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This could be limited by adequate nutrient substrates and nutrient cofactors, especially L-carnitine, which play an important role in the mitochondrial function and metabolic flexibility (Figure 3)

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In either case, the fuel, so to speak, for the increase in sirtuin activity is NAD +

In other GLP-1 medications like Ozempic, Trulicity, or Victoza, fatigue is less frequently reported or not specifically listed as a common side effect in FDA prescribing information