now, there’s no human clinical evidence showing that NAD+ supplementation increases testosterone.
If you’re experiencing symptoms that could be related to low testosterone, proper testing and clinical evaluation are much more useful than experimenting with a supplement. A healthcare provider can determine whether your testosterone is actually low, investigate potential causes, and discuss treatment options when appropriate.
Concerned about your testosterone levels? Connect with a licensed MyRocky clinician who can review your symptoms and advise you on next steps.
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References
- Wang Y, Chen F, Ye L, et al. “Steroidogenesis in Leydig Cells: Effects of Aging and Environmental Factors.” Reproduction. 2017;154(4):R111–R122.
- Health Canada. “Licensed Natural Health Products Database: Nicotinamide Mononucleotide, NPN 80121612.” Licensed Natural Health Products Database.
- Igarashi M, Nakagawa-Nagahama Y, Miura M, et al. “Chronic Nicotinamide Mononucleotide Supplementation Elevates Blood Nicotinamide Adenine Dinucleotide Levels and Alters Muscle Function in Healthy Older Men.” npj Aging. 2022.
- Bhasin S, Brito JP, Cunningham GR, et al. “Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline.” The Journal of Clinical Endocrinology & Metabolism. 2018;103(5):1715–1744.
Disclaimer: This article is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider with any questions about a medical condition or treatment.
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