NAD+, Glutathione, MIC-B12 and Vitamin Shots: What FDA Allows and What Clinics Charge
Released: ·Last reviewed: ·Methodology v4.1
As of October 15, 2026, NAD+, glutathione and methylcobalamin are on FDA’s 503A Category 1 list, so pharmacies may compound them on a prescription, but none is approved for energy, skin or weight loss; the vitamin shots that are FDA-approved, such as cyanocobalamin, are approved for deficiency, and four telehealth clinics charge $73 to $249 a month for these injections.
Whether a pharmacy may make a product and whether the product does what the ad says are separate questions. This page answers the first and prices the second.
Which rules decide whether a pharmacy may compound a wellness injection?
A state-licensed 503A pharmacy may compound from a bulk ingredient only if it meets one of three tests on FDA’s 503A page: it has a USP or National Formulary monograph, it is a component of an FDA-approved drug, or it is on FDA’s 503A bulks list. The list itself, 21 CFR 216.23, names just six substances. To fill the gap, FDA runs an interim policy for substances nominated before January 7, 2025:
- Category 1: FDA “does not intend to take action against a compounder” using these, if its guidance conditions are met.
- Category 2: FDA has identified significant safety risks.
- Category 3: nominated without enough information to evaluate; outside the Category 1 policy.
Category 1 is permission to compound while FDA decides. It is not an approval and says nothing about benefit. Peptides follow the same rules but have their own page: peptide legal status.
Where does each ingredient sit?
We read FDA’s 503A category list (updated May 14, 2026) and searched Drugs@FDA on October 15, 2026. The lists name ingredient forms, not product families, so a “B12 shot” can mean an approved drug or a compounded one.
| Ingredient | FDA 503A list status | FDA-approved product? | What clinics market it for |
|---|---|---|---|
| NAD+ (NAD, NADH) | Category 1 (NAD and NADH); beta-NAD disodium salt trihydrate is Category 3 | None found in Drugs@FDA | Energy, “cellular repair”, anti-ageing |
| Glutathione | Category 1 | Only as an ingredient of an eye irrigation solution (BSS Plus) | Skin, “detox”, antioxidant |
| Cyanocobalamin (vitamin B12) | Not on the category lists; an approved drug | Yes: cyanocobalamin injection (prescription), for B12 deficiency | Energy, weight loss |
| Methylcobalamin | Category 1 | None found in Drugs@FDA | Energy, “active B12” |
| Choline chloride | Category 1 | — | Lipotropic “fat metabolism” |
| Choline bitartrate, inositol hexanicotinate | Category 3 (outside the interim policy) | — | Lipotropic blends |
| Methionine, inositol | Not on the category lists (may qualify another way; not checked) | — | Lipotropic blends |
| L-carnitine | Acetyl-L-carnitine is Category 1 | Yes: levocarnitine (Carnitor), for carnitine deficiency | Fat burning, performance |
| Ascorbic acid (vitamin C) | Not on the category lists; an approved drug | Yes: ascorbic acid injection (prescription, intravenous) | Immunity, “drips” |
“Not on the category lists” is not a problem in itself: an ingredient can qualify through a USP monograph or as a component of an approved drug. We did not check monographs for methionine or inositol.
What is approved, and for what?
Three of these ingredients exist as FDA-approved prescription injections: cyanocobalamin (vitamin B12), ascorbic acid (vitamin C) and levocarnitine (Carnitor). Each approval covers a deficiency or a defined medical use. None covers energy, weight loss, “detox” or skin tone. NAD+ and methylcobalamin have no approved product in Drugs@FDA, and glutathione appears in one: BSS Plus, a solution used to irrigate the eye during surgery.
So when a clinic sells a “B12 shot” for energy, ask which B12. Cyanocobalamin is the approved form; methylcobalamin is a compounded Category 1 ingredient. Both can be lawful on a prescription. Neither is approved for the use on the label of the ad.
What do telehealth clinics charge?
We read four programs’ own pages on October 15, 2026. Prices are the sellers’ figures, not ours, and most are “from” prices.
| Program | Product | Price on the page | Membership or other fees | Source · read date |
|---|---|---|---|---|
| Eden | NAD+ injection | From $91 first month (medication only) | Required Eden membership: $39 first month, then $99/month | eden.health · Oct 15, 2026 |
| Eden | Glutathione | From $95 first month (medication only) | Same membership required | eden.health · Oct 15, 2026 |
| Eden | MIC+B12 | From $73 first month (medication only) | Same membership required | eden.health · Oct 15, 2026 |
| Enhance.MD | NAD+ injections | $199 / $189 / $179 / $169 per 4 weeks on 1-, 3-, 6-, 12-month plans | None stated; NAD+ wafers $99 to $84 | enhance.md · Oct 15, 2026 |
| Shed | NAD+ injections | From $169/month (3 times a week, 1-month supply) | None stated; nasal spray from $144 | tryshed.com · Oct 15, 2026 |
| Shed | Glutathione injections | From $119/month (twice weekly) | None stated | tryshed.com · Oct 15, 2026 |
| Shed | MIC + B12 injections | From $149/month | None stated | tryshed.com · Oct 15, 2026 |
| Sprout Health | NAD+ (1000 mg, twice weekly) | $199 first month, then $249 every 4 weeks | None stated | joinsprouthealth.com · Oct 15, 2026 |
Two structures hide the real monthly cost. Eden’s wellness prices are “medication only”, and the page says “An active Eden Membership is required ($39 for the first month, auto-renews at $99/month thereafter)”. That differs from Eden’s GLP-1 pricing, which states no membership fee. Sprout Health and Enhance.MD bill every four weeks, so a year holds thirteen charges.
