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Tirzepatide with niacinamide adds a B3 vitamin component that some researchers believe supports metabolic function during weight loss

Examination of electron transport chain function in muscle and fibroblast culture, histological and electron microscopy examination of muscle and other biomarkers of mitochondrial metabolism revealed a pattern consistent with the notion that PPA could be interfering with mitochondrial metabolism at the level of the tricarboxylic-acid cycle (TCAC)

McGinnis, R., et al

Figure 2B) when GSH was incorporated in the gels at the highest extent

The IUPAC designation specifies stereochemical configurations at multiple chiral centers ((2S,3S) notation)

doi: 10.1016/s0304-4165(02)00147-2