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The strongest evidence is preclinical but directly tests NNMT inhibition in metabolic disease models

J Drug Deliv Ther 8

If you plan to discontinue tirzepatide, consider a gradual dose reduction over 8-12 weeks

This is due to the liver taking up all the circulating FFAs, which then interfere with insulin and IGF-1 signalling (as described above) and eventually leading to hepatic steatosis