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The second pathogenic variant can be another hemoglobin S allele or other Hb variants such as HbC (HBB GLU6LYS)

Han S, Xiu M, Li S et al (2023) Exposure to cytarabine causes side effects on adult development and physiology and induces intestinal damage via apoptosis in Drosophila

Reported applications include NNMT enzyme inhibition assays measuring 1-methylnicotinamide formation or S-adenosylhomocysteine release, intracellular target-engagement assays in differentiated 3T3-L1 adipocytes where 5-Amino-1MQ reduced intracellular 1-methylnicotinamide with an EC near 2.3 M (Neelakantan et al., Biochem Pharmacol, 2018), membrane permeability and Caco-2 transport characterisation, methyltransferase selectivity panels covering COMT, DNMT1 and PRMT3, and rodent studies of NNMT inhibition in adipose tissue and liver following the antisense knockdown work of Kraus and colleagues (Nature, 2014)

In plain terms: the strongest direct evidence here is for retatrutide alone

Everything seemed a little labored, and it was just disheartening to, like, oh, I dont really have these skills

Weight loss extends beyond appearance