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Taneja S, Chowdhury R, Kvestad I, Bhandari N, Strand TA

[9] Its also prudent to be cautious or avoid NAD+ injections if you have a serious uncontrolled medical condition (for example, end-stage liver or kidney disease or severe heart disease), unless your physician specifically determines its safe

It is unknown whether ZEPBOUND causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of tirzepatide-induced rodent thyroid C-cell tumors has not been determined [see Warnings and Precautions (5.1) and Nonclinical Toxicology (13.1)]