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Cellular studies have shown that exogenous NAD + can impact mitochondrial activity, such as boosting Krebs cycle and the ETC, but also impair genomic DNA replication and induce DNA replication stress due to impairment of pyrimidine biosynthesis 118

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Biemann R, Bluher M, Isermann B

Phase 2: Introduce AOD 9604 (weeks 5-8) Once tirzepatide is tolerated at the initial dose, add AOD 9604 at 250mcg daily