Provider review
Enhance.MD Review: A "12-Month" Plan Billed Every 48 Weeks
Enhance.MD does something unusual with its pricing: it tells you the truth in the same line as the misleading part. Its NAD+ ladder reads "12-month · Save 15% · Billed every 48 weeks · $169/mo" and "1-month · Billed every 4 weeks · $199/mo". A twelve-month plan that ships forty-eight weeks is four weeks short of a year, and a one-month plan billed every four weeks arrives thirteen times a year rather than twelve — and both of those facts are printed on the page rather than discovered at checkout. What the same page does not support is its claim: injectable NAD+ sold on "rapid energy improvement, enhanced mental clarity, and cellular rejuvenation", with the line "85% of patients choose injectable for faster, more dramatic results" — a comparative efficacy statistic for a preparation with no completed human trial by any route.
Compounded only
Phase 3 trials
Not named
None found
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Opens enhance.md. A link is not a recommendation to take anything.
Provenance
What Enhance.MD actually dispenses
Regulatory category is the axis consumers are most reliably misled about, so it comes first. Every product below is sorted by what it legally is, not by what it costs.
Prepared by a state-licensed pharmacy against a prescription for a named patient. Compounded preparations are not FDA-approved and are not reviewed by FDA for safety, effectiveness or quality.
- NAD+ Therapy — injections — $199 a month on the one-month plan, falling to $189, $179 and $169 on the three-, six- and twelve-month plans. ⚠ Enhance.MD prints the real intervals beside those labels: the one-month plan is "Billed every 4 weeks" (13 charges a year, not 12) and the "12-month" plan is "Billed every 48 weeks" — four weeks short of a year.
- NAD+ Wafers (sublingual) — $99 a month on the one-month plan, falling to $94, $89 and $84 on the longer plans, on the same four-week billing blocks.
- GLP-1 Core | Semaglutide — $212 a month advertised, $249 as the walk-away figure, billed in FOUR-WEEK blocks — so about 13 charges a year rather than 12.
- GLP-1 + GIP Advanced | Tirzepatide — $280 advertised, $329 walk-away, on the same four-week billing blocks.
- GLP-1 + GIP Elite | Semaglutide + Tirzepatide — $322 advertised, $379 walk-away, on four-week billing blocks.
- GLP-1 + GIP Microdosing Tirzepatide — $169 advertised, $189 walk-away — the cheapest tier, on the same four-week billing blocks.
Evidence
Is there a human trial at all?
One row per product, graded on how far the published human evidence goes for the use it is sold for — not for the molecule in general. A molecule with phase 3 evidence for one outcome has none for another, and that distinction is where peptide marketing lives.
2
Products with a human trial
Out of 6 reviewed here.
2
Registry records cited
Each read live from ClinicalTrials.gov, never from memory.
The comparison
What they claim, against what the trials show
Each claim below is quoted verbatim from Enhance.MD’s own page, with the page it came from. Grading a paraphrase would prove nothing. Every row is the verdict at a glance — tap it to open the quote, the trial registry entries, and the full note behind that verdict.
NAD+ Therapy — injectionsNAD+ (nicotinamide adenine dinucleotide) · Compounded (503A)No trial supports this claim
“NAD+ Therapy for cellular rejuvenation. […] Maximum bioavailability through subcutaneous injections. Experience rapid energy improvement, enhanced mental clarity, and cellular rejuvenation. 85% of patients choose injectable for faster, more dramatic results. Pharmaceutical-Grade NAD+ Vials. Ongoing Provider Care & Support.”
No human trial
As of 10 August 2026, a ClinicalTrials.gov v2 intervention search for injected NAD+ in humans returns no completed randomised trial supporting a restoration-of-function claim, and no registered study measures a cognitive endpoint for NAD+ by any route. A PubMed search for "nicotinamide adenine dinucleotide" combined with injection or subcutaneous, filtered to the randomised-controlled-trial publication type, returns zero records. No registered trial has compared injected NAD+ with a sublingual preparation for speed or magnitude of effect, which is the specific comparison this page asserts. The substantial human literature concerns ORAL precursors — nicotinamide riboside and nicotinamide mononucleotide — which are different molecules by a different route.
