Provider review
Pallas Health Review: The Only Seller That Admits Its Evidence Is Thin
Pallas Health does almost everything this site spends its time asking companies to do. Six dispensing pharmacies named with phone numbers. The 503A and 503B distinction explained correctly, unprompted. Both of its doctors named and license-checkable, with an instruction to go and check them. And on its NAD+ page, the sentence no other seller of that molecule will write: that "Research on supplemental NAD+ is still developing".
Pallas Health is the company this site would point to if asked what good disclosure looks like. Six pharmacies named with phone numbers. The 503A/503B distinction explained correctly, unprompted. Two doctors named and license-checkable, with an instruction to go and check them. The states requiring a video visit, listed. A promise that a declined patient is not charged, and a statement that compounded drugs are not FDA-approved and are not generics. And, on the product page, the sentence no other NAD+ seller will write: that the research is still developing. It is graded well here not because its evidence is strong — there is no completed human trial of injected or intranasal NAD+, and Pallas does not have one — but because it mostly declines to claim what it cannot support. The failures are narrow and worth knowing. No certificate of analysis exists for anything it sells. Its footer disclaims the reliability of its own health content because some of it is AI-generated. And every price on the site is a twelve-week charge divided by three, which quietly adds about eight per cent to the year: the NAD+ injection is $2,587 annually, not the $2,388 that "$199/mo" suggests.
Worth trusting if
- You want to know who fills the prescription, because Pallas names six pharmacies and publishes a phone number for each one.
- You are weighing compounded against brand-name, because it shows the Zepbound and Ozempic cash prices beside its own instead of hiding them.
- You want the real charge and not just an average, because the plan screen prints the amount billed every 12 weeks next to the monthly figure.
Be skeptical if
- You want to pay month to month, because the compounded plans bill a full 12-week cycle after the first month and offer no shorter rung.
- You budget by the calendar year, because 4.33 twelve-week cycles fall in one and the yearly cost runs about 8% above the monthly figure.
- You need a certificate of analysis before you inject, because Pallas publishes no lot number, potency result or sterility result for anything it sells.
Compounded only
Phase 3 trials
Named
None found
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Opens www.pallashealth.co. A link is not a recommendation to take anything.
Provenance
What Pallas Health 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+ nasal spray — $79 for the first month, then $567 every 12 weeks — which Pallas itself prints, alongside its own "$189/mo average". Twelve weeks is 2.769 months, not three, and the cycle comes round 4.33 times a year — so a year is about $2,457, not the $2,268 that "$189/mo" implies.
- NAD+ subcutaneous injection — $89 for the first month, then $597 every 12 weeks, printed by Pallas beside its own "$199/mo average". On 4.33 cycles a year that is about $2,587, not the $2,388 implied by "$199/mo".
- Compounded semaglutide — $139 for the first four weeks, then $597 every 12 weeks, advertised as "$199/month". At 4.33 cycles a year that is $2,587, not $2,388. There is no month-to-month option for the compounded GLP-1s.
- Compounded tirzepatide — $179 for the first four weeks, then $897 every 12 weeks, advertised as "$299/month". 4.33 cycles a year makes it $3,887, not the $3,588 implied.
Evidence
Has the molecule been tested for what it is sold for?
One row per product, graded on how far the published human evidence goes for the MOLECULE inside it, for the use it is sold for — not for the molecule in general, and never a claim about this seller. Nobody trials a compounded preparation; what a trial can tell you is whether the molecule has been tested for the thing it is being advertised to do. A molecule with phase 3 evidence for one outcome has none for another, and that distinction is where peptide marketing lives.
2
Molecules with human evidence
For the use they are sold for, out of 4 products reviewed here. The evidence belongs to the molecule, not to Pallas Health.
2
Registry records cited
Each read live from ClinicalTrials.gov, never from memory. None of them tested this company's product.
