Does Adderall Lower Testosterone?

Adderall is a controlled prescription medication for ADHD and narcolepsy composed of amphetamine and dextroamphetamine. These two pharmacological drugs have effects beyond improving ADHD symptoms and being nervous system stimulants. Amphetamines and methamphetamines can also lower testosterone levels when used for ADHD or recreationally. This blog summarises the evidence to demonstrate how Adderall lowers testosterone levels and provides practical tips on how to manage testosterone side effects.
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

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What is Adderall?

To understand whether Adderall can lower testosterone levels, it is first critical to understand what Adderall is and how it is used.

Adderall is a tightly controlled prescription medication primarily used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is a combination of two stimulants, amphetamine and dextroamphetamine, which work by stimulating the central nervous system through dopamine and noradrenalin release. Noradrenalin and dopamine are two critical neurotransmitters in the brain that help to improve concentration and memory and manage hyperactivity. A short-term side effects are also increased heart rate and anxiety.

Contrary to popular belief, Adderall does not significantly improve academic performance, as demonstrated by a study of students who took Adderall to enhance their cognitive function [1].

Testosterone: A Crash Course

Understanding how and where testosterone is released is also critical to understanding whether Adderall can lower testosterone.

Testosterone is released from the Leydig cells in the testicles based on signals from the hypothalamus through two hormones: gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH) [2].

Testosterone levels are usually highest in the morning and during sexual intercourse [3]. However, regular sexual intercourse throughout a short period will sensitize your hormonal system to the impulse, so less testosterone will be released in subsequent sexual events.

Amphetamines, Adderall and Testosterone

Methamphetamine and Testosterone

Methamphetamine is a type of stimulant which is used recreationally outside the healthcare setting, for example, in Tesla pills. However, it has similar pharmacological functions to amphetamines found in Adderall. Therefore, the scientific literature exploring the link between methamphetamines and testosterone is highly relevant to Adderall and testosterone.

Methamphetamine can reduce the proliferation of Leydig cells, the cells in the testicles responsible for testosterone production [4]. However, direct measures of testosterone after methamphetamine exposure are less consistent. Some animal studies suggested methamphetamines lowered testosterone [5, 6], whereas others showed methamphetamines increased testosterone [7, 8]. These outcomes were attributed to male dominance within the animal cages, which may also be translatable to male societal status in humans. Hence, further investigation of the effects of amphetamines in humans is required.

Adderall Lowers Testosterone Levels

Transitioning to Amphetamines, the critical active ingredient in Adderall, several studies have looked at pure amphetamine and how this impacted testosterone levels.

An animal study by Tsai et al. from Taipei found that amphetamines reduced testosterone levels in a rat model [9]. Similar effects have been observed in men since one of the common sexual side effects of Adderall is erectile dysfunction [10, 11]. Furthermore, hypogonadism is a condition in which there is reduced activity in the male sex organs, including the testicles that produce testosterone. Hypogonadism was more common in men with a history of taking stimulants like Adderall and phentermine [12].

These findings indicate that Adderall lowers testosterone, although the mechanism through which this occurs has not been clearly defined in humans. Similarly, there is no direct evidence that Adderall would impact fertility.

Adderall Lowers Testosterone: What Can I Do?

Reduced testosterone levels are an unpleasant side effect of taking Adderall. Here are a few tips on managing the impact of Adderall on your testosterone, sex drive and erectile dysfunction:

  • The first advice when you find that Adderall is lowering your testosterone is to determine the reason for taking Adderall. If you have ADHD and find that Adderall increases your ability to carry out daily tasks, it is critical to weigh out the pros and cons of Adderall on ADHD vs testosterone levels. Additional Adderall side effects and consulting a healthcare provider can also help you make this decision whether to stop Adderall use.
  • Try and take Adderall at times when you would find lower testosterone levels less disruptive. When is the correct time? This suggestion is tricky since peak testosterone levels occur during the morning, which is also when Adderall can help with focus and concentration. However, taking Adderall in the morning may have a more significant impact on your ability to produce testosterone.
  • If you do not have ADHD and take Adderall as a study aid, it is best to stop. Evidence suggests that Adderall is ineffective in enhancing learning [1]. Furthermore, low testosterone levels during critical developmental windows can harm subsequent sexual health, bone health, mineral density, oxidation, and carcinogenic activity [13].

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.