NAD+ Therapy Is Everywhere in Telehealth. Here's What the Evidence Actually Says.

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. It plays a central role in metabolism, DNA repair, and cellular energy production. Levels decline with age. And since 2022, injecting supplemental NAD+ has become one of the most aggressively marketed treatments in the telehealth longevity space.

Clinics are charging $250–400/month for NAD+ programs. The marketing language is confident. The clinical evidence is more nuanced.

What NAD+ actually does in your body

NAD+ is essential for mitochondrial function — the energy-producing process in cells. It is also required for sirtuins, proteins involved in DNA repair and gene expression that are associated with longevity research.

The decline in NAD+ levels with aging is well-documented and real. This is not disputed. What is disputed: whether supplementing NAD+ via injection restores meaningful function and produces measurable health outcomes in humans.

What the research shows

Most NAD+ research has been done in animal models (primarily mice). The results in mice are impressive — increased mitochondrial function, improved metabolic markers, extended lifespan in some studies.

Human research is much more limited. The best human trial data shows that NAD+ precursors (specifically NMN and NR, which are orally bioavailable) can raise circulating NAD+ levels. Whether those elevated levels translate to measurable health outcomes is an open question. Large well-designed human trials with clinical endpoints are still ongoing or not yet published.

Injectable vs. oral NAD+

Telehealth platforms offering injectable NAD+ typically charge $250–400/month. Oral NAD+ precursors (NMN or NR) from supplement companies cost $30–60/month.

The argument for injectable: higher bioavailability and more direct cell delivery. The argument against: the premium is large, and the incremental benefit over oral supplementation is not well-established in clinical trials.

The honest assessment

If you are interested in longevity medicine and have the budget for it, NAD+ therapy is low-risk and possibly beneficial. The evidence does not support confident claims that it will extend your life or reverse aging. The evidence is sufficient to make it a reasonable experiment if cost is not prohibitive.

The platforms on ClinicLayer that offer NAD+ — including Enhance MD ($250/month for NAD+ specifically) and MYRNK ($275/month) — are legitimate clinical operations. But you should understand the evidence level before spending $3,000/year on any intervention.