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Avoid smoking since it is a major risk factor for blood vessel disease

[Google Scholar] 26.Quadros E.M., Matthews D.A., Wise I.J., Linnell J.C

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Munib may recommend bloodwork to confirm deficiency and establish baseline levels, though testing isn't always necessary for patients with clear symptoms or known absorption issues

Whilst gastrointestinal side effects (particularly with high-fat meals) are common, orlistat has a well-established safety profile and can produce modest weight loss (typically 2-3 kg more than diet and exercise alone over one year)

Its overactivation disrupts nicotinamide metabolism, reduces NAD+ levels, promotes hepatic lipid accumulation and lipotoxicity, and represents an important therapeutic target for hepatic metabolic disorders