“NAD⁺ therapy” is not one treatment. It is a category name covering five quite different products, sold at prices that differ by a factor of ten, with evidence bases that differ far more than that. This page is the map: what each form is, what it costs, and what is actually behind it.
If you want the molecule explained rather than the market, that is what NAD⁺ is. This page assumes you already know you are considering buying some.
The five forms, cheapest first
Oral precursors — nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) — are capsules, around $40 a month. You do not swallow NAD⁺ itself; you swallow a smaller molecule your cells build it from. This is the only form with randomized human trials showing it reliably raises blood NAD⁺. Which of the two to pick is its own question, and the supplements board ranks them.
Injections are subcutaneous shots of compounded NAD⁺, $93 to $249 a month depending on seller. This is the largest part of the market and the one most people mean by “NAD therapy”. How the shot works and what “compounded” means for it is in the injections explainer; the sellers are ranked on the injections board.
Nasal sprays run $93 to $175 a month and exist mostly for people who will not use a needle. Same compounded status, same absence of outcome trials, plus an extra unknown: how much of an intranasal dose reaches circulation has not been established. Nasal spray rankings.
Patches are the cheapest thing with NAD⁺ on the label, around $30 a month, and the weakest-evidenced format in a category where the evidence is already thin — there is no published human trial showing a transdermal patch raises NAD⁺ at all. Patch rankings.
IV drips are the most expensive by a wide margin — commonly $200 to $500 per session, and rarely one session — and the only format with no outcome trials whatsoever. What a drip actually does covers the one human infusion study, which did not find what the marketing implies.
The inversion nobody selling this will tell you
Lay those five out and the shape is unmistakable: the price ranking runs almost exactly opposite to the evidence ranking. The cheapest form has the human trials. The most expensive has none.
That is not a conspiracy, it is an artifact of how the research went: precursors were studied because they are what absorbs orally, and the injectable and IV market grew up alongside the research rather than out of it. But it does mean the intuition you bring from ordinary medicine — that the expensive, clinically-administered version is the serious one — points you the wrong way here.
What NAD⁺ therapy has actually been shown to do
Two things, and it is worth keeping them apart.
It raises NAD⁺. Oral precursors do this reliably. In a randomized, double-blind, placebo-controlled dose-ranging trial in 80 healthy middle-aged adults (n = 80), blood NAD⁺ rose significantly in every NMN dose group at day 30 and day 60, against both placebo and baseline (all p ≤ 0.001) [1].
Whether that helps you is unresolved. A PRISMA-guided systematic review published in 2026 covered 113 studies — 33 human intervention studies, 28 of them randomized — and found that while oral NR and NMN consistently engage the biochemical target and are generally well tolerated, their effects on functional, metabolic and vascular outcomes were “heterogeneous and often null or endpoint-specific” [2]. The same review states that no eligible outcomes trials evaluated intravenous or intramuscular NAD⁺ at all.
So: the mechanism is real, the biomarker moves, and the benefits it is marketed for are not established. Anyone telling you otherwise is ahead of the literature — including on the specific claims.
What it costs, honestly
A year of oral precursor is roughly $480. A year of mid-priced injections is roughly $2,000. A year of monthly IV sessions can exceed $4,000 before anyone discusses dose.
And dose is the problem. Almost no injectable seller publishes a milligram figure, which makes their prices formally incomparable — a low monthly price at an undisclosed dose is not a bargain, it is an unknown. Our cost calculator exists to make you ask for the number, and the cheapest routes are ranked separately.
Is it safe?
Oral precursors have been through dedicated safety trials and were generally well tolerated. Injectable, IV and intranasal NAD⁺ have no comparable safety dataset, and all of them are compounded — not FDA-approved, and not reviewed by the FDA for safety, efficacy or quality before they reach you. The safety evidence covers what is known and where the gaps are.
How to decide
The order that follows from the evidence is unglamorous: start with the cheapest, best-studied form, and move up only if you have a reason. An oral precursor costs about a tenth of a drip and is the only thing here with randomized human data. If you try it and want more, an injection is the next step. A drip is a choice about supervision and convenience, not about efficacy, and should be priced as one.
Whatever you pick, ask the seller two questions before paying: how many milligrams, and is it compounded. The number of providers who will not answer the first is the most useful thing we have learned writing this site.