Here's the short version. NAD+ and glutathione show up on the same menus, often a click apart. One is sold for energy, the other for skin and "glow". The trials behind them are small, and they mostly tested pills and creams, not shots. Pick by goal, and read the safety section before you pick at all.
What each molecule does in the body
Both sound essential because they are. Your body makes both. The open question is whether adding more from outside changes anything you'd notice. That's what the trials below try to answer.
Evidence by goal
This is the table that decides it. Each cell is the strongest human evidence found for that goal, with the form that was actually tested.
| NAD+ | Glutathione | |
|---|---|---|
| What it is | Coenzyme for energy metabolism | Antioxidant made by your cells |
| FDA status | Not approved; compounded, FDA still evaluating it | Not approved for wellness; compounded, FDA still evaluating it; safety alerts in 2019 and 2026 |
| Skin | No human trial found | Topical plus oral lowered a skin melanin index vs placebo over 8 weeks in 46 people [3] |
| Energy or fatigue | No outcome trial for injected NAD+ [5] | No trial found |
| Blood sugar and insulin | No trial of injected NAD+ found | Oral, 3 weeks: insulin sensitivity rose in 20 men with obesity [2] |
| Raising the body's own levels | Infused NAD+ cleared from plasma fast in one pilot [6] | Oral, 6 months: blood stores up 30–35%, gone a month after stopping [1] |
| Aging or lifespan | None | None |
| Forms programs sell | Injection, nasal spray, oral, patch, cream | Injection, nasal spray, patch |
| Monthly cost (injection) | $79–$303.08 | $57.32–$329.99 |
Status from FDA's 503A bulk-substance categories, updated May 14, 2026 [10].
Notice the pattern. Glutathione's results come from pills and creams. A dermatology review found the case for IV glutathione on skin rests on one poorly designed study, and that oral and topical results were modest and faded after stopping [4]. So "glutathione has skin evidence" doesn't mean "glutathione shots have skin evidence".
NAD+ has the opposite problem. It's sold mostly as shots, and a 2026 systematic review found no outcome trial of injected or infused NAD+ for anti-aging or wellness [5]. Oral building blocks like NMN raise NAD+ in blood, but that's a different product.
Two details from the glutathione trials are worth knowing. In the insulin study, sensitivity improved but markers of oxidative stress didn't change, so the antioxidant story wasn't what moved [2]. And in the six-month stores study, levels went back to where they started within a month of stopping [1]. Whatever glutathione does, it seems to last only as long as you keep taking it.
The one randomized trial of IV NAD+ that does exist was in heart failure. A seven-day course added to standard care nudged heart pumping function at one month, while the six-month difference in heart events wasn't statistically significant [7]. That's a hospital treatment for sick hearts, not evidence for a wellness shot.
Which one fits which goal
Here's how the evidence lines up by goal. None of it is a reason to start, only a way to set expectations.
- Skin tone. Glutathione is the one with trials, but they used pills and creams. If skin is the goal, ask whether a topical or oral form makes more sense than a shot.
- Energy. Neither has a trial showing more energy. If you try NAD+ for energy, treat it as an experiment with your prescriber, not a sure thing.
- Blood sugar. One three-week oral glutathione study in 20 men with obesity. That's a lead, not a treatment, and it isn't a reason to change any diabetes medicine.
- Aging. No human trial has tested either one for aging or lifespan.
If the evidence gap bothers you, that's a fair reaction. Both are legal to prescribe as compounded drugs, but legal to compound isn't the same as proven to work.
Safety: FDA's glutathione alerts, and NAD+'s blank page
Glutathione has the clearer safety record, and it's not a reassuring one. In August 2026, FDA said at least 30 patients had reactions after IV glutathione made by different compounding pharmacies. All of it traced to one supplement-grade lot from the supplier Medisca. Reported problems included fever, chills, pain, dizziness, signs of shock and sepsis-like symptoms, and some people were hospitalized. Two Texas pharmacies recalled products for high endotoxin levels [8].
It had happened before. In February 2019, FDA warned compounders about a repackaged glutathione powder after seven patients had reactions consistent with high endotoxin [9]. The lesson both times: the raw ingredient matters, and supplement-grade powder isn't made for injection.
NAD+ has no FDA label, so there's no FDA-reviewed side-effect list for it. That isn't the same as safe. It means nobody has collected the data in a way FDA has reviewed.
What each costs
Injection prices overlap. Right now, glutathione plans run $57.32–$329.99 a month and NAD+ plans $79–$303.08. For the full NAD+ breakdown, see the NAD+ injection cost guide.
Two things move the real number. Some programs advertise a lower first month on a prepaid plan, then bill the full rate. Others bill every four weeks instead of monthly, which adds a charge each year. Ask for the price from month two on, and ask whether the plan renews on its own.
Programs that offer both
These programs post a monthly injection price for both, so you can compare like with like.
| Program | NAD+ injection | Glutathione injection |
|---|---|---|
| Live Vital | $149 | $99.67 |
| Shed | $169 | $119 |
| HealthRx | $161 | $152 |
Also offered by (no standing monthly price published): LTTL, AgelessRx, bmiMD, Direct Meds Partner. Sorted by glutathione price. Some programs show a lower first month; these are the ongoing monthly prices.
Other programs list both but don't print a standing monthly price for each, such as Eden and Belle Health. Ask for the month-two total in writing.
Taking both
Some programs prescribe the two together. No trial has tested the pair, so there's no evidence either way that they add up to more. If you're considering both, your prescriber should know about each one.
Still deciding by goal? Our skin shortlist and our energy shortlist each start from what you want, and the 30-second match narrows it down. If the real choice is how to take NAD+, see NAD+ injections or IV drips.