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The metabolism and elimination of NAD+ (and its by-products) could be altered in advanced hepatic or renal dysfunction, and high-dose NAD+ might theoretically affect cardiovascular dynamics, so practitioners generally avoid or closely supervise NAD+ use in such settings

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HGH Fragment 176-191 supports fat metabolism by signaling the body to use stored fat for energy and reduce new fat formation

Additionally, loss of muscle mass during rapid weight loss can reduce the efficiency of muscle pumps that help return blood from the extremities to the heart, leading to blood stasis, particularly in the legs, which is a risk factor for deep vein thrombosis (DVT)