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In obesity, NNMT activity is unusually high in fat cells, which means a lot of nicotinamide gets thrown out before it can be turned into NAD+

After up to a year, the GLP-1 group showed significantly lower disease activity, less pain, improved cholesterol and HbA1c, and meaningful weight loss, with inflammatory markers (CRP and ESR) also improving

However, the critical limitation remains the near-total absence of rigorous human clinical trial data

Thats where B12 therapy comes in

While some will likely experience changes in their menstruation during weight loss, contact your doctor or pharmacist for advice if you think something might be wrong