The comparison
What they claim, against what the trials show
Each claim below is quoted verbatim from Pallas Health’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+ nasal sprayNAD+ (nicotinamide adenine dinucleotide) · Compounded (503A)Claim matches the trials
“NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell, where it plays a role in energy metabolism and normal cellular function; levels naturally decline as we age. […] Found in every cell — central to energy metabolism (ATP). Involved in normal cellular repair processes. Levels naturally decline as we age. […] Research on supplemental NAD+ is still developing — which is why a US-licensed clinician reviews your health history and prescribes it only when it's appropriate for you.”
Read on the Pallas Health site, August 2026
No trial for this use
As of 10 August 2026, a ClinicalTrials.gov v2 search returns no completed randomized trial of intranasal NAD+ in humans, and no registered study measures nose-to-brain delivery of NAD+ or a cognitive endpoint from it. A PubMed search for "nicotinamide adenine dinucleotide" combined with intranasal or nasal, filtered to the randomized-controlled-trial publication type, returns zero records. The substantial human literature on raising NAD+ concerns ORAL precursors — nicotinamide riboside and nicotinamide mononucleotide — which are different molecules by a different route.
Graded as matching because every sentence Pallas actually asserts is true, and it is careful to assert only the ones that are. NAD+ is a coenzyme; it is found in every cell; it is central to energy metabolism; levels do decline with age. Each is settled biochemistry. What Pallas conspicuously does NOT do is take the next step every competitor takes — that injecting or spraying it therefore restores function, energy, focus or youth. Instead it publishes the sentence that ought to be on all of them: "Research on supplemental NAD+ is still developing." That is a seller volunteering the weakness of its own product's evidence base, and it is the only instance of it in this wave. The gap that remains is real and unstated: no completed human trial supports intranasal NAD+ for anything, and the page does not say that the evidence which exists is for oral precursors.1
NAD+ subcutaneous injectionNAD+ (nicotinamide adenine dinucleotide) · Compounded (503A)Claim matches the trials
“NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in all of your cells. It supports energy metabolism and normal cellular processes, and its levels tend to decline with age. […] Levels naturally decline as we age — one reason many people explore replenishing it. […] Research on supplemental NAD+ is still developing.”
Read on the Pallas Health site, August 2026
No trial for this use
As of 10 August 2026, a ClinicalTrials.gov v2 intervention search for injected NAD+ in humans returns no completed randomized trial supporting a restoration-of-function claim, and a PubMed search for "nicotinamide adenine dinucleotide" combined with injection or subcutaneous, filtered to the randomized-controlled-trial publication type, returns zero records. The human literature concerns ORAL precursors — nicotinamide riboside and nicotinamide mononucleotide — different molecules by a different route.
The same restraint as the nasal form, and one phrase worth singling out. Where a competitor writes "NAD+ declines with age. This restores it", Pallas writes that declining levels are "one reason many people explore replenishing it" — describing a motivation rather than asserting a result. That is a precise piece of writing and it is doing real work. The unstated gap is identical: no completed human trial of injected NAD+ exists, and the page does not tell the reader that the evidence which does exist concerns oral precursors taken a different way.1
Compounded semaglutideSemaglutide · Compounded (503A)Claim matches the trials
“Personalized GLP-1 Treatments for weight loss. […] Compounded medications are not FDA-approved and are not generic versions of brand-name drugs. Eligibility and treatment are determined by a US-licensed clinician; results vary.”
Read on the Pallas Health site, August 2026
Phase 3 trials
What the trials show for Semaglutide
- NCT03548935 STEP 1 — Phase 3, completed, n=1,961. Tested the approved 2.4 mg product. No compounded semaglutide from any seller has been through a registered trial.
