The Perennial Journal · Longevity & Cost
5 Reasons Half of Hollywood Takes NAD+ Before Breakfast. And Why the Cheaper Version Is the One With the Trials.
A $500 drip in Los Angeles, or $1.31 a day at your kitchen table. Only one of them has six randomised trials behind it.
Summary
It has been the worst-kept secret in the celebrity supplement stack for years. Then the headlines caught up.
NAD+ is not a trend and not a brand. It is a coenzyme, and every cell you own uses it to turn food into usable energy.
In Los Angeles, topping it up means a clinic appointment, a cannula in your arm, and a bill between $429 and $879 a session. Kept up as maintenance, published figures put a year of it at $8,000 to $18,000.4
The oral version costs $472 a year, and it is the one that has been through randomised human trials. Nobody can tell you which route is stronger, because nobody has run that trial. What we can tell you is which one was studied, in whom, on what schedule, and what happens if it does nothing for you.
Here are the five things worth knowing before you spend money on either version.
The five things worth knowing, in short
- 1. It is not a trend. It is the coenzyme your cells use to make energy.
- 2. Topping it up in Los Angeles means a clinic, a cannula and most of an afternoon.
- 3. The most expensive version of this molecule is also the least studied.
- 4. The version you swallow is the one that has been through randomised trials.
- 5. The cleanest trial of all was run on postmenopausal women, not on biohackers.
Each one below, with what the research does and does not support.
Reason 1It is not a trend. It is the coenzyme your cells use to make energy.
It Runs Every Cell You Own. In Human Skin Samples There Is Less of It With Age.
Start with the unglamorous part, because it is the only part that is settled.
NAD+ is not a hormone, not a vitamin and not a stimulant. It is a coenzyme, and it is required for the reactions that turn food into ATP, the currency your cells actually spend.1
It has at least three established jobs. This is textbook cell biology, each with a real review behind it:2
- It runs energy production. Without it, food does not become usable energy.1
- DNA repair spends it. Repair is not free. It is paid for out of the same account.2
- It powers the sirtuins, the enzyme family that governs cellular stress response and maintenance.2
Here is the part that sends people to clinics. NAD+ declines with age in human tissue.3 That is a measurement, not a theory, and it happens to everybody.
What was actually measured
Researchers examined human tissue across age ranges and found NAD+ concentration falls as people get older. The best known of those measurements was taken in skin.3 A measurement in people, not a theory, and not an animal study.
Anyone quoting you a tidy percentage for your NAD+ at 50 is quoting a media paraphrase, not a paper. We are not going to invent one either.
So if the molecule is real and the decline is measured, what exactly is Hollywood buying?
Reason 2Topping it up in Los Angeles means a clinic, a cannula and most of an afternoon.
A Cannula, Three Hours in a Chair, and Up to $879 Before You Have Had Lunch.
The version that made this molecule famous is the intravenous one. You book an appointment. You sit in a chair. A nurse puts a cannula in your arm.
Published Los Angeles price lists put a single in clinic session between $429 and $879, depending on dose. Mobile visits run higher, into four figures.4
The time is the part nobody mentions in the podcast clips. A larger infusion runs three to four hours.4 Not a lunch break. Most of an afternoon, on a schedule you repeat.
What the price actually buys
A staffed room. A clinician's time. Sterile consumables and a chair for several hours. It is priced like a medical appointment because operationally it is one. None of that is covered by insurance, because there is no FDA approved indication for it.4
So the honest framing of the drip is not that it is a scam. It is that you are paying, in large part, for delivery and for somebody's afternoon.
Which of these is the actual obstacle for you?
Tick the ones that apply. The rest of this page is about the version that removes them.
Which raises a question you would ask of any other treatment at that price.
Reason 3The most expensive version of this molecule is also the least studied.
$879 Buys a Staffed Room and a Nurse's Afternoon. It Does Not Buy a Randomised Trial.
Here is where we have to be careful, so we will be exact.
We are not telling you the drip does not work. No trial has compared an infusion against a capsule head to head, and an infusion puts the molecule straight into your bloodstream. Anybody claiming to know which is stronger is ahead of the evidence, including us.
What we can point at is an asymmetry in the paperwork.
Ask any clinic for its published human trial list. Then ask what the session costs. Those two answers rarely match.
The oral route has randomised, placebo controlled human trials behind it, several of them independent. Ask which peer reviewed randomised trials sit behind an IV NAD+ session at $879 and the honest answer is that it is not a well studied intervention.
The question worth asking either way
Whatever you decide, ask any provider of anything in this category for the human trials behind it. Ask what the trial measured and who funded it. We would rather you did that to us too. A page that cannot survive the question does not deserve the money.
So what does the paperwork on the oral version actually say?
