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If tirzepatide has stopped working or weight loss has stalled despite dose escalation, adding AOD 9604 introduces a new mechanism that can restart progress

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and (2) nicotinamide a NAD+ precursor is diverted away from the NAD+ synthesis pathway into the methylation pathway, reducing cellular NAD+ levels

Individuals at higher risk include older adults with reduced stomach acid production, people with gastrointestinal conditions affecting absorption, strict vegans, and those taking medications like metformin or proton pump inhibitors

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At the same time, there is abnormal activity of osteoclasts, enhanced bone resorption, slow loss of bone mass, accompanied by thinning and fracture of bone trabeculae and thinning of cortical bone