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Most tryptophan is metabolized to NAM in the liver, where it is released into the serum, taken up by peripheral cells, and converted to NAD+ by the NAM salvage pathway

After 6 weeks, you see minimal improvement

After the swelling goes down, it takes some time for the body to metabolize the dissolved fat cells

Similar to cagrilintide, pramlintide is primarily eliminated via the kidneys and, in a pharmacokinetic study in participants with type 1 diabetes, no statistically significant differences were noted in total (AUC 0- ) and peak ( C max ) exposure after administration of a single pramlintide 60 g dose in participants with mild, moderate or severe renal impairment compared with those with normal renal function, although inter-patient variability was high [20]