Three unhedged assertions and one statistic, none of them supported. "Experience rapid energy improvement, enhanced mental clarity, and cellular rejuvenation" states outcomes as things the product delivers, for a preparation with no completed human trial of any kind. "Maximum bioavailability through subcutaneous injections" is a pharmacokinetic claim with no published data behind it. And the sentence that does the most work is "85% of patients choose injectable for FASTER, MORE DRAMATIC RESULTS" — which reads as a popularity figure and functions as a comparative efficacy claim: it tells a reader that the injectable outperforms the wafer. No trial has compared the two routes for speed or magnitude, and the 85% figure itself is unsourced. ⚠ "Pharmaceutical-Grade NAD+ Vials" adds nothing checkable either: "pharmaceutical grade" is a marketing term with no regulatory definition and is not an FDA designation.1
NAD+ Wafers (sublingual)NAD+ (nicotinamide adenine dinucleotide) · Compounded (503A)No trial supports this claim
“Sublingual NAD⁺ delivery without injections. Support cellular energy, mental clarity, and daily vitality through quick-dissolving wafers designed for convenient, consistent use over time. Pharmaceutical-Grade NAD+ Vials. Ongoing Provider Care & Support.”
No human trial
As of 10 August 2026, no completed randomised trial of sublingual NAD+ in humans is registered on ClinicalTrials.gov, and a PubMed search for "nicotinamide adenine dinucleotide" combined with sublingual, filtered to the randomised-controlled-trial publication type, returns zero records. The human literature on raising NAD+ concerns ORAL precursors — nicotinamide riboside and nicotinamide mononucleotide — which are different molecules, and none of that work establishes absorption or effect for a sublingual NAD+ wafer.
The wafer page is more restrained than the injection page — "support cellular energy, mental clarity, and daily vitality" rather than "experience rapid energy improvement" — but it is selling the same molecule by a third route with no trial behind it. Sublingual absorption of a molecule the size of NAD+ is an open question, not an established one, and nothing on the page addresses it. ⚠ The copy also carries "Pharmaceutical-Grade NAD+ VIALS" on a product that is a wafer, not a vial — the feature list was not updated for the format.1
GLP-1 Core | SemaglutideSemaglutide · Compounded (503A)Claim matches the trials
“Metabolic Reset Program with GLP-1 & NAD+ Therapy. […] GLP-1 Core | Semaglutide. Begin GLP-1 weight loss with up to $100 off your first order.”
Phase 3 trials
- NCT03548935 STEP 1 — Phase 3, completed, n=1,961. Tested the approved 2.4 mg product over 68 weeks. No compounded semaglutide from any seller has been through a registered trial.
Enhance.MD makes almost no efficacy claim for its GLP-1s in its own voice — no percentage, no trial named, no transformation promised — so there is nothing here that outruns what the trials show. The product naming is also honest about what is in each tier: "Core | Semaglutide", "Advanced | Tirzepatide", "Elite | Semaglutide + Tirzepatide" name the molecules rather than hiding them behind brand words. The standing caveat applies unstated: STEP 1 tested the approved finished product, not a compounded preparation.2
GLP-1 + GIP Advanced | TirzepatideTirzepatide · Compounded (503A)Claim matches the trials
“GLP-1 + GIP Advanced | Tirzepatide. […] Metabolic Reset Program with GLP-1 & NAD+ Therapy.”
Phase 3 trials
- NCT04184622 SURMOUNT-1 — Phase 3, completed, n=2,539. Tested the approved product at the highest tolerated dose over 72 weeks.
Correctly labelled where several competitors are not: Enhance.MD calls this tier "GLP-1 + GIP", which is the actual pharmacology of tirzepatide — a dual agonist at both receptors. Two other companies in this review series describe tirzepatide as a GLP-1 receptor agonist and never mention GIP at all, and one calls it an antagonist. No efficacy figure is claimed, so nothing here reaches past the trials.3
GLP-1 + GIP Elite | Semaglutide + TirzepatideSemaglutide and tirzepatide · Compounded (503A)Claim reaches past the trials
“GLP-1 + GIP Elite | Semaglutide + Tirzepatide.”
