Kesbury
Longevity Stack · Cross-product

NAD+ and sermorelin together

Two separately studied pathways in one program. What each is supported by on its own, and why the combination is a rationale rather than a result.

Medically reviewed by the Kesbury Health Clinical Team · Last updated 2026-09-02

Quick answer

The Longevity Stack is Kesbury Health's combined NAD+ and sermorelin program at $499 per month, and the honest description of why they are combined is that they act on two separate, individually studied pathways rather than that any trial has shown them to work better together. NAD+ is a coenzyme required by the cellular reactions that produce energy and support DNA repair, and its availability declines with age [1][2]. Sermorelin is a GHRH analog that signals the pituitary to release the body's own growth hormone, and that signal also weakens with age [4][5]. No controlled trial has tested the two in combination, so no synergy claim is made here. Both are compounded, physician-prescribed medications, both require physician review, and the sermorelin half still requires the $179 baseline panel. Compounded medications are not FDA-approved and individual results vary.

Two pathways, described separately

The NAD+ pathway

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in every living cell, required as an electron carrier in the reactions that convert nutrients into usable cellular energy and used by repair enzymes. Its role in ageing biology has been reviewed in detail [1]. Its decline with age has been measured in human tissue: in a 2012 study of 49 human skin samples from donors aged 15 to 77 plus newborns, NAD+ levels correlated negatively with age in both men (p = 0.001, r = -0.706) and women (p = 0.01, r = -0.537) [2].

Whether restoring NAD+ availability changes how a person feels is a separate and much less settled question. A 2018 review of NAD-boosting molecules concluded that the strongest data remains preclinical or early-stage [3], and a 2018 randomized crossover trial of nicotinamide riboside in healthy middle-aged and older adults was designed primarily around tolerability and NAD+ elevation rather than around clinical outcomes [6].

The growth hormone pathway

Growth hormone is released in pulses driven by hypothalamic GHRH, and that output falls with age. A 1991 study of healthy men reported that each decade of increasing age attenuated the growth hormone production rate by 14% and the half-life of circulating growth hormone by 6% [5]. A 1992 controlled study in older men showed that twice-daily GHRH(1-29) over 14 days reversed the age-related decrease in growth hormone and IGF-1 [4].

Again, restoring a signal is not the same as delivering an outcome, and the human outcome literature for sermorelin in healthy adults is small.

So why combine them?

Because they are non-overlapping. One is a coenzyme-repletion therapy operating inside cellular metabolism; the other is an endocrine signal operating through the pituitary. They do not compete for the same mechanism, and the physiological argument for addressing both is that both decline. That is a rationale for a program, and it is the whole of the claim being made.

What is deliberately not claimed: that the combination is synergistic, that it produces results neither would produce alone, or that any trial has tested it. None of that has been shown, and the absence is the reason this page says so plainly.

What the combined program involves

  • One evaluation covering both. A licensed physician reviews your history for both therapies rather than twice over.
  • The baseline panel still applies. The $179 Sermorelin Baseline Panel is a prerequisite for the sermorelin half, and its results can mean the sermorelin half is not prescribed even if NAD+ is.
  • Two medications, two sets of considerations. Screening, monitoring and side-effect watch apply to both.
  • One shipment cadence and one price. $499 per month against $299 and $279 separately.
  • One re-evaluation rhythm, including the 90-day sermorelin re-evaluation.

Should you start with both?

Often the more sensible sequence is one at a time. If two therapies start on the same day and something changes, attribution becomes guesswork, and the physician adjusting your plan has less to work with. Starting with one, giving it a real interval, and then deciding is a slower path with more information in it. That is a conversation to have during the evaluation rather than a rule.

