Men’s Health Spotlight: Testosterone, Circulation & NAD Optimization

A lot of men carry health changes quietly for a long time before they ever bring them up. It can start subtly: you’re getting through the day, but your energy isn’t what it used to be. Motivation is lower. Workouts feel harder and recovery takes longer. Sleep is lighter or more interrupted. Belly fat seems to show up even when you’re “not eating that differently.” Libido dips, or performance isn’t as reliable as it once was. And perhaps most frustrating of all, you can’t quite put your finger on it—you just don’t feel like yourself, even though life looks fine on paper.

One reason men often feel stuck is that these issues are frequently reduced to a single explanation: “It’s testosterone.” Testosterone matters, but men’s vitality is rarely governed by one hormone alone. Energy, mood, metabolism, and performance are influenced by multiple systems working together—especially hormones, circulation, and cellular energy. When one area is under strain, it can ripple across the others.

Here’s what that looks like in real life:

• Testosterone supports lean muscle, healthy metabolism, motivation, mood stability, and sexual function—but it’s also sensitive to sleep quality, stress load, inflammation, and blood sugar balance.
• Circulation determines how well oxygen and nutrients reach tissues (including the brain, muscles, and reproductive organs). When circulation is compromised, men may notice fatigue, slower recovery, brain fog, or erectile changes—often before anything shows up as a major diagnosis.
• Cellular energy—how efficiently your cells produce fuel—affects stamina, mental clarity, resilience, and recovery. This is where NAD (a key cellular coenzyme) becomes part of the conversation, because it supports the body’s ability to create energy at the mitochondrial level and respond to stress over time.

A systems approach brings the bigger picture into focus. It helps answer the most important question: Why are these shifts happening now? That “why” might involve stress physiology, sleep debt, metabolic strain, nutrient depletion, inflammation, or a combination—often layered over time. And that’s good news, because when you identify what’s driving the change, you can build a plan that targets the real root causes instead of chasing symptoms.

Sustainable improvement doesn’t come from quick fixes or pushing harder. It comes from understanding what your body is responding to—and supporting it strategically. That’s the foundation of modern men’s health optimization: not just “more testosterone,” but better hormone balance, better blood flow, and better cellular energy so you can feel strong, clear, and resilient again.

Testing and Evaluation: What a Personalized Men’s Health Workup May Include

When a man comes in with concerns like low energy, reduced motivation, slower recovery, stubborn belly fat, or libido changes, the most helpful first step is often to stop guessing and start gathering the right data. A functional, integrative men’s health workup isn’t a “one panel fits all” checklist—it’s a targeted evaluation built around your symptoms, history, goals, training load, and lifestyle.

Hormone evaluation

Testosterone is important—but the context around testosterone is what makes the picture clear. A thoughtful evaluation may include:

• Total testosterone, free testosterone, and SHBG
  Total testosterone can look “fine,” while free testosterone (the active portion) is low—especially if SHBG is elevated.
• LH/FSH (when indicated) and estradiol
  LH/FSH can help clarify whether the signal from the brain to the testes is strong. Estradiol matters because men need balance—not “as low as possible.” Too high or too low can affect mood, libido, and body composition.
• DHEA-S and prolactin (as clinically appropriate)
  These can provide additional context when symptoms suggest deeper endocrine patterns.
• Cortisol rhythm / stress response markers (especially for “wired but tired”)
  If you’re exhausted but can’t shut off at night, or you crash after stress, this can be an important piece of the puzzle.
• Thyroid markers (TSH, Free T3, Free T4; antibodies if indicated)
  Thyroid function influences metabolism, energy, weight resistance, and mental clarity—and it can affect how testosterone is experienced in the body.

Metabolic and cardiovascular markers

Men’s vitality is tightly linked to cardiometabolic health. Many “hormone” symptoms are actually rooted in blood sugar or vascular strain.

• Fasting glucose, fasting insulin, and A1c
  Glucose can look normal while insulin is elevated—often showing up as energy crashes, stubborn fat gain, cravings, and reduced performance.
• Lipid panel + advanced markers when appropriate (ApoB, Lp(a))
  These can offer more specific insight into cardiovascular risk patterns than a basic cholesterol panel alone, depending on history and risk factors.
• hs-CRP and blood pressure review
  Inflammation and vascular tone matter for circulation, recovery, and long-term performance.
• CBC/CMP
  A practical baseline: anemia patterns, electrolyte status, liver and kidney markers, and overall system readiness.