Pallas makes almost no efficacy claim for its GLP-1s in its own voice — no percentage, no trial named, no before-and-after promise — and it prints the sentence most of this category avoids: "Compounded medications are not FDA-approved and are not generic versions of brand-name drugs." That is precisely the distinction FDA has issued warning letters to two other companies in this wave for blurring. The standing caveat still applies and Pallas does not spell it out: STEP 1 tested the approved finished product, not a compounded preparation.2
Compounded tirzepatideTirzepatide · Compounded (503A)Claim matches the trials
“Personalized GLP-1 Treatments for weight loss. […] Compounded medications are not FDA-approved and are not generic versions of brand-name drugs. Eligibility and treatment are determined by a US-licensed clinician; results vary.”
Read on the Pallas Health site, August 2026
Phase 3 trials
What the trials show for Tirzepatide
- NCT04184622 SURMOUNT-1 — Phase 3, completed, n=2,539. Tested the approved product at the highest tolerated dose over 72 weeks.
The same near-silence, and the same compounded-vs-approved disclaimer printed plainly. Pallas's signup shows semaglutide and tirzepatide side by side with separate prices and does not default a patient onto either, which is a small but genuine courtesy — several competitors quietly steer to the dearer molecule. Nothing on the page overstates what tirzepatide does, because the page barely says what it does.3
Dispensing chain
Who actually fills your prescription
- Belmar Pharmacy
- Strive Pharmacy
- Epiq Scripts
- Casa Pharma Rx
- The Pharmacy Hub
- Foothills Pharmacy
Read the full account
This is the best supply-chain disclosure of any company we track, and it is not close. Pallas names six dispensing pharmacies, each with a phone number and a web address, under a heading that states the arrangement plainly — "Pallas Health does not own or operate a pharmacy": Belmar Pharmacy (800-525-9473), Strive Pharmacy (855-405-5993), Epiq Scripts (833-654-3553), Casa Pharma Rx (877-937-6868), The Pharmacy Hub (888-958-1382) and Foothills Pharmacy (480-496-4444). It then explains, unprompted and accurately, what the regulatory categories mean: "503A pharmacies are licensed and inspected by their respective state boards of pharmacy. 503B outsourcing facilities are registered with and inspected by the FDA under current Good Manufacturing Practice (cGMP) standards." It tells you what determines which one fills your prescription — "the medication, the patient's shipping state, and current capacity" — and offers state pharmacy license numbers "on request to support@pallashealth.co". The one thing withheld is which pharmacy fills your order, and Pallas says why rather than pretending the question does not exist. Belmar, Strive, Epiq Scripts and Casa Pharma Rx also fill for several other brands, which fits the CareValidate white-label platform Pallas names as its clinical-operations partner. A shared back end is not grounds to treat these companies as one, and naming the pharmacy still counts in Pallas's favor. Clinical care is delivered by Lion MD, named as a separate entity, with Pallas stating it "does not employ medical providers, does not practice medicine, and does not direct clinical decisions".
Read on the Pallas Health site, August 2026.
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 — the same gap as every other company in this wave, and the one thing Pallas's otherwise excellent disclosure does not cover. What it publishes instead is better than a testing slogan: it identifies the six pharmacies that actually do the compounding, gives their phone numbers, and explains that 503A pharmacies are inspected by state boards while 503B facilities are FDA-registered under cGMP. That does not tell a patient what was in their vial, but it tells them exactly who to ask and how to reach them, which no competitor here does. Set against that, the site-wide footer carries a disclaimer that sits awkwardly on a health platform: "Some content on this site is AI-generated; no representation or warranty is made regarding its accuracy, completeness, or reliability." Pallas publishes 51 state-by-state telehealth guides and a set of clinical calculators; that sentence disclaims the reliability of all of it. Also unreconciled: the homepage advertises "200,000+ patients" while the clinical page describes a patient portal that "goes live alongside our July 2026 launch" and three product lines remain marked "Coming soon".
Read on the Pallas Health site, August 2026.
Licensing
Licensed to dispense, and where
Coverage
All 50 states and Washington, D.C., with a synchronous video visit required in 7 states plus D.C.
