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NNMT permanently removes NAM by transferring the methyl group from S-adenosyl methionine (SAM) to NAM to produce meNAM and S-adenosyl-l-homocysteine (SAH) 57

The dual mechanism is why Eli Lilly positions tirzepatide as a distinct therapeutic option and why some patients specifically need it rather than a single-agonist alternative

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If youre losing fat and gaining muscle simultaneously, the net change in scale weight may be smaller than expected, or in some cases negligible over a given period, even though significant positive body composition changes are occurring