Worked examples
Example 1: Eden’s first month. NAD+ at $91 plus the $39 first-month membership is $130. From month two the membership alone is $99 a month, so the membership costs $39 + (11 × $99) = $1,128 in the first year before any medication. Eden’s page did not print the NAD+ medication price after the first month.
Example 2: a year of NAD+ at the other three. Shed at $169 a month: 12 × $169 = $2,028. Enhance.MD on its 12-month plan at $169 per 4 weeks: 13 × $169 = $2,197. Sprout Health: $199 + (12 × $249) = $3,187 for 13 four-week cycles. The cheapest-looking monthly figure is not always the cheapest year.
Example 3: what Sprout’s dose implies. Sprout lists a typical dose of 1,000 mg twice a week. Over a four-week cycle that is 8 doses, or 8,000 mg, for $249: about $31 a dose. Eden advertises “Only $15/shot” at 500 to 1,000 mg per vial. Dose and frequency differ between sellers, so compare cost per dose, not cost per month.
What should you know about safety?
- Compounded means unreviewed. FDA does not review compounded drugs for safety, effectiveness or quality before they are sold. A Category 1 ingredient is still a compounded product.
- Injections carry injection risks. In its 2026 warning letters FDA wrote that injectable products “bypass some of the body’s key defenses against toxins and microorganisms”. Sterility depends on the pharmacy; ask which one fills the prescription.
- Marketing claims are the seller’s. One page says MIC + B12 “can assist with fat processing, energy production”; another says most patients “report increased energy within 24-48 hours”. FDA has not reviewed those claims for these products.
- Deficiency is a lab question. If you think you are low in B12, a blood test and an approved product are the evidence-based route; a lipotropic blend is not a substitute.
What should you ask before you pay?
- Which ingredient form is in the vial? Cyanocobalamin or methylcobalamin; choline chloride or bitartrate. The lists are form-specific.
- Which pharmacy compounds it, and is it 503A or 503B? Check the licence with the state board and search FDA’s warning letters.
- What does a year cost, including membership? Count four-week billing as 13 charges.
- Does any label say “research use only”? If so, stop; see what FDA’s 2026 warning letters say about research-labelled products.
More detail: NAD+, glutathione, MIC-B12, L-carnitine and our provider checklist.
Frequently asked questions
Which wellness injectables can a U.S. pharmacy compound in 2026?
As of October 15, 2026, FDA's 503A Category 1 list includes NAD and NADH, glutathione, acetyl-L-carnitine, choline chloride and methylcobalamin, so state-licensed 503A pharmacies may compound these ingredients on a prescription under FDA's interim policy if the policy's conditions are met. Category 1 is a temporary enforcement policy, not an approval, and says nothing about whether the products work. Choline bitartrate and inositol hexanicotinate are Category 3. Cyanocobalamin, ascorbic acid and levocarnitine injections are FDA-approved prescription drugs, but for deficiencies, not for energy or weight loss.
How much do NAD+ injections cost online?
On October 15, 2026, four telehealth programs priced NAD+ injections at $169 to $249 a month: Shed from $169, Enhance.MD $169 to $199 per 4 weeks, and Sprout Health $249 every 4 weeks after a $199 first month. Eden listed $91 for the first month, medication only, plus a required $99 monthly membership.
Is a B12 shot the same as an MIC-B12 shot?
No. A cyanocobalamin injection is an FDA-approved prescription drug for vitamin B12 deficiency. An MIC-B12 or lipotropic shot is a compounded mix that adds methionine, inositol and choline, and no such mix is FDA-approved for weight loss or energy.
Are glutathione injections FDA-approved?
No glutathione injection is FDA-approved. Glutathione is in FDA’s 503A Category 1, so a pharmacy may compound it on a prescription under the interim policy, and the only approved product we found that contains it is BSS Plus, an eye irrigation solution.
Does Category 1 mean a product is safe?
No. Category 1 means FDA had enough information to evaluate a nominated substance and does not intend to act against 503A pharmacies that compound it, under conditions, while it decides. It is a temporary enforcement policy, not a finding of safety or effectiveness.
Where are peptides like BPC-157 covered?
On our peptide legal status page and the individual peptide pages. This article covers the non-peptide wellness injectables only: NAD+, glutathione, MIC-B12 and other lipotropic or vitamin shots.
Sources
- FDA: bulk drug substances used in compounding under section 503A (content current as of May 14, 2026; read October 15, 2026)
- FDA: 503A categories 1, 2 and 3 list (updated May 14, 2026)
- eCFR: 21 CFR 216.23, the 503A bulks list (as of October 1, 2026)
- Drugs@FDA and openFDA: cyanocobalamin, ascorbic acid and hydroxocobalamin injections, Carnitor, BSS Plus; no NAD or methylcobalamin product (read October 15, 2026)
- Eden: NAD+, glutathione and MIC+B12 (read October 15, 2026)
- Enhance.MD: NAD+ therapy (read October 15, 2026)
- Shed: NAD+, glutathione and MIC + B12 (read October 15, 2026)
- Sprout Health: NAD+ (read October 15, 2026)