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The 2023 GRAS designation permits marketing as a dietary supplement ingredient but NOT as a therapeutic agent

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

The combination of reduced caloric intake (from tirzepatide appetite suppression) and enhanced fat breakdown (from AOD 9604 lipolysis) creates a steeper downward trajectory

This delivers the highest local concentration but can be difficult to perform on yourself

At-home roller depth is typically 0.5 to 1.0 mm