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It declines with age, and lower NAD+ is associated with slower metabolism and the changes we lump together as getting older. NNMT, meanwhile, consumes the raw materials your body uses to make NAD+ and in fat tissue, NNMT is often overexpressed, which can drag NAD+ down right where you least want a sluggish metabolism

For general context, see peer-reviewed articles in major journals (reading list below)

The RxPepsDirect protocol does use a different dosing schedule than branded Mounjaro (1.5 mg twice weekly versus 2.5 mg once weekly)

bioRxiv2025 April 15

It is located on the banks of the confluence of the Madre de Dios River and the Tambopata River and is one of the main commercial centers of the Amazon

That's the kind of transformation many experience when their B12 levels are properly maintained