Your first 90 days on a GLP-1
Week by week: what the starter dose actually feels like, when appetite changes show up, when your provider will titrate, and the three weeks most people find hardest.
Longevity · Cellular energy
NAD+ is the coenzyme your cells use to turn food into usable energy. Levels fall with age, and injection is the most direct way to raise them.
Your consult is free. We will not prescribe this — or anything — before a clinician has spoken with you and reviewed your bloodwork. Final cost depends on the form and dose prescribed.

Mechanism
Nicotinamide adenine dinucleotide sits at the centre of mitochondrial energy production and DNA repair. Concentrations decline substantially with age.
Subcutaneous injection bypasses digestion, which is the main argument for it over oral precursors — bioavailability is far higher.
Human outcome data is still early. Patients commonly report improved energy and mental clarity; the long-term anti-ageing claims made across this category run well ahead of the evidence.

Protocol
A typical schedule. Yours is set by your clinician after your labs come back.
| Phase | Weeks | Typical | Purpose |
|---|---|---|---|
| Start | 1–2 | Low dose, twice weekly | Assesses tolerance — flushing is common. |
| Build | 3–6 | Increased per response | Frequency adjusted by your provider. |
| Maintenance | 7+ | Weekly or twice weekly | Lowest effective frequency. |
What to expect
Flushing and warmth are common and expected.
Most patients who respond notice it here.
Reported improvements in focus and sleep quality.
If you notice nothing by month three, we say so.
Evidence
NAD+ decline with age is well documented. Whether supplementation reverses age-related dysfunction in humans is not yet established.
Most supporting data is preclinical or from small studies. Reported benefits are largely subjective. We will not claim more than that.
Your consult and labs screen for all of the following.
FAQ
NAD+ is a coenzyme central to mitochondrial energy production and DNA repair. Levels decline with age. Supplementation aims to restore them, though whether that reverses age-related dysfunction in humans is not yet established.
Injection delivers higher bioavailability and is the more common choice for a loading protocol. Nasal spray is more convenient for maintenance and needle-averse patients. Many patients use both.
Flushing, warmth and chest tightness during dosing are common and generally relate to how fast it is administered. Slowing the injection usually reduces it substantially.
Book a one-to-one consult with the clinical team. We talk through your goals, order the bloodwork that matters, and build a plan from what we find.
Licensed providers · 100% online
Medical weight loss, hormone therapy, longevity protocols and lab testing — prescribed by licensed clinicians, delivered to your door. No waiting rooms, no insurance runaround.
Why NovaraMD
Almost every online clinic hands you a questionnaire, matches you to one drug and ships it. They never capture your full biology — so they can’t know what will actually work for you.
We start the other way around. Your first step is a one-on-one visit with a member of our clinical team to talk through what you’re trying to change. Then we test, build the plan around your numbers, and stay with you through the whole journey.
What we treat
Not a catalog of everything. Three areas we run properly — each one backed by labs, a real clinician and dose adjustments over time.
GLP-1 and dual-agonist therapy, titrated to you, with muscle protection and metabolic labs built in.
Explore weight lossTestosterone, fertility, desire and intimacy — for men and women, dosed off bloodwork rather than a symptom quiz.
Explore hormonesCellular energy, recovery, sleep and cognition — protocols you re-test, not supplements you hope about.
Explore longevity01 · Weight & metabolic health
We treat the metabolism underneath it — appetite signalling, insulin sensitivity, sleep and muscle retention. That’s why the program pairs medication with labs, protein targets and check-ins instead of shipping a pen and disappearing.
Free tool
Move the sliders for an estimate based on published clinical-trial averages. Not a diagnosis, not a prescription — a starting point for a conversation.
Estimated at 72 weeks
160 lb
Estimates use average total body-weight reduction reported in published GLP-1 trials (SURMOUNT-1, STEP-1) and typical lifestyle-intervention results. Individual results vary widely and depend on dose, adherence, diet, activity and medical history. This tool is not medical advice and does not guarantee any outcome. Eligibility is determined by a licensed provider after a full evaluation.
Curve shape follows the mean weight-loss trajectory reported in the pivotal trials (SURMOUNT-1 for tirzepatide, STEP-1 for semaglutide) applied to your starting weight, with the early plateau during dose titration. Trial averages, not a prediction for you. Your provider sets the dose and the pace.
02 · Hormones & sexual health
Low energy, low drive and stalled progress all have overlapping causes. We run the full panel first — total and free testosterone, estradiol, SHBG, LH/FSH, thyroid, prolactin — then treat what the numbers and your symptoms agree on, and re-test at six to eight weeks.
Consultations are 100% private, and every plan is reviewed by a clinician licensed in your state.
03 · Longevity & performance
The longevity space is full of things people take on faith. We only run protocols with a plausible mechanism and a marker we can actually follow — and we tell you plainly where the evidence is thin.
Bloodwork & diagnostics
Optimization without data is just expensive guessing. Establish your baseline, then track what actually moves — hormones, metabolic markers, inflammation, fertility.
How it works
A real conversation — about twenty minutes by video or phone — about your goals, your history and what you’ve already tried. Free, and no obligation.
A licensed provider reviews everything, screens for contraindications, and prescribes only if it’s appropriate for you.
Shipped free from a licensed pharmacy in discreet packaging. Message your care team any day; doses adjust as you progress.
Resources
Plain-English guides on GLP-1 therapy, nutrition, hormones and recovery — written for patients, not for search engines.
Week by week: what the starter dose actually feels like, when appetite changes show up, when your provider will titrate, and the three weeks most people find hardest.
A four-week plan with protein targets by body weight, meal timing around your injection day, the foods that reliably trigger nausea, and how to hit your numbers when you have no appetite at all.
Patient stories
“Lost 27 lbs in 12 weeks. I’ve struggled with food noise my entire life, but for the first time, I feel in control. This was the missing piece of the puzzle for my health journey.”
“I’ve gained 8 lbs of lean mass and dropped my body fat by 5% in just four months. I feel stronger, more motivated, and more like myself again.”
Testimonials from real NovaraMD patients. Individual results vary and are not typical or guaranteed. Keep signed consent on file for every published testimonial.
FAQ
Answer a few questions and a licensed provider will tell you what’s appropriate for you — including when the honest answer is that treatment isn’t.