Pallas Health NAD+ Review: $189 a Month Is a $567 Charge

Pallas Health does the disclosure work that almost nobody in compounded telehealth bothers with. It names the six pharmacies that dispense its medication. It names two of its physicians and publishes their NPI numbers with a link telling you to go and check them in the federal registry — and both of them check out. It carries a LegitScript merchant certification whose seal ID resolves to a real record. Its advertised price is the price its checkout actually charges, which sounds like a low bar until you have priced twenty of these companies.

And then it sells you a product with no monthly option, at a price advertised per month.

The NAD+ nasal spray is $79 for your first month. After that it is $567, billed every twelve weeks. Pallas advertises that as "$189/mo average", which is $567 divided by three. The injection is $89 for the first month, then $597 every twelve weeks, advertised as "$199/mo average". There is no cadence selector in the funnel. No monthly rung exists to choose.

That is the whole review in one paragraph, and everything below is either the arithmetic behind it or the reasons this company is nonetheless one of the more carefully run operators we have looked at.

The bill you actually receive

Set aside the averages and follow the charges in order. You pay $79. Four weeks later — the renewal is anchored "every 12 weeks starting 4 weeks after approval" — you pay $567 in a single payment. Then $567 again, every twelve weeks, indefinitely.

The gap between a $79 first payment and a $567 second one, four weeks apart, is the most likely place a reader of this page gets a surprise. It is not hidden: Pallas states the renewal terms plainly, and it sends a pre-renewal email reminder. But "$189/mo" is the number on the page, and $189 is not a payment anyone ever makes.

Twelve weeks is not three months

The second thing the average does is smaller and steadier, and it is pure arithmetic on Pallas's own published renewal terms.

A twelve-week cycle is 84 days. A year is 365.25 days. That is 4.35 renewals a year, not four — but the advertised monthly figure is the twelve-week charge divided by three, which is the maths you would do if twelve weeks were a quarter. It is not. Over a full year of the nasal spray at the standing rate, 4.348 × $567 is $2,465, or about $205 a month, against an advertised $189. The injection works out at 4.348 × $597 — $2,596 a year, about $216 a month, against an advertised $199. The advertised average understates the ongoing rate by roughly 8.7%.

Your first year is different again, because it contains the intro period. Fifty-two weeks is one four-week intro block plus four twelve-week blocks: $79 + 4 × $567 = $2,347 for the spray, or $195.58 a month; $89 + 4 × $597 = $2,477 for the injection, or $206.42 a month.

None of this is unusual and none of it is hidden — "12 weeks ≈ 3 months" is ordinary industry shorthand and Pallas publishes every number needed to check it. We are stating it because the number a reader compares against the rest of our NAD+ provider board should be the one they will keep paying, not the one on the badge.

What Pallas actually is

Pallas Health is a cash-pay telehealth brand operated by Brentmoor, Inc., registered at 131 Continental Drive, Suite 305, Newark, Delaware. It says plainly what most of this field leaves ambiguous: it is a technology platform and it does not employ medical providers. The clinical care is delivered by Lion MD, a nationwide group of US-licensed clinicians, running on the CareValidate clinical-operations platform.

That last detail is worth a sentence for anyone comparing rows on our board, because Lion MD is not exclusive to Pallas — Breeze Meds, which we also rank, runs its clinical side through the same group. Two brands with different prices, different pharmacies and different checkout behaviour can sit on top of the same clinical operation. It is not a mark against either of them; it is a reason not to read two brands as two independent second opinions.

Coverage is all fifty states and Washington DC. In forty-three states the intake is fully asynchronous. In Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota and West Virginia, plus Washington DC, state rules require one video visit before anything is prescribed. There is no insurance in any state, ever; the site's own banner marks the purchase FSA/HSA eligible, and shipping is free when a clinician prescribes.

The checkout is a real, instrumented one rather than a lead-capture form dressed as a shop — Stripe Elements, Klarna pay-over-time, a working promo-code field, a shipping-state eligibility guard that stops the order before payment if you are somewhere it cannot ship, a self-serve cancellation portal at pallashealth.co/portal, and a pre-renewal email reminder. Price changes require at least thirty days' notice. There is no minimum term — you can cancel at any time, effective at the end of the current billing period, and Pallas states that "Canceling is always free."

Read that last sentence against the twelve-week cycle, though. No minimum term is a genuinely good policy, and it costs less than it sounds like it does when the shortest period you can be inside is twelve weeks long.

The disclosure, which is the best thing here

Three things are unusually well done, and we checked each of them rather than repeating the badge.

Six pharmacies, named. Pallas's clinical page lists Belmar Pharmacy, Strive Pharmacy, Epiq Scripts, Casa Pharma Rx, The Pharmacy Hub and Foothills Pharmacy, and it explains the difference between a 503A compounding pharmacy and a 503B outsourcing facility rather than waving at "FDA-registered facilities". Most companies on our board name none at all; the most any other one names is four. This is the single biggest disclosure gap in compounded telehealth and Pallas simply does not have it.

Two physicians, named, with NPIs that verify. The site publishes Dr. Ana Lisa Carr, MD with NPI 1689841744 and Dr. Kelly Tenbrink, MD with NPI 1346482684, and invites you to verify them in the NPPES registry. We did. Both records are active: Carr's primary taxonomy is family medicine, with licences in fifteen states; Tenbrink's is emergency medicine, licensed in Tennessee and Florida. Volunteering a number that can be used to check you is a real credential signal, and it is rare.

One caveat belongs with it. The site also describes Carr as board-certified in obesity and addiction medicine. Those are subspecialty claims NPPES does not carry, so they are not verifiable through the registry and we did not check them independently. What is verified is family medicine, and an active licence.