Read the full licensing claim
Pallas publishes its telehealth position more precisely than any other seller we've reviewed. It serves all fifty states and the District of Columbia, and it names the jurisdictions where the law requires a real-time encounter before a prescription can be issued: "currently Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, and West Virginia, plus Washington, D.C. — a real-time video visit is scheduled before any prescription is issued. In states that permit asynchronous review under the applicable standard of care, the clinician may evaluate and prescribe based on" the intake. It also publishes a per-jurisdiction rules tracker with 51 state guides and a changelog. No states are listed as excluded in this review, and that is a finding rather than a gap: Pallas turns nobody away, it varies the kind of appointment instead. Both doctors are named and license-checkable — Dr. Ana Lisa Carr, MD, board-certified in family, obesity and addiction medicine, and Dr. Kelly Tenbrink, MD, emergency medicine — each printed with their federal provider number and the site's own instruction to look them up in the government registry rather than take Pallas's word for it. Pallas states that clinicians "may decline to prescribe when treatment is not clinically appropriate" and that a declined patient "is not charged". The platform operator is Brentmoor, Inc., 131 Continental Dr, Suite 305, Newark, DE 19713, +1 (440) 601-3717.
Read on the Pallas Health site, August 2026.
Regulatory
The FDA warning letter
Checked, and none found
We did this ourselves
What happens when you sign up with Pallas Health
We went through Pallas Health’s signup ourselves in August 2026 to find out what you actually meet before you pay — the steps, when a price appears, and what it asks for. We used placeholder answers, and we stopped before paying, so nothing here is a prescription or a medical outcome. It is what the screens showed.
- Say what you want to accomplish, from a list of seven goals.
- Say whether you already have a medication in mind or want a recommendation.
- Give your age band, then your height and weight, which Pallas turns into a BMI on the spot.
- Pick a target from the loss figures it calculates for you.
- Give your sex, then work through the health history: symptoms, diabetic status, the disqualifying conditions, and a second list that Pallas says are not necessarily exclusions.
- Choose your medication on a screen that prints the first-month price, the ongoing monthly average and the amount actually billed, side by side.
- The full schedule sits on the homepage before you answer anything. Pallas writes it out: “Compounded semaglutide is $139 for your first month, then $597 every 12 weeks ($199/mo average)”.
- The medication screen repeats that and adds the brand-name cash prices, which nobody else in this category shows: Zepbound $1,069 a month, Ozempic $1,299, Wegovy and Mounjaro $1,349, each marked billed monthly.
- Twelve weeks is 2.77 months, not three, so 4.33 cycles land in a year and the yearly cost runs about 8% above what the monthly average implies.
- The opening rates are first-month only. The second charge is the whole 12-week cycle, and there is no month-to-month rung for either compounded plan.
- Eleven disqualifying conditions are listed by name on one screen rather than buried, and the homepage says a patient a clinician declines is refunded in full.
- The homepage promises "Unlimited 24/7 support" while the footer publishes hours of Monday to Friday, 9 AM to 5 PM ET. Both sentences ship on the same page.
- Pallas publishes which states require a live video visit. Texas is not one of them, and no video visit and no lab result were demanded on the path walked here.
Pallas Health support
- Phone
- +1 (440) 601-3717
- Hours
- Monday to Friday, 9 AM to 5 PM ET
Assessment
What holds up, and what does not
- It names six dispensing pharmacies — Belmar, Strive, Epiq Scripts, Casa Pharma Rx, The Pharmacy Hub and Foothills — each with a phone number and a web address. Nothing else in this market comes close.
- It explains the 503A/503B distinction correctly and unprompted, including that 503B registration means FDA inspection under cGMP and 503A licensing means state board oversight.
- Its NAD+ page states that "Research on supplemental NAD+ is still developing" — the only seller of the molecule in this wave to concede anything about its own evidence base.
