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Written By: Jeffrey Atlas, PA-C, Health Content Writer
Medically Reviewed By: Dr. Gopal Grandhige, MD, FACS, Board-Certified Surgeon
Last Reviewed: March 20, 2026
NAD+ (nicotinamide adenine dinucleotide) supports testosterone production by stimulating luteinizing hormone (LH) in the pituitary gland, which signals the testes to produce more testosterone. It also enhances how efficiently your body converts testosterone into its active form, dihydrotestosterone (DHT), making it a valuable addition to testosterone replacement therapy.
As men age, both NAD+ and testosterone levels naturally decline, contributing to fatigue, reduced muscle mass, decreased libido, and cognitive changes. Combining NAD+ therapy with TRT addresses these issues at the cellular level by supporting energy production, hormone regulation, and overall metabolic function.
At Formation in Tampa, Dr. Gopal Grandhige, a board-certified general surgeon, offers NAD+ and testosterone therapy using only human-grade medications from licensed compounding pharmacies. This ensures patients receive properly regulated treatments rather than research-grade products sold online that lack safety oversight. The clinic also provides access to a concierge dietitian to support hormone optimization through personalized nutrition guidance.
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in every living cell throughout the body. It plays an essential role in energy production, DNA repair, and supporting optimal cellular function. NAD+ serves as a catalyst in numerous metabolic processes, helping cells transform nutrients into energy the body can actually use.
As we get older, NAD+ levels naturally decrease. This decline can contribute to age-related health concerns, lower energy levels, and diminished cognitive function. By boosting NAD+ levels through targeted therapies, it becomes possible to address these effects and support improved overall health and wellness.
NAD+ plays a crucial role in converting testosterone into its active form, dihydrotestosterone (DHT). By increasing NAD+ levels, Tampa men can maximize the effectiveness of their testosterone replacement therapy, ensuring their bodies fully utilize supplemented hormones.
This enhanced testosterone utilization can lead to improved energy levels, better cognitive function, and an overall sense of well-being, amplifying the already significant benefits of TRT. Many men also pair hormone therapy with non-invasive neck and jawline treatments to address visible signs of aging alongside internal health improvements.
Testosterone and NAD+ work synergistically to boost cellular energy production. While testosterone helps increase muscle mass and strength, NAD+ ensures that cells have the necessary resources to power these gains.
By combining TRT with NAD+ therapy, Tampa men can experience a noticeable increase in energy levels, reduced fatigue, and improved athletic performance. This powerful combination helps combat the age-related decline in energy production, allowing men to maintain their vitality and active lifestyles well into their later years. For men interested in enhancing their physical appearance alongside hormone optimization, body contouring procedures can complement these internal improvements.
In addition to optimizing the utilization of supplemented testosterone, NAD+ can also support the body’s natural testosterone production. NAD+ stimulates the production of luteinizing hormone (LH) in the pituitary gland, which then signals the testes to produce more testosterone.
By promoting the body’s innate ability to create testosterone, NAD+ therapy can help men achieve a more balanced and sustainable hormone profile. This is particularly beneficial for those who may be hesitant to rely solely on external testosterone supplementation. Men seeking comprehensive care in the area can also visit our Tampa Heights location for consultations.
NAD+ supports the function of enzymes involved in hormone metabolism and regulation. These enzymes help maintain a delicate balance between various hormones, ensuring they are broken down and eliminated efficiently when no longer needed.
By promoting better hormone regulation, NAD+ therapy can help prevent the buildup of excess hormones, which can lead to unwanted side effects and potential health risks. This regulatory effect is crucial for men undergoing TRT, as it helps maintain a stable and optimal hormone balance throughout the treatment process. Men looking to address facial aging while optimizing hormones often consider Botox treatments as part of a comprehensive wellness plan.
Although the advantages of pairing NAD+ with testosterone replacement therapy are substantial, this combination isn’t necessarily ideal for every patient. Like any medical intervention, personal health history, existing medications, and individual wellness objectives all play a role in determining suitability.
Men interested in this combined protocol should work with a qualified medical professional experienced in hormone optimization and age management. A comprehensive assessment that includes detailed bloodwork and a complete review of medical background helps clarify whether NAD+ alongside TRT aligns with each patient’s specific needs.
Keep in mind that even with notable benefits, this treatment pairing isn’t a universal solution. Treatment dosages and schedules often require fine-tuning based on how each patient responds, and consistent follow-up remains critical to maintaining both safety and therapeutic results.
