Wellness support,
reviewed by a licensed provider.

In-depth guide

A plain-language guide to NAD+, glutathione and other wellness injectables

This page covers NAD+, glutathione and a few similar wellness products that some adults ask about: B12 MIC injection, L-carnitine injection and methylene blue tablets. If you are curious about them, you probably want a clear answer to one question first: do they work? The honest answer is that it depends on the product and on you, and for most of them, research in humans is limited.

NAD+ is a molecule your cells use in energy metabolism. Glutathione is an antioxidant your body makes on its own. Vitamin B12 is a nutrient your body needs, and giving B12 by injection is an established treatment for B12 deficiency. Beyond that, evidence that these products slow aging, extend life or raise energy in otherwise healthy people is limited. Some people report feeling better, but that is not proof. A licensed provider reviews your health history and decides whether a product is reasonable for you.

How the program works, step by step

1. Choose what you want to ask about. Pick NAD+ (injection, nasal spray or oral liposomal) or one of the other options: glutathione injection, B12 MIC injection, methylene blue tablets or L-carnitine injection. Choosing one only starts your intake.
2. Complete the online intake. You answer questions about your health history, current medications, supplements, allergies and goals. Be as complete as you can. Small details, like an antidepressant, can matter a great deal.
3. A licensed provider reviews your intake. Your intake is reviewed asynchronously, which means the provider reads it on their own time rather than meeting you live. In some states a live video visit is required, and it may also be requested if the provider needs more information. The provider decides whether a prescription is appropriate. A prescription is never guaranteed.
4. First prescription, if appropriate. For NAD+, a first prescription is written for 4 weeks. For glutathione, B12 MIC, methylene blue and L-carnitine, the first prescription may be written for 12 weeks. If you are approved, the medication is prepared by a compounding pharmacy and shipped to you.
5. Refill reviews. For NAD+, a refill review happens at 3 to 4 weeks. If it goes well, 12-week refill prescriptions follow, with a review every 12 weeks after that. For the other products, refills are reviewed every 12 weeks. At any point you can ask for a live consult with a provider at no extra cost.

What's included

• Review of your online intake by a licensed provider.
• A prescription, only if the provider decides it is appropriate for you.
• The prescribed medication, prepared by a compounding pharmacy and shipped to you.
• Scheduled refill reviews, with a live consult available at no extra cost if you ask for one.

Pricing summary

NAD+ (injection, nasal spray or oral liposomal) is $229 per 4 weeks.

Methylene blue tablets, glutathione injection and L-carnitine injection are $149 per 4 weeks. B12 MIC injection is $145 per 4 weeks. Sermorelin is $229 per 4 weeks.

These are cash-pay prices. FSA and HSA cards, Visa, Mastercard, Apple Pay and Google Pay are accepted. American Express is not accepted. Pricing covers the provider review and, if prescribed, the medication.

Eligibility, safety and side effects

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness or quality before they are marketed. NAD+, glutathione, methylene blue and L-carnitine are not FDA-approved for anti-aging, energy or longevity purposes. Always tell your provider about every medication and supplement you take, and whether you are pregnant or breastfeeding.

Common side effects

• Pain, redness or swelling at the injection site.
• Headache.
• With NAD+, some people report flushing, nausea, chest tightness or cramping, particularly when it is delivered quickly. Tell your provider if this happens.
• With L-carnitine, upset stomach and other digestive symptoms are generally what is reported.

Serious risks and warnings

• Methylene blue can cause serotonin syndrome when taken with antidepressants such as SSRIs or MAOIs. Symptoms can include agitation, fast heartbeat, high fever, muscle stiffness and confusion. This is a medical emergency.
• Methylene blue can also be dangerous for people with G6PD deficiency, an inherited condition that affects red blood cells. Tell your provider if you have it or if it runs in your family.
• B12 injections can rarely cause a serious allergic reaction. They can also interact with other medications, and in people being treated for certain anemias, potassium levels can drop.
• Call 911 or go to the nearest emergency room if you have trouble breathing, swelling of the face or throat, chest pain that does not go away, fainting or severe confusion.

This page is general education, not medical advice. Your provider can tell you whether any of these products make sense for your situation, and may decide they do not.

Sources and further reading

• U.S. Food and Drug Administration: Compounding and the FDA, Questions and Answers
• MedlinePlus (National Library of Medicine): Cyanocobalamin Injection
• MedlinePlus (National Library of Medicine): Vitamin B12

Frequently asked questions