A NAD⁺ injection — often sold as a “NAD⁺ shot” — is a dose of NAD⁺ delivered under the skin rather than swallowed. In the United States it is almost always bought through a telehealth service: you fill in an intake form, a licensed prescriber reviews it, and a compounding pharmacy ships you vials or pre-filled syringes to administer yourself.
That is the whole product. The interesting questions are what it costs, what it is legally, and whether it does anything an oral capsule costing a fraction as much does not.
Why people choose an injection over a capsule
The argument you will hear is bioavailability: swallowing a precursor means digestion and first-pass metabolism get a share, whereas an injection puts the compound past both. That reasoning is sound as far as it goes.
Where it stops going is evidence. Bypassing digestion is a mechanism, not a result. There is no controlled human outcome trial showing that injected NAD⁺ produces better results than an oral precursor — or, for that matter, better results than placebo — for the energy, focus and anti-aging claims it is sold on. Meanwhile the oral precursors have randomized trials showing they reliably raise blood NAD⁺[1] and, in one dose-ranging trial of 80 adults (n = 80), did so at every dose against placebo and baseline (all p ≤ 0.001) [2].
“Compounded” is the word that matters
Every injectable NAD⁺ product sold through US telehealth is a compounded preparation. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, efficacy or quality before they reach you. This is not a fact about one disreputable seller — it is the structure of the entire category, and any provider implying otherwise is misleading you.
Practically, it means the quality of what arrives depends on the compounding pharmacy. A provider willing to name its pharmacy is giving you something you can actually check, which is worth more than most of the marketing differences between them. It is one of the things we weigh in our scoring.
What it costs, and the question nobody answers
Among the providers we can currently verify, published pricing for NAD⁺ injections starts at $169 per month and runs to about $199. What almost none of them publish is the dose that price buys — and without milligrams, two monthly prices are not comparable at all.
Ask for it before you pay. If you get a number, our cost-per-milligram calculator turns competing offers into a figure you can actually compare. If you do not get a number, that is information too.
Injection, IV, or capsule?
On cost, injections sit well below IV therapy and well above oral precursors. On evidence, injections and IV are level — both have no controlled outcome trials — and both sit below oral precursors, which have actual randomized data.
So the honest summary is uncomfortable for the format: an injection is the middle option on price and the joint-worst on evidence. It is a reasonable choice if you have decided you want a non-oral route and want to spend less than a drip costs. It is not the choice the evidence points to.
If you want the providers themselves, with prices and what each one does and does not disclose, that is our injections ranking. Before starting anything, read what is known about safety — for this format, less than you would hope.