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The peptide simply does not interact with the receptors and pathways that stimulate IGF-1 production

Fatigue and energy changes Some researchers report transient fatigue when first combining the two compounds

[6] Because NAD + -dependent enzymes are involved in DNA repair, protein deacetylation, stress responses, mitochondrial function, and cellular signaling, NNMT-related changes in NAD + availability should be interpreted in a pathway-specific manner rather than as a simple beneficial-or-harmful binary

Pernicious anemia occurs when the body lacks intrinsic factor, a protein needed to absorb vitamin B12 from food

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(jofem.org) The best-case signal: modest weight loss in a shorter trial A frequently cited 12-week randomized trial result (as summarized in reviews) reported: ~2.6 kg average loss with AOD-9604 1 mg/day vs ~0.8 kg with placebo (PMC) This is the kind of result that can be statistically meaningful, clinically modest, and very sensitive to study design (diet, activity, baseline metabolic status, adherence)