Elevated NAD+ levels activate sirtuins, particularly SIRT1, which are NAD+-dependent deacetylases that regulate numerous metabolic processes including fat oxidation, glucose metabolism, mitochondrial biogenesis, and cellular stress responses
Combining cycle tracking with weight and symptom data helps your clinician distinguish expected adaptation from concerning changes
Side effects for both medications are similar, primarily gastrointestinal, and can usually be managed through gradual dose escalation and lifestyle adjustments
stop Wegovy immediately and seek urgent medical attention Severe trauma or significant injury preceding the pain Contact your GP urgently or call NHS 111 if experiencing: Severe, unremitting pain that does not respond to simple analgesia or worsens progressively Neurological symptoms including numbness, tingling, or weakness in the legs Fever, night sweats, or unexplained weight loss beyond that expected from Wegovy treatment Known cancer history or other risk factors for metastatic disease Severe morning stiffness lasting more than 30 minutes, particularly in younger patients (possible inflammatory arthropathy) Right upper quadrant pain, fever, or jaundice may indicate gallbladder disease, which is more common during weight loss Reduced urine output with back/flank pain may indicate acute kidney injury, especially if dehydrated from gastrointestinal side effects Patients should also consult their healthcare provider if back pain significantly impairs daily functioning, persists beyond 46 weeks despite conservative management, or if they have concerns about continuing Wegovy treatment
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