Reason 4The version you swallow is the one that has been through randomised trials.
Six Randomised Trials Tested a Daily Capsule, Not an Afternoon in a Chair.
This is where the molecule gets a name. NMN is the precursor your body converts into NAD+, and it is the form used in most of the human research.
What the trials did show
- Oral NMN raises blood NAD+ in humans, dose dependently. Replicated across multiple independent randomised trials. Not a contested point.6
- It is well tolerated, with no serious adverse events, across trials running 250 to 1,250 mg a day for up to twelve weeks.7
What they did not show
That raising your NAD+ makes you feel measurably different has not been demonstrated in a human trial.
The outcome research on energy, sleep and physical performance is null to mixed. Several positive trials were funded by manufacturers. Several independent ones found nothing.
The sentence we would rather you heard from us
A 2025 review in Nature Metabolism describes the human evidence for NAD+ precursor supplementation as limited.5 That is the establishment's own assessment of the category we sell in, and we would rather print it ourselves than have you find it later.
With one exception, and it is the reason this page exists.
Reason 5The cleanest trial of all was run on postmenopausal women, not on biohackers.
They Are Selling Hollywood a $500 Version of Something Studied on You.
One human trial deserves naming precisely, because it is usually either ignored or overstated.
In 2021 a study published in Science found oral NMN produced a real, measurable metabolic effect: improved muscle insulin sensitivity.8 It was NIH funded and investigator led rather than industry funded, which is rare in this category.
It was run at Washington University. The participants were postmenopausal women. Not athletes. Not biohackers. Not anybody in a longevity clinic in Los Angeles.
One trial, named precisely
Yoshino and colleagues, Science, 2021. Washington University. Randomised and placebo controlled. NIH funded. It measured muscle insulin sensitivity in postmenopausal women with prediabetes. It is unreplicated and it is a single endpoint, and it did not measure energy, sleep, memory or menopause symptoms.8
So hold the two facts next to each other.
The clinics sell this molecule to executives and actors at several hundred dollars a session. The cleanest human trial of it was run on women going through menopause.
They are selling Hollywood a $500 version of something that was studied on you.
That is not proof it will do anything for you. It is a comment on who gets sold what, and at what markup.
So which one should you actually buy?
Nobody Can Tell You Which Is Stronger. Here Is What You Can Actually Compare.
We will say the uncomfortable part once more, plainly. No trial has put an infusion against a capsule head to head, and an infusion puts its molecule straight into the bloodstream. Anybody who tells you which one wins is ahead of the evidence, and that includes us.
But strength is the one axis nobody can settle, and it is not the only axis a decision runs on. Four others can be settled, and they are the reason this page exists.
Better does not have to mean stronger
- It was studied in her, not in general. The cleanest human trial of this molecule ran at Washington University, in postmenopausal women, funded by the NIH rather than by a manufacturer.8
- What the trials tested was a daily habit, not a session. The randomised trials gave people a capsule every day, 250 to 900 mg, for up to twelve weeks.6 If you want the thing that was actually studied, you want the schedule that was actually studied.
- Neither route is a repair. Both are a supply. In the oral trials the NAD+ rise reverses about four weeks after people stop.6 That is the honest shape of this whole category, and it changes the question from which one is stronger to which one you can keep running for a year.
- One of them is refundable. A session at the top of the Los Angeles menu is $879 and it is spent the moment the line comes out. A bottle here is $59, and if it does nothing for you inside 60 days you email us and you keep it.
| An LA clinic session | Perennial NMN at home | |
|---|---|---|
| One session or one month | $429 to $879 | $59 |
| A year, kept up | $8,000 to $18,000 | $472 |
| What it takes | Appointment, travel, three to four hours in a chair | Two capsules with breakfast |
| Human trials you can look up | Ask the clinic for the list | Six randomised, placebo controlled |
| Studied in postmenopausal women | Ask the clinic | Washington University, NIH funded |
| What you can verify before you take it | Ask the clinic | The certificate of analysis, published |
| If it does nothing for you | The session is spent | 60 days, refunded, keep the bottle |
| Covered by insurance | No. There is no FDA approved indication. | No. It is a supplement, not a treatment. |
Cost, access and paperwork only. These are two different molecules delivered by two different routes. No head to head trial has compared them, and nothing in this table says which one is stronger. Clinic figures are from published Los Angeles price lists retrieved July 2026.4
See what is actually in the bottleWhat We Made, and What We Can Honestly Say About It
Perennial NMN is one ingredient at a transparent dose. 500 mg of NMN per serving, two veggie capsules, once a day. No stimulants, no hormones, no proprietary blend.