No human trial
The molecules have phase 3 evidence; this COMBINATION does not. As of 10 August 2026, a ClinicalTrials.gov v2 search returns no registered trial administering semaglutide and tirzepatide together in humans. STEP 1 and SURMOUNT-1 each tested a single agent against placebo; neither studied co-administration, and no completed trial reports the safety or efficacy of taking both.
The name is the claim. "Elite" positions a semaglutide-plus-tirzepatide combination as the top tier of a ladder, which tells a reader it is the strongest option — and no registered trial has ever administered these two molecules together. Both are GLP-1 receptor agonists; tirzepatide additionally acts at GIP. Combining them is not a documented protocol, and there is no published human safety or efficacy data for the pairing. Enhance.MD makes no explicit efficacy claim for it, which is why this is graded as reaching past the trials rather than unsupported — but the tier naming does the persuading that a sentence would otherwise have to.2,3
GLP-1 + GIP Microdosing TirzepatideTirzepatide · Compounded (503A)Claim reaches past the trials
“GLP-1 + GIP Microdosing Tirzepatide. […] Metabolic Reset Program.”
No human trial
The molecule has phase 3 evidence; this USE does not. As of 10 August 2026, a ClinicalTrials.gov v2 search returns no completed trial of a sub-therapeutic "microdose" tirzepatide regimen against any endpoint. The SURMOUNT programme tested full therapeutic doses titrated to target in people with obesity and reported weight and cardiometabolic outcomes; it did not test a deliberately reduced dose, and no registered trial supports a claim that microdosing retains benefit while lowering side effects.
Microdosing is sold across this category as a gentler route to the same benefit, and no trial has tested that proposition for tirzepatide at all. Enhance.MD is more restrained than most — it makes no explicit longevity or side-effect claim for the tier, and it prices it as the cheapest rung rather than as a premium longevity protocol, which is how a competitor in this wave sells the same idea. What remains is the implication carried by offering it: that a lower dose is a real therapeutic option with known properties. It is not one that has been studied.3
Dispensing chain
Who actually fills your prescription
Read the full account
No dispensing pharmacy is named anywhere on the site. The clinical side is disclosed more fully and is checkable: prescriptions are written by Enhance Wellness PC across most of its footprint, with Arizona and California routed to iThriveMD PC — two named professional corporations, which is more than most of this roster publishes, and the routing is visible inside the sign-up gate rather than asserted in marketing. ⚠ The product-quality language does not survive scrutiny. "Pharmaceutical-Grade NAD+ Vials" appears as a feature on both NAD+ products, and "pharmaceutical grade" is a marketing term with no regulatory definition — it is not an FDA designation, not a compounding category, and not something a patient can verify. The site states no compounding category at all: neither 503A nor 503B appears. ⚠ The same feature list is carried unchanged onto the wafer product, which is a sublingual tablet rather than a vial.
Read on August 2026 from https://enhance.md/product/nad-therapy
Quality
Third-party testing, and what is published
Describes a testing regime
Nothing published on the pages searched
Certificate of analysis readable
No lot report a buyer can open
Read the full testing account
No certificate of analysis, lot number, potency result, sterility result, named laboratory or batch lookup is published for any product, and no pharmacy is named to ask for one. The only quality assertion on the site is "Pharmaceutical-Grade NAD+ Vials", which is not a standard: "pharmaceutical grade" has no regulatory definition, is not conferred by FDA, and cannot be checked by a patient. No compounding category is stated — neither 503A nor 503B appears anywhere. ⚠ The one place the site makes a numerical claim about its own results is the NAD+ page's "85% of patients choose injectable for faster, more dramatic results", which is unsourced and, read carefully, asserts a comparative outcome rather than a preference. ⚠ No study, trial identifier or publication is cited anywhere on the site, for any product — including for the two GLP-1 molecules with large phase 3 programmes behind them.