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- It describes NAD+ decline as "one reason many people explore replenishing it" rather than asserting that replenishing it works. That is a deliberate and unusual piece of restraint.
- Both doctors are named and license-checkable, and Pallas tells you to look them up in the federal registry rather than take its word for it.
- It names the seven states plus D.C. that require a synchronous video visit, and publishes a per-jurisdiction telehealth rules tracker with a changelog.
- It prints the real billing cycle beside its averaged figure — "$567 every 12 weeks ($189/mo average)" — so the amount actually charged is on the page.
- It states plainly that "Compounded medications are not FDA-approved and are not generic versions of brand-name drugs" — the exact distinction FDA has written to two other companies in this wave about.
- Patients declined by a clinician are not charged, and Pallas says so in its clinical disclosures rather than in a refund policy nobody opens.
- Refills are not automatic: "each renewal involves clinician review of progress and tolerability."
- Its GLP-1 signup shows semaglutide and tirzepatide side by side with separate prices and doesn't default you onto the dearer one.
- No FDA warning letter for Pallas Health, or for Brentmoor, Inc., the company that operates it.
- Every plan runs on a twelve-week cycle averaged to "/mo" by dividing by three. Twelve weeks is 2.769 months and 4.33 cycles fall in a year, so a year costs about 8.3% more than the monthly figure implies.
- In cash: NAD+ injection is $2,587 a year rather than $2,388; the nasal spray $2,457 rather than $2,268; tirzepatide $3,887 rather than $3,588.
- No certificate of analysis, lot number, potency result or sterility result is published for any product.
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- The site-wide footer disclaims its own content — "Some content on this site is AI-generated; no representation or warranty is made regarding its accuracy, completeness, or reliability" — beneath 51 state telehealth guides and a set of clinical calculators.
- The homepage claims "200,000+ patients" while the clinical page describes a portal going live "alongside our July 2026 launch" and three product lines are still marked "Coming soon".
- Neither NAD+ page mentions that the human evidence for raising NAD+ concerns oral precursors by a different route, which is the single most useful thing a buyer could be told.
- Which of the six pharmacies fills a given order is not disclosed, and state license numbers are available only on request rather than published.
- There is no month-to-month option for the compounded GLP-1s — the twelve-week cycle is the only rung.
- The intro rates ($79 and $89 for NAD+, $139 and $179 for the GLP-1s) are first-period only and step up to the standing cycle price afterwards.
- Its peptide range is thin for a peptide buyer: NAD+ is a coenzyme rather than a peptide, and the only true peptides sold are the two GLP-1s.
Verdict
The bottom line
This is what good disclosure looks like, and it is not the same thing as good evidence — there is still no completed human trial of injected or intranasal NAD+, and Pallas does not claim one. Two things to check before you buy: no certificate of analysis exists for anything it sells, and every price on the site is a twelve-week charge divided by three, which understates your year by about eight per cent.
Opens www.pallashealth.co. A link is not a recommendation to take anything.
What Pallas publishes that nobody else does
Most of this review series is spent establishing what a company has withheld. Pallas Health inverts the exercise, so it is worth starting with the list.
It names the pharmacies. Not "our partner pharmacy" — six of them, with phone numbers and domains, under a heading that opens by stating "Pallas Health does not own or operate a pharmacy":
Belmar Pharmacy — 800-525-9473 · Strive Pharmacy — 855-405-5993 · Epiq Scripts — 833-654-3553 · Casa Pharma Rx — 877-937-6868 · The Pharmacy Hub — 888-958-1382 · Foothills Pharmacy — 480-496-4444
It explains the regulatory categories, correctly, without being asked:
"503A pharmacies are licensed and inspected by their respective state boards of pharmacy. 503B outsourcing facilities are registered with and inspected by the FDA under current Good Manufacturing Practice (cGMP) standards."
