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Glucagon receptor activation: Increases energy expenditure by promoting fat oxidation and thermogenesis

Under normal circumstances, insulin maintains the NAD(+)/NADH ratio by activating the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway and inhibiting the forkhead box protein O1/heme oxygenase 1 (Foxo1/Hmox1) pathway, thereby mediating the activation of the sirtuin 1/peroxisome proliferator-activated receptor-gamma coactivator 1-alpha (SIRT1/PGC-1) pathway and regulating mitochondrial physiological functions (27)

Importantly, tirzepatide carries a boxed warning regarding thyroid C-cell tumors observed in rodent studies, though the relevance to humans remains uncertain

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NAD injections supports DNA repair mechanisms and reduces oxidative stress, two major factors that slows down aging