Read on August 2026 from https://enhance.md/product/nad-therapy
Licensing
Licensed to dispense, and where
Coverage
40 states, taken from the sign-up gate rather than the FAQ
Read the full licensing claim
Enhance.MD serves 40 states, and the figure comes from the gate inside its own sign-up application rather than from its marketing: 38 states covered by Enhance Wellness PC, plus Arizona and California routed to iThriveMD PC. Washington, D.C. is not in the gate. ⚠ Its FAQ publishes a DIFFERENT list — 41 entries, adding the District of Columbia and West Virginia and dropping North Dakota. Where the two disagree, the gate is the one that decides whether an address is accepted, so the gate is what is recorded here and the ten excluded states above are taken from it. Publishing two conflicting coverage lists is a real defect, though a smaller one than publishing none: most of this roster claims all fifty states and names no exclusions at all. No individual clinician is named and no licence number is published for either professional corporation.
Named as outside that footprint
Read on August 2026 from https://enhance.md
Regulatory
The FDA warning letter
Checked, and none found
Assessment
What holds up, and what does not
- It prints the real billing interval beside the plan name — "12-month · Billed every 48 weeks" and "1-month · Billed every 4 weeks" — so the discrepancy is disclosed on the page rather than discovered on a statement.
- Its product tiers name the molecules rather than hiding them: "Core | Semaglutide", "Advanced | Tirzepatide", "Elite | Semaglutide + Tirzepatide".
- It labels tirzepatide correctly as "GLP-1 + GIP" — the actual dual-agonist pharmacology — where two competitors in this series call it a GLP-1 agonist and one calls it an antagonist.
Show 6 more
- It publishes a full price ladder across one-, three-, six- and twelve-month plans for both NAD+ formats, so the cost of every commitment length is visible before signing up.
- Coverage is a real 40-state gate inside its own sign-up application, with Arizona and California routed to a separately named professional corporation.
- Two prescribing entities are named — Enhance Wellness PC and iThriveMD PC — which is more than most of this roster discloses.
- It offers NAD+ in two formats, injection and sublingual wafer, at genuinely different prices ($199 against $99) rather than steering everyone to the dearer one.
- It makes no efficacy claim at all for its GLP-1s — no percentage, no trial name, no transformation promised.
- No FDA warning letter — screened against the live index on the trading name with a positive control that fired.
- A "12-month" plan is billed every 48 weeks — four weeks short of a year — and a "1-month" plan every four weeks, which is 13 charges a year rather than 12.
- "85% of patients choose injectable for faster, more dramatic results" is an unsourced comparative efficacy claim dressed as a popularity statistic. No trial has compared the routes.
- "Experience rapid energy improvement, enhanced mental clarity, and cellular rejuvenation" is unhedged, for a preparation with no completed human trial by any route.
Show 9 more
- "Maximum bioavailability through subcutaneous injections" is a pharmacokinetic claim with no published data behind it.
- "Pharmaceutical-Grade" is a marketing term with no regulatory meaning, and it is the site's only quality assertion.
- The "Pharmaceutical-Grade NAD+ Vials" feature is carried unchanged onto the wafer product, which is not a vial.
- The "Elite" tier combines semaglutide and tirzepatide, a pairing no registered trial has ever administered together.
- Microdosed tirzepatide is sold as a tier of its own, and no trial has tested a sub-therapeutic tirzepatide regimen against any endpoint.
- Two conflicting coverage lists are published: a 40-state sign-up gate and a 41-entry FAQ list that adds DC and West Virginia and drops North Dakota.
- No dispensing pharmacy is named, and no certificate of analysis, lot number or test result is published for any product.
- No compounding category is stated anywhere — neither 503A nor 503B.
- No study, trial identifier or publication is cited anywhere on the site.
Verdict
The bottom line
Enhance.MD is unusually honest about its billing and unusually loose about its evidence, and the two sit a scroll apart on the same page. Its NAD+ pricing table prints "12-month · Billed every 48 weeks" and "1-month · Billed every 4 weeks" — telling you, in the same line as the misleading label, that a year here is forty-eight weeks and a month is twenty-eight days. Almost nobody in this roster does that. Its GLP-1 tiers name the molecules and get tirzepatide's dual-agonist pharmacology right, where competitors get it wrong. Then the NAD+ page sells injections on "rapid energy improvement" and "85% of patients choose injectable for faster, more dramatic results" — a comparative outcome claim, unsourced, for a preparation with no completed human trial by any route — and calls the product "pharmaceutical-grade", which means nothing. If you are buying a GLP-1, this is a competent operator that will tell you what it charges and when. If you are buying NAD+, you are paying $199 a month, thirteen times a year, for the least-evidenced product on the site.