That is accurate. It is also the distinction another company in this wave gets wrong by claiming a 503B designation its pharmacies do not hold.
It names its doctors and tells you to check them. Dr. Ana Lisa Carr, MD and Dr. Kelly Tenbrink, MD — each printed with their federal provider number and an instruction to look it up in the government's public registry rather than take Pallas's word for it.
It names the states where the law requires a real conversation:
"currently Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, and West Virginia, plus Washington, D.C. — a real-time video visit is scheduled before any prescription is issued."
And it prints the sentence FDA has written to two other companies in this wave for omitting: "Compounded medications are not FDA-approved and are not generic versions of brand-name drugs."
Full analysis — 5 more sectionsThe sentence on the product page · The twelve weeks that are not three months · The footer that disclaims the site · What is actually for sale · What this means if you are buying
The sentence on the product page
Here is what Pallas says about NAD+, the product it is trying to sell you:
"Research on supplemental NAD+ is still developing — which is why a US-licensed clinician reviews your health history and prescribes it only when it's appropriate for you."
Read that against how the same molecule is sold elsewhere in this market. One competitor's page: "NAD+ declines with age. This restores it. Feel like yourself again." Another promises it will "boost your immune system" and "reduce inflammation" and calls it "the ultimate biohack". A third calls NAD+ "a peptide that signals your own pituitary gland", which it is not.
Pallas writes that levels decline with age and that this is "one reason many people explore replenishing it". That sentence describes a motivation rather than asserting a result, and the difference is the whole of what this site exists to notice.
The underlying evidence position is no better than anyone else's. There is no completed randomized trial of injected NAD+ in humans supporting a restoration-of-function claim, and none of intranasal NAD+ at all. 1 The substantial human literature concerns oral precursors — nicotinamide riboside and nicotinamide mononucleotide — different molecules taken a different way, whose results do not transfer to a spray or an injection.
Pallas does not tell you that last part, and it is the single most useful thing a buyer of this product could be told. But it also does not pretend the evidence is settled, which makes it the only company here whose NAD+ page a reader can trust to be under-claiming rather than over-claiming.
The twelve weeks that are not three months
The defect, and there is really only one of substance.
Every Pallas plan bills on a twelve-week cycle. The site advertises monthly figures derived by dividing by three:
| Product | First period | Then | Advertised | Real year |
|---|---|---|---|---|
| NAD+ nasal spray | $79 | $567 / 12 weeks | "$189/mo" | $2,457 |
| NAD+ injection | $89 | $597 / 12 weeks | "$199/mo" | $2,587 |
| Semaglutide | $139 | $597 / 12 weeks | "$199/mo" | $2,587 |
| Tirzepatide | $179 | $897 / 12 weeks | "$299/mo" | $3,887 |
Twelve weeks is 2.769 months, not three. And a twelve-week cycle arrives 4.33 times a year, not four — so the year costs about 8.3% more than "$X/mo × 12" implies. On tirzepatide that is roughly $300 a year the monthly figure does not mention.
Two things in Pallas's favor here, because the arithmetic alone would be unfair. It prints the cycle total — "$567 every 12 weeks ($189/mo average)" — where several competitors print only the divided number and leave you to discover the protocol length at checkout. And it labels the figure an "average" rather than a price. The unit is still wrong, and a reader budgeting monthly will still be short, but Pallas has put the true number on the page.
There is no month-to-month rung for the compounded GLP-1s. Twelve weeks is the only commitment on offer.
The footer that disclaims the site
Underneath all of this, on every page:
"Some content on this site is AI-generated; no representation or warranty is made regarding its accuracy, completeness, or reliability."
Pallas publishes 51 state-by-state telehealth guides, a dosing calculator, a BMI calculator, a body-fat calculator, a calorie calculator and a weight-loss projection tool. That sentence disclaims the reliability of all of it.
