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This also explains why effects can outlast blood levels

The critical caveat with semaglutide: weight regain after discontinuation is significant

When 5-Amino-1MQ inhibits NNMT, nicotinamide is preserved and available for NAD+ synthesis, leading to increased intracellular NAD+ concentrations

doi: 10.3389/fimmu.2026.1769281 Received 16 December 2025 Revised 08 April 2026 Accepted 13 April 2026 Published 29 April 2026 Volume 17 - 2026 Edited by Douglas Sborov, The University of Utah, United States Reviewed by Nomie Leblay, University of Calgary, Canada Xuan Jiang, Shanghai Jiao Tong University, China Updates Copyright 2026 Horenstein, Frerichs, Faini, van de Donk and Malavasi