Opens enhance.md. A link is not a recommendation to take anything.
The plan that is four weeks short of a year
Enhance.MD's NAD+ pricing table, transcribed exactly:
| Plan | Discount | Interval | Price | |---|---|---|---| | 12-month | Save 15% | Billed every 48 weeks | $169/mo | | 6-month | Save 10% | Billed every 24 weeks | $179/mo | | 3-month | Save 5% | Billed every 12 weeks | $189/mo | | 1-month | — | Billed every 4 weeks | $199/mo |
Read the second and third columns together.
A "12-month" plan billed every 48 weeks is not twelve months. Twelve four-week blocks is 48 weeks; a year is 52. A patient who prepays for what is described as a year receives eleven months and a week of medication.
A "1-month" plan billed every 4 weeks does not arrive twelve times a year. Twenty-eight-day billing produces about 13 charges in a 52-week year, so $199 "a month" is roughly $2,587 annually rather than the $2,388 the label implies.
Both of those are ordinary defects in this category — a competitor in this same review series runs the identical four-week cycle. What is not ordinary is that Enhance.MD prints the interval. "Billed every 48 weeks" is on the page, in the same line as "12-month", where competitors leave a buyer to discover it on a bank statement. The label is misleading and the correction is right beside it.
The same four-week blocks govern the GLP-1 tiers: semaglutide at $212 advertised and $249 walk-away, tirzepatide at $280 and $329, the combination tier at $322 and $379, and microdosed tirzepatide at $169 and $189.
Full analysis — 5 more sectionsThe sentence that does the selling · "Pharmaceutical-grade" · What Enhance.MD gets right on the GLP-1s · Where you can actually sign up · What this means if you are buying
The sentence that does the selling
Enhance.MD's NAD+ page offers two formats — subcutaneous injections at $199 a month and sublingual wafers at $99 — and here is how it distinguishes them:
"Maximum bioavailability through subcutaneous injections. Experience rapid energy improvement, enhanced mental clarity, and cellular rejuvenation. 85% of patients choose injectable for faster, more dramatic results."
That last sentence is worth taking apart, because it is built to read as a fact about customers and function as a claim about outcomes.
"85% of patients choose injectable" is a popularity figure. "for faster, more dramatic results" is the reason given — and it asserts that the injection outperforms the wafer, in speed and in magnitude. A reader deciding between a $99 product and a $199 one has just been told the dearer one works better and faster.
No trial has compared them. There is no completed randomised trial of injected NAD+ in humans at all, none of sublingual NAD+, and none comparing routes for speed or magnitude of effect. 1 The 85% figure is unsourced.
The claims above it are unhedged in a way the rest of the site is not: "Experience rapid energy improvement, enhanced mental clarity, and cellular rejuvenation" — not "may support", not "studied for". And "maximum bioavailability" is a pharmacokinetic assertion with no published data behind it.
The substantial human literature on raising NAD+ is about oral precursors — nicotinamide riboside and nicotinamide mononucleotide — which are different molecules taken a different way. Neither the injection page nor the wafer page mentions this.
"Pharmaceutical-grade"
Both NAD+ products list, as a feature: "Pharmaceutical-Grade NAD+ Vials".
The phrase has no regulatory meaning. FDA does not confer a "pharmaceutical grade" designation, there is no standard a patient can look up, and nothing about it can be verified. It is the only quality assertion on the site.
The site also states no compounding category anywhere — neither 503A nor 503B — and names no dispensing pharmacy at all. There is no certificate of analysis, lot number, potency or sterility result for any product, and no party identified to ask for one.
*(A small tell: the "Pharmaceutical-Grade NAD+ Vials" feature is carried unchanged onto the wafer product, which is a sublingual tablet.)*
What Enhance.MD gets right on the GLP-1s
Its tiers are named for their contents rather than for a marketing ladder:
- GLP-1 Core | Semaglutide
- GLP-1 + GIP Advanced | Tirzepatide
- GLP-1 + GIP Elite | Semaglutide + Tirzepatide
- GLP-1 + GIP Microdosing Tirzepatide
"GLP-1 + GIP" is the correct pharmacology for tirzepatide — a dual agonist at both receptors. Two other companies in this review series describe tirzepatide as a plain GLP-1 receptor agonist and never mention GIP; one calls it an antagonist, which is the opposite of what it does. Getting this right is not a low bar in this category, and Enhance.MD clears it.