It is an honest disclosure in one sense — most sites generating content this way say nothing — and a strange one to place under health information a patient might act on. It is the one place where Pallas's instinct for transparency produces something that undermines rather than helps.
A second thing does not reconcile. The homepage advertises "200,000+ patients". The clinical page says the patient portal "goes live alongside our July 2026 launch", refers to "existing waitlist patients", and three of the five product lines on the homepage — MIC + B12, skincare, hormone therapy — are still marked "Coming soon". Those statements can perhaps be squared, but the site does not square them.
What is actually for sale
For a peptide buyer, Pallas's range is thin and worth being clear about.
NAD+ is a coenzyme, not a peptide — a dinucleotide, with no amino-acid chain. Pallas gets this right on the page, calling it "a coenzyme found in every cell", where a competitor in this same wave calls it a peptide.
That leaves the two GLP-1s, semaglutide and tirzepatide, as the only true peptides Pallas sells. Both have genuine phase 3 evidence behind the approved products — STEP 1 and SURMOUNT-1 2 3 — and Pallas makes almost no efficacy claim about either in its own voice: no percentage, no trial named, no transformation promised. There is nothing here to grade as overstatement because there is very little claimed.
MIC + B12 is on a waitlist and is not sold. It is not a peptide either.
What this means if you are buying
If what you want is a company that will tell you who is compounding your medication and how to reach them, Pallas is the best answer among the companies we track, and it is not a close call. Six named pharmacies with phone numbers, two named doctors you can look up yourself, an accurate account of what its regulatory categories mean, and a clear statement that you are not charged if you are turned down.
Budget on the cycle, not the month. The NAD+ injection is $597 every twelve weeks, which is $2,587 a year — not the $2,388 that "$199/mo" suggests. Tirzepatide is $3,887.
And on the product itself, take Pallas at its word rather than at its competitors'. The research on supplemental NAD+ is still developing. What the page leaves out is that the developing research is mostly about oral precursors, not the spray or the injection you would be buying.
Questions
Frequently asked questions
Which pharmacy does Pallas use?
One of six, and Pallas names all of them with phone numbers and web addresses — the fullest supply-chain disclosure we've found anywhere in this market. They are Belmar Pharmacy (800-525-9473), Strive Pharmacy (855-405-5993), Epiq Scripts (833-654-3553), Casa Pharma Rx (877-937-6868), The Pharmacy Hub (888-958-1382) and Foothills Pharmacy (480-496-4444). Pallas states plainly that it "does not own or operate a pharmacy", explains that which one fills a given prescription "depends on the medication, the patient's shipping state, and current capacity", and offers state pharmacy license numbers on request. It also explains the regulatory categories accurately and unprompted: 503A pharmacies are licensed and inspected by state boards, 503B outsourcing facilities are FDA-registered and inspected under cGMP. The one thing it does not tell you is which of the six will fill your specific order.
What does Pallas actually cost per year?
More than the monthly figures suggest, because every plan bills on a twelve-week cycle that Pallas averages to a month by dividing by three. Twelve weeks is 2.769 months, and a twelve-week cycle arrives 4.33 times a year rather than four. The NAD+ nasal spray is $79 for the first month then $567 every 12 weeks — advertised as "$189/mo", which is about $2,457 a year rather than $2,268. The NAD+ injection is $89 then $597 every 12 weeks, "$199/mo", about $2,587 a year rather than $2,388. Compounded semaglutide is $139 for four weeks then $597 every 12 weeks; tirzepatide is $179 then $897 every 12 weeks, "$299/mo", which is $3,887 a year rather than $3,588. To Pallas's credit it prints the twelve-week total beside the averaged figure and calls it an average, which several competitors do not. There is no month-to-month option for the GLP-1s.
Is there evidence for NAD+ injections or nasal spray?
