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Long-term deficiency can damage the protective myelin around nerves, and if it is not addressed, some of that damage can become permanent, causing numbness, pain, and balance problems

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Exercise can also increase NAD+ in skeletal muscle

Dosage Adjustments for Special Populations Patients who are older, have kidney or liver issues, or have certain neurological disorders might need changes in their medication dosage amounts

If these appear, reduce tirzepatide dose, pause 5-amino-1MQ, and increase caloric intake by 200400 kcal daily until symptoms resolve