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Low NAD+ levels can sneak up on you, and the symptoms often look like things we chalk up to getting older even though theyre not always inevitable

They seem to be prone to colds, sinusitis, ear infections, cystitis, oral and vaginal thrush (candida), other fungal infections of the skin and nails, cracked lips, mouth ulcers and influenza

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Certain metabolic issues such as insulin resistance, where the bodys cells stop responding properly to insulin, may also block semaglutides actions

Seek immediate medical attention (call 911 for severe symptoms) if you experience: Chest pain, pressure, or discomfort, particularly if new or worsening Severe shortness of breath or difficulty breathing at rest Rapid or irregular heartbeat accompanied by dizziness or lightheadedness Swelling in the legs, ankles, or abdomen that develops suddenly or worsens Unexplained fatigue or exercise intolerance that significantly limits daily activities These symptoms may indicate cardiovascular complications unrelated to tirzepatide itself but requiring urgent evaluation, especially in patients with diabetes and obesity who have elevated baseline cardiovascular risk