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In a systematic review of 10 clinical trials in patients with HIV lipodystrophy, tesamorelin was effective in reducing VAT and increasing lean body mass and did not alter subcutaneous adipose tissue (146), and increased GH and IGF-I while insulin and glucose levels are unchanged indicating preservation of insulin sensitivity (147150) ( Table 1 )

Mitochondrial Support: Higher NAD+ levels supported more efficient energy production and reduced oxidative stress

These cells accumulate in various tissues, contributing to chronic inflammation, metabolic dysfunction, and organ degeneration

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Mechanism Mapping The three-mechanism vs two-mechanism distinction is the clearest selection framework: Wolverine Stack engages the blood-supply-plus-cell-mobilization combination the two mechanisms that directly address recovery and repair bottlenecks