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This metabolic shift occurs due to the peptides action on the nicotinamide methylation pathway , which increases intracellular NAD+ availability, facilitating greater oxidative metabolism

While some individuals may experience the effects for several weeks, others may find that the benefits wear off sooner

The SURPASS-3 MRI substudy added another layer, showing tirzepatide actually reduced muscle fat infiltration across all doses, indicating improved muscle quality even as total muscle volume decreased

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