Fierce Health review

What it is

Fierce Health is a direct-to-consumer telehealth brand selling compounded semaglutide and tirzepatide in both standard and microdose programmes, alongside a longevity shelf. That shelf carries an NAD⁺ injection, glutathione, methylene blue, ivermectin, and an ivermectin-plus-mebendazole product. NAD⁺ is sold as a once-weekly subcutaneous injection with monthly, three-month and six-month prepay cadences. A licensed nurse practitioner reviews each intake and issues a prescription if eligible; the intake form is sent after checkout. The company is LegitScript Certified, publishes the FDA compounded-medication disclaimer, offers free US shipping, and enumerates thirty service states verbatim in its Terms of Service.

How it works

Checkout-then-intake, which is an unusual ordering and worth knowing about. You buy, then complete a medical intake form, then a licensed nurse practitioner reviews it and prescribes if you are eligible; the company states you are refunded if it cannot ship to your state. Buying before being assessed is a structure we would rather see reversed, though the published refund for unserviceable states does blunt the worst of it. What Fierce does unusually well is jurisdictional clarity: thirty states are written out one by one in the Terms, so you can confirm eligibility before spending anything — most of this board publishes nothing. The disclosure gaps are on the other side of the transaction. No compounding pharmacy is named, only "partner pharmacies". No operating entity name appears anywhere; the only jurisdictional signal is that Idaho law governs. The clinical network behind the nurse practitioner is not identified. And at the last full verification the tirzepatide programme showed as unavailable across every cadence, which may be a storefront artefact rather than an inventory problem but is worth checking before you count on any product being in stock.

Pricing transparency

Published, which is the reason this entry earns its place. The NAD⁺ injection is $250 a month, with three-month and six-month paid-in-full cadences offered alongside the monthly plan, and glutathione is $149. Free US shipping is included. For context on where that sits, the platform's GLP-1 ladder runs $197 for the semaglutide microdose, $297 for standard semaglutide and the tirzepatide microdose, and $497 for standard tirzepatide — but those are weight-loss figures and do not bear on the NAD⁺ decision. The honest way to read $250 a month is as a significant standing cost for a compounded product with no controlled outcome trials behind it, and the prepay cadences make that commitment longer rather than smaller. Before ordering, confirm what dose the monthly price supplies, whether the prepaid blocks are refundable if you stop, and — given the checkout-then-intake flow — exactly what happens to your money if the nurse practitioner declines you for a reason other than your state.

Branded vs compounded

Compounded; not FDA-approved. Prescription required only if a licensed provider finds it appropriate. Fierce publishes the disclaimer plainly — its own wording is that compounded medications are not reviewed by FDA for safety or efficacy — which is more than several competitors manage, though it names no pharmacy behind the phrase "partner pharmacies", and compounded sterile products are not FDA-reviewed for purity and potency the way approved drugs are. The claims are where this has to be contradicted. Its NAD⁺ page lists, among potential benefits, slowing down the aging process and reducing the risk of age-related diseases, alongside DNA repair, brain function and metabolism. There are no controlled human outcome trials supporting any of those for injected NAD⁺; the single human intravenous study was a pharmacokinetic pilot showing infused NAD⁺ clears from plasma quickly. The NAD⁺ forms with human trial data are the oral precursors NR and NMN, and what those trials demonstrate is a raised blood NAD⁺ level — a biomarker, not a demonstrated clinical outcome. Glutathione has essentially no controlled human outcome evidence either. Separately, the shelf itself is a signal: FDA has issued public statements against using ivermectin outside its approved labels, and a longevity catalogue that pairs NAD⁺ with ivermectin and mebendazole is telling you something about the editorial standard applied to what it stocks. Individual results vary.

Pros and watch-outs

The evidence behind what Fierce Health prescribes

We grade the molecules, not the marketing. Here is what the human data actually shows for each thing on their menu.

• NAD+ precursors (NR and NMN): what the human trials actually show

  They raise NAD+ and look safe short-term — but human evidence is surrogate-marker level, and no trial shows they extend healthspan.

• Glutathione: the master antioxidant, and where the evidence actually is

  Oral glutathione really does raise your body stores (a 6-month RCT proved it) — but the longevity and detox claims are unproven, skin-lightening is modest, and IV glutathione is the most marketed, least evidenced route. The precursors may be the smarter bet.

How Fierce Health compares

A few alternatives worth a look, depending on what you’re optimizing for.

• TNTru Niagen

  The most clinically-studied oral NAD⁺ precursor (NR)

  See Tru Niagen →
• RBRenue By Science

  Liposomal/sublingual NMN with posted lab testing

  See Renue By Science →
• AgelessRx

  Sermorelin from a longevity-medicine practice

  See AgelessRx →