It also claims nothing for the drugs. No percentage, no trial named, no before-and-after. Where several competitors borrow STEP 1's 15% and attach it to a compounded product, Enhance.MD simply does not make the claim — which is why its two single-agent tiers grade as matching the evidence. 2 3
Two tiers do carry an implication the trials do not support.
"Elite | Semaglutide + Tirzepatide" puts a combination of the two molecules at the top of the ladder. No registered trial has ever administered semaglutide and tirzepatide together. STEP 1 and SURMOUNT-1 each tested a single agent against placebo, and there is no published human safety or efficacy data for the pairing. Calling it "Elite" does the persuading that a sentence would otherwise have to.
"Microdosing Tirzepatide" is sold as its own tier, and no trial has tested a deliberately sub-therapeutic tirzepatide regimen against any endpoint. To Enhance.MD's credit it prices this as the cheapest rung rather than as a premium longevity protocol, and makes no side-effect or healthspan claim for it — where a competitor in this wave sells the same idea as a "low-dose longevity protocol".
Where you can actually sign up
Enhance.MD serves 40 states, and the number comes from the gate inside its own sign-up application rather than from marketing copy: 38 covered by Enhance Wellness PC, plus Arizona and California routed to iThriveMD PC. Naming two prescribing corporations, and showing which one handles which state, is more disclosure than most of this roster offers.
Its FAQ then publishes a different list — 41 entries, adding the District of Columbia and West Virginia and dropping North Dakota. Where the two disagree the gate is what decides whether your address is accepted, so the gate is what this review records.
Publishing two conflicting coverage lists is a genuine defect. It is also a smaller one than publishing none, which is what most of this category does.
What this means if you are buying
For a GLP-1, Enhance.MD is a competent, honestly-billed operator. It names the molecule in every tier, gets tirzepatide's pharmacology right, claims nothing it cannot support, and tells you the billing interval. Budget on four-week blocks: thirteen charges a year, not twelve.
Avoid the "Elite" combination tier unless a clinician has given you a specific reason — no trial has ever given both molecules together.
For NAD+, understand what the $100 difference between the injection and the wafer is buying. The page says the injection gives "faster, more dramatic results" and that 85% of patients choose it. No study has compared the two, no study has tested either one, and "pharmaceutical-grade" is not a standard. At $199 a month billed thirteen times a year, it is the most expensive thing on the site per unit of evidence.
Questions
Frequently asked questions
Is Enhance.MD's "12-month" plan really twelve months?
No — it is 48 weeks, and Enhance.MD says so on the same line. Its pricing table reads "12-month · Save 15% · Billed every 48 weeks · $169/mo". Twelve four-week blocks is 48 weeks; a calendar year is 52, so a patient prepaying for what is labelled a year receives eleven months and a week of medication. The same applies at the other end: the "1-month" plan is "Billed every 4 weeks", which produces about 13 charges in a year rather than 12 — so $199 a month is closer to $2,587 annually than the $2,388 the label suggests. The label is misleading; the correction is printed beside it, which is more than most of this category does.
Does injectable NAD+ work better than the wafer?
Nobody knows, and Enhance.MD's page asserts that it does. It reads: "Maximum bioavailability through subcutaneous injections. Experience rapid energy improvement, enhanced mental clarity, and cellular rejuvenation. 85% of patients choose injectable for faster, more dramatic results." That final sentence reads as a popularity statistic and functions as a comparative efficacy claim — it tells a reader the $199 product outperforms the $99 one. No registered trial has compared injected and sublingual NAD+ for speed or magnitude of effect. In fact there is no completed randomised trial of injected NAD+ in humans at all, and none of sublingual NAD+; the substantial human literature concerns oral precursors, which are different molecules by a different route. The 85% figure is unsourced.
What does "pharmaceutical-grade" mean here?