For men in Tampa dealing with low testosterone symptoms and the natural effects of aging, combining NAD+ with testosterone replacement therapy could represent a meaningful path forward. By targeting the root causes of hormonal imbalance and promoting healthy cellular activity, this forward-thinking approach supports men in regaining energy, physical resilience, and an improved sense of overall wellness. Many patients also benefit from injectable treatments that address aesthetic concerns alongside hormone therapy.
One of the most critical factors in any hormone or peptide therapy is the quality of the medications being used. At Formation, Dr. Gopal Grandhige ensures that all treatments utilize only human-grade medications sourced from licensed compounding pharmacies. These pharmacies operate under strict regulatory oversight, ensuring purity, potency, and safety standards that protect patient health.
Unfortunately, many individuals turn to online sources to purchase NAD+ or testosterone products on their own. What they often receive are research-grade compounds labeled “not for human use.” These products lack regulatory oversight, meaning there’s no guarantee of what’s actually in the vial. Contaminants, incorrect dosages, and unstable formulations are common issues with these unregulated options.
When you work with a board-certified general surgeon like Dr. Grandhige at Formation, you receive medications that meet pharmaceutical standards designed specifically for therapeutic use in humans. This distinction is not just about effectiveness; it’s about your safety. Patients seeking men’s aesthetic surgery in Tampa benefit from this same commitment to quality across all services.
Men in Tampa considering NAD+ and testosterone replacement therapy can expect a thorough and personalized experience at Formation. Dr. Grandhige begins with an in-depth consultation that reviews your complete medical history, current symptoms, lifestyle factors, and wellness goals.
From there, comprehensive lab work provides objective data on your hormone levels, metabolic markers, and overall health status. This information guides the creation of a customized treatment plan tailored specifically to your body’s needs. You can view patient results to see the outcomes achieved at the clinic.
Ongoing monitoring ensures your protocol remains effective and safe over time. Adjustments are made as needed based on follow-up bloodwork and your feedback about how you’re feeling. This attentive, hands-on approach sets Formation apart from clinics that offer cookie-cutter solutions. Whether you’re interested in hormone therapy or procedures like HD liposuction for men or FaceTite, every treatment plan is built around your individual needs.
For men in Tampa ready to address the effects of low testosterone and age-related decline, combining NAD+ and testosterone replacement therapy under proper medical supervision offers a promising path. With human-grade medications, integrated nutritional support, and the expertise of a board-certified general surgeon, Formation provides the comprehensive care needed to help you feel stronger, more energized, and more like yourself again.
Many patients find that addressing hormone health opens the door to exploring additional treatments such as PDO thread lifts, liposuction for men, or tummy tuck surgery to complete their transformation. To learn more or schedule an appointment, contact Formation today.
For men in Tampa noticing the effects of declining testosterone and reduced cellular energy, the combination of NAD+ and testosterone replacement therapy represents a science-backed approach to reclaiming vitality. These two therapies work together to address hormonal imbalance at multiple levels, from optimizing how your body uses testosterone to supporting the cellular processes that keep you energized and functioning at your best.
What sets Formation apart is the commitment to using only human-grade medications from licensed compounding pharmacies. Unlike research-grade products available online that lack regulatory oversight and carry real safety risks, the treatments provided by Dr. Gopal Grandhige meet strict pharmaceutical standards designed for therapeutic use in humans.
The addition of a concierge dietitian on-site ensures that your nutrition supports your hormone optimization goals rather than working against them. This integrated approach recognizes that lasting results require attention to the full picture, not just one piece of the puzzle.
If you’re experiencing symptoms like persistent fatigue, decreased muscle mass, low libido, or difficulty concentrating, these could be signs that your hormones need attention. A comprehensive consultation at Formation can help determine whether combining NAD+ with TRT is the right path for your specific situation and wellness goals.
NAD+ supports testosterone production by stimulating luteinizing hormone (LH) in the pituitary gland, which signals the testes to produce more testosterone. It also helps your body use supplemented testosterone more effectively.
Most men begin noticing improvements in energy and mental clarity within a few weeks. Full benefits, including changes in body composition and overall vitality, typically develop over two to three months with consistent treatment.
No. Products sold online are typically research-grade compounds labeled "not for human use." They lack regulatory oversight, often contain contaminants or incorrect dosages, and pose real health risks. Always work with a licensed medical provider using human-grade medications.
Men experiencing symptoms of low testosterone, such as fatigue, reduced muscle mass, low libido, and mood changes, may benefit. A thorough evaluation including bloodwork and medical history review is necessary to determine individual suitability.
