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Some patients report less nausea with certain formulations, but this could reflect dose titration speed, individual variability, or placebo effects rather than formulation differences
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This effect is achieved through the activation of signaling pathways such as the ERK1/2, PI3K/AKT, and cAMP/PKA/-cat-Ser675 pathways, which are mediated by GLP-1RAs
A potential inhibitory effect of NAM on sirtuins was hypothesized [161,162,163], although SIRT1 feedback inhibition by NAM may not play a significant role in vivo [164,165]
