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This is especially relevant if your weight loss has stalled or felt slower than expected
Neutrophils fail to translocate into capillaries and arterioles because of the absence of adhesion molecules such as E-selectin on these vessels (Manriquez et al., 2021)
The goal should be improved metabolic function, better body composition, and a lower-risk physiologic state
What to monitor during treatment Whether you are on the standard or enhanced protocol, monitoring ensures safety and allows dose adjustments: Weight: Weekly, same time and conditions Energy levels: Daily subjective rating GI symptoms: Daily during titration, weekly at maintenance Blood work (every 3 months): Complete metabolic panel, fasting glucose, HbA1c, liver enzymes, lipid panel, B12, folate Injection sites: Monitor for redness, lumps, or persistent reactions If you notice persistent fatigue despite the niacinamide compound, discuss with your provider whether adjusting your overall approach might be warranted
