Compounded B12 / Glutathione / NAD+ / Sermorelin Bundle

This bundle is compounded for you by a licensed compounding pharmacy in our clinical partner's network and is not FDA-approved. It is not a brand-name or generic product. Each component stands on a different footing: a manufacturer's vitamin B12 injection is FDA-approved only for B12 deficiency, and the methylcobalamin form a pharmacy may use instead sits on FDA's Category 1 list; glutathione and NAD+ are on FDA's list of bulk substances under evaluation for compounding (Category 1); sermorelin has had no FDA-approved product on the US market since the brand-name Geref was discontinued in 2008, for reasons unrelated to safety, and its compounding standing is under FDA review. Human outcome data for the combination is limited.

This is four separate injectables in one supply, and each does something different. Vitamin B12 is the cofactor for two enzymes your body cannot run without — one that recycles folate for DNA synthesis and red-cell formation, one that keeps nerve myelin healthy; an injection bypasses the gut, which is why it is the treatment for deficiency caused by malabsorption. Glutathione is the cell's main home-made antioxidant and the molecule the liver uses to tag toxins for excretion. NAD+ is the coenzyme at the center of converting food into cellular energy and a substrate for DNA-repair enzymes. Sermorelin is a fragment of growth-hormone-releasing hormone that prompts your own pituitary to release growth hormone in its own rhythm. Bundling them does not make any one of them work differently: it is a supply convenience, and your provider decides whether each belongs in your plan at all. There is no published trial of the four together, and the outcome data for each on its own is limited — the mechanisms are what we can describe.

1. 01

   Week 1

   Instruction on which vial is which, how often each is injected and how to store them. Injection-site soreness is the common early experience across all four.

2. 02

   Weeks 2–6

   Sleep quality is typically the first thing people notice with sermorelin. Flushing or nausea after NAD+ or glutathione usually means the dose went in too fast. Fever or chills within minutes of any dose are not normal — stop and contact the care team the same day.

3. 03

   Ongoing

   Reviewed at check-ins like any prescription — and reviewed per component: your provider may keep some and drop others, which is the point of prescribing them one at a time.

Injection-site pain or redness is common with all four. B12 injections can cause itching, a transient rash, mild diarrhea and, rarely, a serious allergic reaction; the cyanocobalamin label also warns of low potassium when a severe anemia is treated intensively. Glutathione and NAD+ can cause flushing, nausea, cramps and headache, generally mild, and both carry the contamination risk of any compounded injectable, which is why the pharmacy's endotoxin testing matters. Sermorelin can cause flushing, headache and dizziness, and because it raises growth-hormone signalling, cancer history is screened before prescribing. Long-term safety of the combination has not been studied.

• Cyanocobalamin injection USP prescribing information, DailyMed, revised 04/2025 — indications, contraindications, warnings and adverse reactions
• Forman HJ, Zhang H, Rinna A. Glutathione: overview of its protective roles, measurement, and biosynthesis. Molecular Aspects of Medicine, 2009;30:1–12
• Covarrubias et al., Nature Reviews Molecular Cell Biology, 2021 — NAD+ metabolism and aging review
• Walker RF. Sermorelin: a better approach to management of adult-onset growth hormone insufficiency? Clinical Interventions in Aging, 2006;1(4):307–308 — a commentary on the mechanism, not a trial

Complete safety information is provided during your visit and with every prescription. This page is a summary, not a substitute for your provider's advice.