Nutrition directly impacts hormone production and how well your body responds to treatment. Formation's concierge dietitian creates personalized meal plans that complement your protocol, helping maximize results and support long-term health.
There’s a story behind every decision.
Cosmetic surgery is a personal decision. Yet people who choose it often find themselves having to explain or defend that choice to others.
Some want to restore changes after pregnancy or weight loss. Others have worked hard to get in shape but still have areas they’d like to improve. And some simply want to feel more comfortable with their appearance.
The reasons are different for everyone. And they don’t have to make sense to anyone else.
At Formation, Dr. Gopal believes the decision to pursue cosmetic surgery should be guided by a patient’s personal goals, realistic expectations, and what’s medically appropriate for them.
Because ultimately, the person making that decision is the one who will live with it.
#Tampa #CosmeticSurgery #BodyContouring #Liposuction
Our first four-legged patient. 🐾
Dr. Gopal takes his liposuction and body contouring very seriously.
Even when his patients have four legs.
From loose skin and neck liposuction to a jawline that deserves its own before-and-after reveal, this might be his most dramatic transformation yet.
And yes, he even got the patient’s permission to share the results. 😂
A little Halloween fun from Dr. Gopal and his two very patient pups! 🎃🐶
No dogs underwent surgery. Just two willing participants and one very committed surgeon.
#SurgeonLife #tampa #necklipo
What weight loss can’t fix.
After losing over 100 pounds, this patient had achieved significant weight loss, but was left with excess skin around his abdomen and back that weight loss alone couldn’t address.
During an 8-hour surgery, Dr. Gopal performed a circumferential body lift, a procedure that removes excess skin around the entire midsection to improve body contour.
In this video, Dr. Gopal walks through the procedure, explaining how he removed approximately 3 pounds of skin from the back and estimated another 4–5 pounds would be removed from the abdomen.
He’s also using a small amount of fat collected during the procedure to add volume to the upper chest, improving its contour without performing a separate chest lift.
For patients who have experienced major weight loss, body contouring can help address the excess skin that remains after the weight is gone.
Considering surgery after weight loss? Schedule a consultation with Dr. Gopal at Formation in Tampa to explore your options.
Actual patient footage. Individual results vary.
#BodyContouring #BodyLift #ExcessSkinRemoval
Only 3 months after surgery. And still healing.
This patient had previously undergone a tummy tuck but wanted to improve his abdominal contour, create more definition, and address the appearance of his existing scar.
Dr. Gopal combined several body contouring techniques, including HD liposuction, skin tightening with Renuvion, fat transfer to the chest, and revision of the previous tummy tuck scar.
The result so far? A more defined abdomen, improved body contours, and a revised scar that’s still in the early stages of healing.
At just three months after surgery, these aren’t the final results. Swelling can continue to decrease, and scars typically soften and fade as healing progresses.
Swipe to see a closer look at the scar revision.
Considering body contouring or looking to improve the results of a previous procedure? Schedule a consultation with Dr. Gopal at Formation Tampa. Link in bio.
Actual patient photos. Individual results vary.
#HDLiposuction #BodyContouring #ScarRevision #SkinTightening #TummyTuck
Your fat is liquid gold.
The fat you don’t want might be exactly what another part of your body needs.
During liposuction, the fat we remove doesn’t always have to be discarded. In fact, Dr. Gopal refers to it as “liquid gold.”
Why? Because that fat can sometimes be transferred to another area of the body to add volume, enhance natural contours, and create a more balanced shape.
For women, that might mean adding volume to the breasts, hips, or buttocks. For men, fat transfer can help enhance the chest or shoulders.
And because we’re using your own fat, we can potentially improve two areas during the same surgery.
Of course, fat transfer isn’t right for everyone. It’s something Dr. Gopal discusses with patients beforehand and incorporates into the surgical plan when appropriate.
Considering liposuction in Tampa? Schedule a consultation with Dr. Gopal at Formation to explore your body contouring options.
#TampaLiposuction #FatTransfer #BodyContouring
Cosmetic surgery isn’t just cosmetic.
We often measure the success of plastic surgery by what we can see in before-and-after photos. But some of the most meaningful changes happen in ways a photograph can’t capture.
How someone feels about themselves. The confidence they carry into everyday life. The freedom of no longer feeling uncomfortable in their own skin.
For Dr. Gopal, that’s what makes this work so meaningful.
A patient who underwent body contouring in 2025 recently reached out to share how much the experience continues to mean to her.
She didn’t talk about measurements or how her body looked. She talked about how much better her days had become.
