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This restoration of metabolic cofactor availability enables enhanced function of NAD+-dependent enzymes including sirtuins, poly(ADP-ribose) polymerases, and various deacetylases that regulate cellular metabolism, stress responses, and aging processes
Poor sleep increases ghrelin (hunger hormone) and decreases leptin (satiety hormone), directly undermining dietary adherence
Key variants in GLP1R (the GLP-1 receptor), GIPR (glucose-dependent insulinotropic peptide receptor), FTO (fat mass and obesity-associated gene), and MC4R (melanocortin 4 receptor) may affect medication sensitivity, baseline hunger signaling, and metabolic rate
Weeks 1 to 2: Most patients feel nothing different
Step 3: Targeted Peptide Layering Once hormones are optimized (typically 48 weeks), we layer in 12 targeted peptides based on your remaining symptoms
