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However, with long-acting GLP-1 RAs, the body may develop tolerance (tachyphylaxis) to this specific effect over time (Dungan & DeSantis, 2026)

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This inhibition preserves nicotinamide availability for the NAD+ salvage pathway, the primary route for NAD+ regeneration in mammalian cells

(2023) Periconceptional intakes of methyl donors and other micronutrients involved in one-carbon metabolism may further reduce the risk of neural tube defects in offspring: a United States populationbased case-control study of women meeting the folic acid recommendations