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Elevated insulin suppresses hormone-sensitive lipase (the enzyme that releases fatty acids from adipocytes), so even though NAD+ rises and sirtuins activate, there's no substrate available to oxidize

Similar content being viewed by others Introduction Insulin-like growth factor-1 (IGF-1) is a growth factor with multiple roles in various aspects of normal and pathological growth and differentiation 1,2

Mid-cycle reviews and follow-up labs track your response, body composition changes (often using DEXA or InBody where available) and metabolic markers

Do not use if you or your family have a history of a type of thyroid cancer called MTC or MEN 2