NAD injections: benefits, risks and clinic costs

Most online NAD+ clinics start with a health questionnaire. A handful go further and require actual blood work before they will prescribe. We read the intake process pages of all 25 clinics then in our ranked set (September 2026) and found three that incorporate lab testing in a meaningful way. Not as an upsell, but as a prerequisite or a structural part of the protocol.

The short answer

The other 22 clinics we reviewed use intake questionnaires (some short, some detailed) but none require a blood draw before prescribing.

Made Med: CMP and IGF-1 before sermorelin

Made Med is the clearest example of lab-gated prescribing in the set. Their protocol for sermorelin explicitly states that dosing is confirmed by IGF-1 levels. A marker that reflects growth hormone activity and can only be measured with a blood draw. A Comprehensive Metabolic Panel (CMP) is also part of intake.

Their clinical page states: "Your doctor will confirm it's right for you based on your IGF-1 levels." The CMP + IGF-1 protocol is described as a prerequisite, not an optional add-on. Without the labs, you do not get the sermorelin prescription.

Made Med's starting price is $169/mo for sermorelin. Lab costs are not bundled into the monthly rate and are quoted separately. The lab requirement does have a practical consequence: your first month will cost more in total than the monthly rate suggests.

The upside of this approach: when a clinic adjusts dosing based on an actual marker, you know what you are getting is calibrated to your physiology, not just to a filled-out form. Whether that calibration matters at the doses involved is a clinical question the lab result does not by itself answer. But the baseline is there.

Hone Health: 50+ biomarkers at intake

Hone Health structures its longevity program around a comprehensive intake panel: 50+ biomarkers tested through a network of 2,000+ lab locations in the US. The blood draw happens at a physical location, not at home. After the results come in, you have a video consultation with a board-certified physician who reviews the panel and determines your protocol.

The recurring program costs $175/mo, but there are additional mandatory costs at intake: a $25 membership fee and a $65 lab panel fee (minimum. The panel scope can affect the final figure). The $25 + $65 means the first-month total is at minimum $265 before the monthly medication cost.

On the Premium plan, Hone includes regular retesting. The labs are not a one-time intake screen but an ongoing part of the program. If you want a number-driven protocol that updates as your markers change, that structure is unusual among the clinics we reviewed.

Hone's pricing model is classified as membership-plus-meds in our data. The monthly medication cost is separate from the membership. This makes a direct monthly comparison with flat-rate clinics misleading: the ongoing rates are closer than the entry figures suggest once the membership is annualized.

Get Heally: four kinds of testing on one menu

Get Heally lists four kinds of testing alongside its treatments. Their program includes a comprehensive blood panel, a DUTCH test (dried urine test for comprehensive hormones. Covers cortisol, androgens, estrogens, and metabolites), a microbiome gut test, and continuous glucose monitoring (CGM). They also offer video consultation with board-certified physicians and carry LegitScript certification.

Starting price is $165/mo. The breadth of testing positions Get Heally as a full-panel longevity diagnostic, not just an NAD+ subscription. For someone who wants a complete hormonal and metabolic baseline before starting any protocol, that scope is unusual.

The tradeoff is complexity. With four separate test types at intake, coordinating results and scheduling extends the time between signup and first prescription. Clinics that use a questionnaire are faster to start. That convenience is real, even if it comes at the cost of individualization.

What questionnaire-only intake looks like

For comparison: MYRNK, one of the clinics we ranked, begins intake with a "Quick Quiz: See if NAD+ is right for you in seconds." That quiz is the entire clinical gating mechanism. No blood draw, no physician review of lab results before prescribing.

Most of the 26 clinics fall somewhere between MYRNK's quiz and Get Heally's four-test panel. A few require a short health questionnaire plus a provider review; a few include a video consultation. Almost none require a blood draw. The three above are the exceptions.

Does lab-gated prescribing matter for NAD+?

It depends on what the labs are measuring and why. For sermorelin, where Made Med and Hone both focus, IGF-1 is a clinically relevant marker: dosing sermorelin without knowing where your IGF-1 sits means adjusting a system you have not measured. For NAD+ specifically, there is no single standard marker equivalent to IGF-1 for growth hormone protocols. The broader panels at Hone and Get Heally capture metabolic and hormonal context that a physician can use to interpret how a longevity intervention might fit, even if the NAD+ dose itself is not set by a specific blood value.

What the labs do unambiguously: they add a physician-reviewed medical record to your protocol history, they catch contraindications a questionnaire might miss, and they create a baseline for measuring change. Whether that is worth the added cost and time at intake is a judgment that depends on your reasons for starting.

See our full ranking of 26 online longevity clinics for scores, prices, and what each clinic discloses about its intake process.