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For patients who cannot tolerate GLP-1 side effects, who have already lost weight with GLP-1 therapy and want to sustain metabolic health, or whose primary issue is insulin resistance and visceral fat rather than caloric surplus, MOTS-c addresses a different problem

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The overall reaction (ΔG°′ = −6.2 kcal/mol) favors NH₄⁺ release, especially under acidic conditions that raise the Km for ammonia and push the equilibrium toward oxidative deamination