No completed human trial, and Pallas is the only seller we've reviewed that concedes anything of the kind. Its own page says "Research on supplemental NAD+ is still developing". As of 10 August 2026, a ClinicalTrials.gov search returns no completed randomized trial of injected NAD+ supporting a restoration-of-function claim and none of intranasal NAD+ at all, and a PubMed search for nicotinamide adenine dinucleotide combined with injection, subcutaneous or nasal, filtered to the randomized-controlled-trial publication type, returns zero records. What Pallas does not tell you is where the real evidence sits: the substantial human literature concerns oral precursors — nicotinamide riboside and nicotinamide mononucleotide — which are different molecules by a different route, and whose results do not transfer to a spray or an injection.
Does Pallas serve my state?
All fifty and the District of Columbia — but the kind of appointment differs, and Pallas is unusually precise about it. In seven states plus D.C. the law requires a synchronous encounter before anything can be prescribed: Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota and West Virginia, plus Washington, D.C. In those, "a real-time video visit is scheduled before any prescription is issued". Everywhere else a clinician may evaluate asynchronously from your intake. Pallas also publishes a per-jurisdiction telehealth rules tracker covering all 51 jurisdictions with sources and a changelog, which none of its competitors publish.
Is NAD+ a peptide?
No, and Pallas gets this right where others do not. NAD+ is nicotinamide adenine dinucleotide — a coenzyme, specifically a dinucleotide, containing no amino-acid chain. Pallas describes it accurately as "a coenzyme found in every cell". A competitor selling the identical molecule in this same review wave heads its page "Meet NAD+ — a peptide that signals your own pituitary gland", which is wrong twice over. For a peptide buyer this matters for a practical reason: the only true peptides Pallas sells are the two GLP-1s, semaglutide and tirzepatide. Its MIC + B12 injection is on a waitlist and is not a peptide either.
Why does Pallas disclaim its own website?
Because some of it is machine-written, and Pallas says so. Every page carries the footer line: "Some content on this site is AI-generated; no representation or warranty is made regarding its accuracy, completeness, or reliability." That is more candid than most sites doing the same thing silently, and it is also an odd sentence to place beneath 51 state-by-state telehealth guides, a dosing calculator and a weight-loss projection tool that a patient might act on. It is the one place where Pallas's transparency works against it. A related loose end: the homepage claims "200,000+ patients" while the clinical page describes a patient portal going live "alongside our July 2026 launch" and refers to existing waitlist patients.
Glossary
Key terms
Show definitions
- 503A pharmacy
- A state-licensed pharmacy compounding a preparation for an individual named patient against a prescription, inspected by its state board. Pallas explains this correctly on its clinical page.
- 503B outsourcing facility
- A compounder registered with FDA, subject to FDA inspection under current Good Manufacturing Practice. Registration is not approval of any product. Pallas states this accurately; another company in this wave claims the designation without holding it.
- NAD+
- Nicotinamide adenine dinucleotide — a coenzyme present in every cell and central to energy metabolism. It is a dinucleotide, not a peptide. Levels decline with age; whether replacing it by injection or spray does anything has not been established in a completed human trial.
- Federal provider registry
- The government's free public directory of National Provider Identifiers — the number issued to every licensed US clinician. A site that prints its doctors' numbers is letting you confirm, in a minute, that they exist and are who it says. Pallas prints two and tells readers to go and check.
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Others selling what Pallas Health sells
Companies we have also reviewed that dispense at least one of the same compounds, ordered by how much of what they say about their products matches the trials behind them. Nothing here is a recommendation, and none of these links earns us anything.
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 Pallas Health's own pages, first-hand, on the date stamped against it — never from a summary, an aggregator, or an earlier version of this review.
Trials read from the registry
Phase, status and enrollment 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 intranasal NAD+ in humans: no completed randomised trial supporting a restoration-of-function claim, no registered study of nose-to-brain NAD+ delivery, and zero randomised-controlled-trial publications for nicotinamide adenine dinucleotide combined with injection, subcutaneous or nasal administration. 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.