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The figure shows the precursors of L-methylmalonyl-CoA: Fatty acids and amino acids can be metabolized to propionyl-CoA, which is converted to D-methylmalonyl-CoA and then to L-methylmalonyl-CoA

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The clinical evidence overwhelmingly favors semaglutide for meaningful fat reduction, but the nearly nonexistent side effect profile of AOD 9604 gives it a unique position for specific use cases

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NAD+ Preservation and Sirtuin Activation First and most directly, NNMT activity consumes nicotinamide, which is a key precursor for NAD+ biosynthesis through the salvage pathway (the predominant NAD+ synthesis route in most mammalian cells)