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The NAD + -consuming reactions are thought to be the primary reason for high turnover, pointing to the importance of salvaging the NAM thats leftover from these reactions as a means to maintain healthy NAD + levels.[6,59] As shown in figure 6, while tryptophan (Trp) and the different niacins (NAM, NA, NR) can generate NAD + , its the NAM thats split off during the consuming reactions that needs to be continuously salvaged and recycled to maintain NAD + levels

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Lipoatrophy is the opposite: fat tissue breakdown creating divots or depressions