And that’s something Dr. Gopal has always believed: Cosmetic surgery isn’t simply about changing how someone looks. It’s about understanding what that change means to the person choosing it.
#Tampa #CosmeticSurgery #BodyContouring
A flatter stomach without a tummy tuck? 👀
Pregnancy, and sometimes increased pressure from fat deep inside the abdomen, can cause the abdominal muscles to separate down the middle. This is called diastasis recti, and it can make your belly stick out even if you’re otherwise lean.
Traditionally, repairing that separation often meant undergoing a tummy tuck. But what if you don’t have much loose skin to remove?
For the right patient, Dr. Gopal can use robotic-assisted surgery to bring those separated muscles back together through three small incisions, without the long scar associated with a traditional tummy tuck.
That’s exactly what he did for the patient in these before-and-after photos. No tummy tuck. No additional procedures.
**But this approach isn’t for everyone.** If you have significant loose skin or excess fat, a different treatment may be more appropriate. That’s why understanding what’s causing your belly to protrude matters before deciding on surgery.
Curious whether you’re a candidate? DM us or schedule a consultation with Dr. Gopal at Formation Tampa. Link in bio.
Actual patient results. Individual results vary.
#DiastasisRecti #MuscleSeparation #DiastasisRectiRepair #RoboticSurgery #Tampa
Why does fluid sometimes collect after surgery?
After certain surgical procedures, fluid can accumulate beneath the skin, forming what’s called a seroma.
In this video, Dr. Gopal demonstrates how he drains a seroma in a patient recovering from diastasis recti repair.
This is one of the reasons postoperative follow-up matters. It allows Dr. Gopal to monitor healing, identify any issues, and address them when necessary.
Considering surgery? DM us to schedule a consultation with Dr. Gopal at Formation Tampa.
#DiastasisRecti #Seroma #TampaSurgeon #AbdominalMuscleRepair
The fat is gone. But what takes its place?
When fat is removed during liposuction, it leaves behind space beneath the skin. As the body heals, fluid can sometimes collect in that space, creating what’s called a seroma.
And here’s why that matters.
If fluid continues to collect, it can potentially affect the final contour.
That’s why Dr. Gopal pays close attention to fluid buildup during recovery. His approach is to identify seromas early and address them quickly.
Considering liposuction in Tampa? Schedule a consultation with Dr. Gopal at Formation to learn more.
#Liposuction #Seroma #BodyContouring
From medical weight loss to body contouring, her transformation was approached as a journey, not just a single procedure.
This patient started with a personalized medical weight loss program at Formation, working with Dr. Gopal to achieve significant weight loss. Once she reached her goal, Dr. Gopal performed a tummy tuck to remove excess abdominal skin and refine her contour.
Considering medical weight loss or a tummy tuck? Schedule a consultation with Dr. Gopal at Formation Tampa. Link in bio.
Actual patient results. Individual results vary.
References:
Igarashi, M., Nakagawa-Nagahama, Y., Miura, M., Kashiwabara, K., Yaku, K., Sawada, M., Sekine, R., Fukamizu, Y., Sato, T., Sakurai, T., Sato, J., Ino, K., Kubota, N., Nakagawa, T., Kadowaki, T., & Yamauchi, T. (2022). Chronic nicotinamide mononucleotide supplementation elevates blood nicotinamide adenine dinucleotide levels and alters muscle function in healthy older men. NPJ Aging, 8(1), Article 5. https://pmc.ncbi.nlm.nih.gov/articles/PMC9158788/
Liang, Y., Cai, D., & Chen, H. (2023). The safety and antiaging effects of nicotinamide mononucleotide in human clinical trials: An update. Advances in Nutrition, 14(6), 1416–1435. https://pubmed.ncbi.nlm.nih.gov/37619764/
Poljsak, B., Kovač, V., & Milisav, I. (2023). The central role of the NAD+ molecule in the development of aging and the prevention of chronic age-related diseases: Strategies for NAD+ modulation. International Journal of Molecular Sciences, 24(3), Article 2959. https://pmc.ncbi.nlm.nih.gov/articles/PMC9917998/
Verdin, E. (2015). NAD+ in aging, metabolism, and neurodegeneration. Science, 350(6265), 1208–1213. https://www.science.org/doi/10.1126/science.aac4854
Yi, L., Maier, A. B., Tao, R., Lin, Z., Vaidya, A., Pendse, S., Thasber, S., Bhardwaj, N., Bhardwaj, R., & Das, S. (2023). The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: A randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. GeroScience, 45(1), 29–43. https://pubmed.ncbi.nlm.nih.gov/36482258/