Every batch is third party tested to ISO 17025 standards. The current batch verified at 533 mg per serving, slightly over label, which is the direction you want, with heavy metals and microbials clean.
What we can tell you with confidence: what molecule it is, exactly how much is in there, that an independent lab confirmed it, and that in randomised trials this molecule raises blood NAD+ and is well tolerated.
What we will not tell you: that it replaces an infusion, or that it will hand you back your thirty five year old energy. Nobody has shown either, us included.
What we will tell you is the price. $59 a month on subscription. No clinic, no appointment, no cannula.
See the full label and the certificateSo what do people actually describe?
What People Describe, and How to Read It
This is not a stimulant. There is no jolt on day one, and any page promising one is selling caffeine.
What follows is the pattern people in this category commonly describe. It is not a result you should expect, it is not specific to us, and no trial has demonstrated it.
- Weeks 1 to 2. Sleep tends to be mentioned first. A good number of people report nothing at all in the first fortnight. Both are common.
- Month 1. The afternoon is the next thing raised. Getting through it without stopping, not reaching for the second coffee.
- Months 2 to 3. The most common report is the least dramatic. Feeling more like themselves, and being unable to point at which part changed.
Bodies work on their own schedule rather than a marketing timeline, which is the actual reason the guarantee runs 60 days rather than 30.
And if you turn out to be one of the people it does nothing for?
Sixty Days. Keep the Bottle Either Way.
You have already spent money on things that did not work. It is entirely reasonable to assume this is another one. So the terms are built so that assumption costs you nothing.
Perennial NMN
500 mg NMN per serving · 2 veggie capsules daily · 60 count, 30-day supply · open label, no proprietary blends, no stimulants
Subscriptions include free express shipping and can be skipped, paused, or cancelled from your account at any time. No phone call.
The guarantee, in plain terms: take it daily and give it a fair run. If you do not feel it supporting your energy or general wellbeing, email us within 60 days of your first delivery and we will refund that first bottle. You do not ship anything back. You keep the bottle.
Start with Perennial NMN60-day money-back guarantee · Free express shipping · Skip, pause, or cancel anytime
Only you can decide whether this is worth it
If the drip sounds right for you, book it. This page is not an argument against infusions and we are not qualified to talk you out of one.
If it sounded expensive and impractical for the life you actually have, you have three options.
- Do nothing. Entirely valid. None of this is urgent. It just does not tend to improve on its own.
- Work it out yourself. The research is public and listed at the bottom of this page. Read it, then find a supplier who publishes a certificate of analysis and doses NMN properly. It took us a long time.
- Try ours for 60 days. If it does nothing, you email us, you keep the bottle, and you are out nothing but the time.
60-day money-back guarantee · Free express shipping · Skip, pause, or cancel anytime
↑ Back to the topAbout this page
The Perennial Journal is published by Live Perennial, which makes the product described here. We have said so up front because you would have worked it out anyway, and finding out later is worse. The research cited below is independent of us and describes the underlying biology. None of it is a clinical trial of this product, and where the evidence is thin or absent we have said so in the body of the article rather than in a footnote.
References
- Cantó, C. et al. “NAD+ metabolism and the control of energy homeostasis.” Cell Metabolism, 22(1), 2015. (established cell biology) ↩ back to text
- Covarrubias, A. J. et al. “NAD+ metabolism and its roles in cellular processes during ageing.” Nature Reviews Molecular Cell Biology, 22, 2021. (review) ↩ back to text
- Massudi, H. et al. “Age-Associated Changes In Oxidative Stress and NAD+ Metabolism In Human Tissue.” PLOS ONE, 7(7), 2012. (human tissue, skin; correlational) ↩ back to text
- Published Los Angeles NAD+ IV clinic price lists and treatment durations, retrieved July 2026. (published price lists, not a clinical source) ↩ back to text
- Vinten, J. et al. Nature Metabolism, 2025. Review describing human NAD+ precursor intervention evidence as limited. (narrative review) ↩ back to text
- Yi, L. et al. “The efficacy and safety of β-nicotinamide mononucleotide supplementation.” GeroScience, 2023. (randomised controlled trial, dose-ranging) ↩ back to text
- Fukamizu, Y. et al. “Safety evaluation of β-nicotinamide mononucleotide oral administration.” Scientific Reports, 12, 2022. (randomised controlled trial, safety endpoints) ↩ back to text
- Yoshino, M. et al. “Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women.” Science, 372(6547), 2021. DOI 10.1126/science.abe9985. (randomised, placebo-controlled, investigator-led, NIH-funded; single endpoint, unreplicated) ↩ back to text
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider before starting any new supplement, particularly if you are pregnant, nursing, taking medication, or managing a health condition. If your fatigue is severe, sudden, or getting worse, please speak to a doctor.