Nothing checkable. "Pharmaceutical-Grade NAD+ Vials" appears as a feature on both NAD+ products, and the phrase has no regulatory definition — FDA confers no such designation, there is no published standard behind it, and a patient cannot verify it. It is the only quality assertion on the site. Enhance.MD names no dispensing pharmacy, states no compounding category (neither 503A nor 503B appears anywhere), and publishes no certificate of analysis, lot number, potency or sterility result for any product. A small sign of how closely the feature list is maintained: the "Vials" bullet is carried unchanged onto the wafer product, which is a sublingual tablet.
Should I take the "Elite" semaglutide-plus-tirzepatide tier?
Not without a specific clinical reason, because no trial has studied it. Enhance.MD's top tier is "GLP-1 + GIP Elite | Semaglutide + Tirzepatide" at $322 advertised and $379 walk-away. No registered trial has ever administered those two molecules together in humans: STEP 1 tested semaglutide against placebo and SURMOUNT-1 tested tirzepatide against placebo, and there is no published human safety or efficacy data for the combination. Both are GLP-1 receptor agonists, with tirzepatide additionally acting at GIP. Enhance.MD makes no explicit efficacy claim for the tier — but placing it at the top of a ladder called "Elite" carries the implication that it is the strongest option available, and that implication has nothing behind it.
Does Enhance.MD serve my state?
It serves 40 states, and it publishes two lists that do not agree. The number that decides is the gate inside its own sign-up application: 38 states covered by Enhance Wellness PC plus Arizona and California routed to iThriveMD PC, with Washington, D.C. absent. Its FAQ publishes a different, 41-entry list that adds DC and West Virginia and drops North Dakota. Since the gate is what accepts or rejects an address, the gate is what this review records, and the ten excluded states are taken from it: Alabama, Arkansas, Georgia, Hawaii, Louisiana, Mississippi, Missouri, South Carolina, Tennessee and West Virginia. Naming two prescribing corporations and showing which handles which state is more disclosure than most of this roster offers; publishing two conflicting lists is still a defect.
Glossary
Key terms
Show definitions
- Four-week billing
- A 28-day charge cycle. It produces about 13 charges in a 52-week year rather than 12, so a "monthly" price billed this way costs roughly 8% more per year than it appears to.
- "Pharmaceutical grade"
- A marketing phrase with no regulatory definition. FDA does not award it, no published standard defines it, and a patient cannot verify it. It is not the same as an approval, a compounding category, or a certificate of analysis.
- GIP
- Glucose-dependent insulinotropic polypeptide, the second receptor tirzepatide acts on. A drug acting at both GIP and GLP-1 is a dual agonist, which is why "GLP-1 + GIP" is the correct label and "GLP-1 receptor agonist" alone is not.
Method
How we checked this
Non-product facts last checked August 2026. Read the editorial policy for the rules this page is held to.
Read our methodology
Claims read first-party
Every quoted claim was read off Enhance.MD's own pages on the date stamped against it, and the URL it came from is published beside it.
Trials read from the registry
Phase, status and enrolment come from ClinicalTrials.gov; identifiers and journals from PubMed's own records. Nothing here is cited from memory.
Absence claims bounded
Where we report that no trial exists, the page says what was searched, where, and when — never an unbounded claim that nobody has tested something.
Letters matched on full name
FDA letters are matched on the complete company name. A substring match would attach one firm's regulatory history to another with a similar name.
Sources
References
Show all 3 sources
- US National Library of Medicine (2026). ClinicalTrials.gov v2 and PubMed searches for injected and sublingual NAD+ in humans: no completed randomised trial supporting a restoration-of-function claim, no registered study reporting a cognitive endpoint by any route, and no trial comparing routes for speed or magnitude of effect. Run 2026-08-10.. ClinicalTrials.gov / PubMed. https://clinicaltrials.gov/search?intr=NAD%2B
- Wilding JPH, Batterham RL, Calanna S, et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine 384(11):989-1002. https://pubmed.ncbi.nlm.nih.gov/33567185/
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine 387(3):205-216. https://pubmed.ncbi.nlm.nih.gov/35658024/
Medical disclaimer: This content is for general educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional before starting, stopping, or changing any treatment.