Nutrient status

Even high-performing men can run nutrient deficits—especially with chronic stress, inconsistent meals, heavy training, poor sleep, or digestive issues.

• Vitamin D (immune function, mood, testosterone signaling support)
• B12/folate (energy production, cognitive function)
• Magnesium (sleep quality, stress resilience, muscle recovery)
• Ferritin/iron patterns (especially if fatigue, low stamina, or exercise intolerance is present)

Circulation-related considerations

Men’s health optimization isn’t only “labs”—it’s also how your daily inputs shape your physiology.

• Lifestyle review: training intensity vs. recovery, sleep patterns, alcohol intake, nicotine use, stress load, and nutrition consistency
• Erectile health screening as a vascular clue: approached respectfully and clinically
  Erectile changes can reflect blood flow and endothelial function. In integrative care, this is often considered an early “check engine light” for vascular health—not just a sexual issue.

Building the Plan: Evidence-Informed Strategies That Move the Needle

Once the “why” becomes clearer, the plan becomes more precise. For most men, the biggest gains come from aligning the fundamentals first—then layering targeted support.

Testosterone-supportive foundations

• Resistance training + adequate protein
  Strength training supports lean mass and metabolic health. Pair it with sufficient protein to support recovery and hormone signaling.
• Sleep quality + a consistent wake time
  Sleep is one of the most powerful testosterone-supportive tools. Even small improvements in consistency can shift outcomes.
• Realistic stress reduction
  Not hour-long meditation—think short daily practices: 3–5 minutes of breathwork, a walk after meals, or a screen-free wind-down routine.
• Weight and visceral fat focus (when relevant)
  Reducing visceral fat can improve insulin sensitivity and inflammation, which often supports healthier hormone balance.
• Alcohol moderation + endocrine disruptor reduction
  Alcohol can impair sleep architecture and hormone signaling. Reducing plastics/chemical exposures where practical can also support endocrine health over time.

Circulation-supportive strategies

• Movement “snacks” during the day
  Brief walks or mobility breaks improve glucose handling and circulation—especially for desk jobs.
• Zone 2 cardio + strength training balance
  Zone 2 supports cardiovascular conditioning and mitochondrial function; strength supports insulin sensitivity and lean mass.
• Dietary patterns that support blood vessels
  Fiber, omega-3 fats, and colorful plants support inflammation balance and endothelial function.
• Hydration and electrolytes (when appropriate)
  Dehydration and low minerals can feel like fatigue, cramps, headaches, and reduced stamina.

NAD optimization foundations

NAD support works best when it’s layered onto strong basics—because NAD is part of cellular energy production, which depends on sleep, fuel, and recovery.

• Sleep + circadian rhythm support
  Morning light exposure, consistent wake time, and reducing late-night stimulation can help restore a healthier rhythm.
• Metabolic flexibility (stable blood sugar)
  Prioritize protein, fiber, and healthy fats—especially earlier in the day—so energy is steadier and crashes are fewer.
• Recovery practices
  Deload weeks, active recovery, and (for the right person) sauna or cold exposure can support resilience.
• Targeted NAD support options guided by clinician assessment
  Supplements and in-office approaches should be personalized to your history, needs, and tolerance.

A Smarter Path to Men’s Vitality

If you’ve noticed changes in your energy, performance, body composition, or recovery, you’re not alone. These shifts are common—especially with demanding schedules, stress, and changes in sleep—but they’re not something you have to accept as “just aging.” Feeling run down, less driven, or stuck in a cycle of slower recovery is often your body’s way of asking for a deeper look.

A functional medicine approach offers a smarter path forward by focusing on why these changes are happening—then building a plan that targets the real drivers. That means:

• Evaluating testosterone and the factors influencing it, including stress physiology, sleep quality, thyroid patterns, inflammation, and metabolic health
• Supporting circulation and cardiometabolic function, because blood flow and blood sugar regulation directly impact endurance, cognition, recovery, and sexual health
• Optimizing cellular energy, including NAD-supportive strategies when appropriate, to improve resilience, recovery, and long-term vitality

When you bring these pieces together, men’s health becomes less about chasing one number and more about restoring the systems that create strength, clarity, and stamina.

Schedule a Men’s Health Consultation

If you’re ready for a personalized men’s health plan—built on targeted testing, expert interpretation, and an integrative strategy tailored to your goals—schedule a consultation with Dr. Linette Williamson.

Contact Information:
Phone: (760) 875-2627
Website: https://www.linettewilliamsonmd.com
Locations: Encinitas, CA & Winter Park, FL
Telehealth: Available in Florida