How physician-directed care works at Kesbury Health

  1. Complete a short online assessment about your goals, symptoms and health history. It takes about 60 seconds to begin.
  2. A licensed Kesbury Health physician reviews what you submitted and decides whether therapy is a reasonable fit for you, or whether something else should be looked at first.
  3. Baseline labs where they apply. The $179 Sermorelin Baseline Panel is a prerequisite for sermorelin therapy, and the results can end the conversation rather than continue it.
  4. If therapy is appropriate, the medication is compounded by a licensed U.S. pharmacy and shipped to your door, with dosing set to you rather than to a chart.
  5. Ongoing physician oversight adjusts the protocol over time, with a 90-day re-evaluation built into the sermorelin program.

Care is delivered by telehealth to residents of the ten states where your Kesbury Health physician is licensed: Alabama, District of Columbia, Delaware, Florida, Maryland, Michigan, New Jersey, Ohio, Pennsylvania and Texas. Eligibility is confirmed during the assessment.

Frequently asked questions

What is the Longevity Stack?

It is Kesbury Health's combined program of NAD+ therapy and sermorelin therapy at $499 per month, below the $299 and $279 they cost separately. Both are compounded, physician-prescribed medications, and the sermorelin half still requires the $179 baseline panel.

Do NAD+ and sermorelin work better together?

There is no controlled trial testing the combination, so no synergy claim is being made. What can be said is that they act on separate, individually studied pathways: NAD+ on coenzyme-dependent cellular metabolism [1][2], sermorelin on the growth hormone axis [4]. Combining two separately studied pathways is a rationale, not a result.

Is it safe to take both?

That is a decision for the prescribing physician, based on your history and your baseline panel. Both are prescription medications with their own screening considerations, and taking two things means two sets of considerations rather than one.

Why is the combined price lower than the two separately?

Because the evaluation, the oversight and the shipping are shared across one program rather than duplicated. The pricing is published so the comparison is easy to make: $299 for NAD+, $279 for sermorelin, $499 for both.

Can I start with one and add the other?

Yes, and that is often the more sensible sequence. Starting one therapy at a time makes it easier for you and your physician to tell what is doing what.

See whether one therapy or two makes sense for you

Take the free 60-second Kesbury Health assessment. A licensed physician reviews your goals and history and can recommend one therapy, both, or neither.

Start your free 60-second assessment →

Kesbury Health is a LegitScript-certified (#51875982) telehealth longevity practice licensed in ten states. Sermorelin and NAD+ are compounded medications prescribed by a licensed physician after review. Compounded medications are not FDA-approved. This page is educational and is not individualized medical advice. Statements on this page have not been evaluated by the FDA. Individual results vary.

References (primary sources)

Every reference below was checked against its PubMed record on 2026-09-02. Links open the abstract.

  1. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology. 2021;22(2):119-141. doi:10.1038/s41580-020-00313-x. PMID 33353981.
  2. Massudi H, Grant R, Braidy N, Guest J, Farnsworth B, Guillemin GJ. Age-associated changes in oxidative stress and NAD+ metabolism in human tissue. PLoS One. 2012;7(7):e42357. doi:10.1371/journal.pone.0042357. PMID 22848760.
  3. Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metabolism. 2018;27(3):529-547. doi:10.1016/j.cmet.2018.02.011. PMID 29514064.
  4. Corpas E, Harman SM, Pineyro MA, Roberson R, Blackman MR. Growth hormone (GH)-releasing hormone-(1-29) twice daily reverses the decreased GH and insulin-like growth factor-I levels in old men. Journal of Clinical Endocrinology and Metabolism. 1992;75(2):530-535. doi:10.1210/jcem.75.2.1379256. PMID 1379256.
  5. Iranmanesh A, Lizarralde G, Veldhuis JD. Age and relative adiposity are specific negative determinants of the frequency and amplitude of growth hormone (GH) secretory bursts and the half-life of endogenous GH in healthy men. Journal of Clinical Endocrinology and Metabolism. 1991;73(5):1081-1088. doi:10.1210/jcem-73-5-1081. PMID 1939523.
  6. Martens CR, Denman BA, Mazzo MR, Armstrong ML, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications. 2018;9(1):1286. doi:10.1038/s41467-018-03421-7. PMID 29599478.

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