LegitScript, checked rather than trusted. Pallas displays LegitScript Healthcare Merchant Certification with seal ID 49989444. A seal image proves nothing — anyone can host one — so the ID was resolved against LegitScript's own record and returned a real certificate. Three invented control IDs returned nothing in the same pass, which is what makes the positive result mean something.

And its own enforcement record is clean. The FDA warning-letter index was searched for "pallas health", "pallashealth", "Brentmoor" and "CareValidate" on 7 August 2026, and every one returned zero records — with a known positive in the same pass, so "clean" is a result rather than a broken query.

The Belmar disclosure

Naming your pharmacies means a reader can check them, and one of the six has a record. Belmar received an FDA warning letter issued 31 March 2023 (posted 18 April 2023) concerning compounding practices, addressed to "Belmar Pharma Solutions, Drug Depot, LLC., dba APS Pharmacy". The FDA closed that letter out on 30 October 2023.

We are not going to characterise what the letter alleged — that is the FDA's document, and paraphrasing an enforcement action turns a public record into a claim of ours. What matters for a reader deciding where to spend $567 is the shape of it: a letter on a dispensing partner is a disclosure, not a disqualification, it is closed out, and it exists at all only because Pallas named the pharmacy. A company that names nobody has nothing to check, and that is a worse position to be in, not a better one.

What it will not tell you

Whether lab work is included. Nothing on the site states whether baseline or follow-up bloodwork is bundled into the price or billed separately. Not published.

Whether the price moves with dose. There is no dose selector before purchase, and beyond a flat claim that the price is the price, nothing states what happens if a clinician prescribes differently. Not published.

Who actually writes your prescription. Two clinicians are named site-wide, and the footer's "Provider directory" link resolves to a section naming the same two. Lion MD's affiliated professional corporations — the actual prescribing network — are not published. For a platform that discloses this much elsewhere, that is a real gap.

Where the 4.8 comes from. The advertised rating cites no published source, and there is no Trustpilot or BBB corroboration to check it against, so we do not repeat it as a fact.

What its blog is worth. Pallas's own footer says that "Some content on this site is AI-generated; no representation or warranty is made regarding its accuracy, completeness, or reliability." We take that at face value: nothing on their blog should be used as a clinical source, including by us.

Who the people in the photographs are. The before-and-after "Verified Customer" stories carry the caveat that individuals shown in marketing may be actors or models.

Two small charges worth knowing about

In the seven video-visit states and DC, the visit carries a $60 deposit. Attend or reschedule and it is refunded in full and credited against your first order; skip it and abandon the intake and it can be retained.

Separately, a $5 fee is deducted from each refunded payment on purchases made on or after 14 July 2026. It is never applied when a clinician declines to prescribe or when an order goes unfulfilled — those refund in full, which is the case that matters most.

And the headline numbers are intro rates. $79 and $89 are first-period prices, and the sitewide "Up to $120 off your first month" banner is a discount against them, not a price.

The evidence, which is the same for every provider we rank

This site's position on NAD+ does not change because a company sells it well, and it does not change for a company we earn a commission from. No rigorous human trial shows that nasal or injected NAD+ improves cognition, focus or energy. The best available evidence runs against the claim rather than for it: in older adults with mild cognitive impairment, oral nicotinamide riboside raised NAD+ levels and did not improve cognition versus placebo¹; a second randomized trial in subjective cognitive decline and MCI likewise found no cognitive benefit²; and the only human data on a parenteral route is a pilot that tracked NAD+ metabolites through a six-hour infusion and measured no cognitive outcome at all³.

The full picture is in our pillar review, NAD+, brain fog and focus: what the evidence shows, and the precursor literature specifically in what the NMN and NR trials actually found.

One thing that follows from this directly: the compounded preparations Pallas dispenses are not FDA-approved products, and a compounded drug is not a generic equivalent of an approved one⁴. Pallas discloses this properly, and we repeat it because it is the fact that most changes what a price means.

Who it is for, and who it is not

If what you want is an operator that will tell you who dispenses your medication and who prescribed it, Pallas is the strongest answer on our board, and it is not close. If you live in one of the forty-three fully asynchronous states, the intake is genuinely low-friction, and the checkout behaves like a real shop rather than a lead form.

If you are budgeting monthly, it is the wrong shape. The smallest NAD+ decision at Pallas after the intro month is $567, and it repeats every twelve weeks. Providers on the same board sell a month at a time — our #1 pick is a flat monthly rate — and if what you are pricing is the needle specifically, the NAD+ injection comparison puts Pallas's $597-per-quarter beside every other injectable we could price.

And if you are here because your thinking feels slow and you are hoping a prescription will fix it, read what actually causes brain fog first. Sleep debt, thyroid, iron, B12, alcohol and ordinary medication side effects account for far more foggy thinking than a coenzyme does, and every one of them is cheaper to rule out than $2,465 a year.

The bottom line

Pallas Health is the best-disclosed company on this board and one of the newest — it arrived on our affiliate network on 1 July 2026, so there is no track record behind it yet. It names six pharmacies, names two physicians whose NPIs verify as active, carries a LegitScript certification that resolves to a real record, has no FDA warning letter of its own, and charges at checkout exactly what it advertises. When one of the pharmacies it names turned out to have a 2023 warning letter, that was findable because Pallas named it, and the FDA closed it out in October of the same year.

What it does not sell is a month. The advertised $189 is $567 charged every twelve weeks, the second charge lands four weeks after a $79 first payment, and at 4.35 cycles a year the standing rate is nearer $205 a month than $189. Every number in that sentence is published on their own site. We have just put them in the order you will experience them.