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While this risk has not been confirmed in human epidemiological studies, patients with personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not use orforglipron or any GLP-1 receptor agonist

Risk factors include older age, gastrointestinal disorders, vegan diets, or use of certain medications like metformin or PPIs

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In addition to the endogenous cellular pathways, recent studies have also investigated the role of the gut microbiome in affecting NAD + levels

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