Thiamine and pyruvate dehydrogenase
A patient with chronic alcohol use disorder has elevated blood pyruvate and lactate. Deficiency of which vitamin best explains this?
Answer C: explanation for every choice
A
Cobalamin is a cofactor for methylmalonyl-CoA mutase and methionine synthase.
B
Folate carries one-carbon units for nucleotide synthesis.
C
Correct. Thiamine pyrophosphate is a cofactor for pyruvate dehydrogenase. Without it, pyruvate builds up and is diverted to lactate.
D
Vitamin C is needed for collagen hydroxylation.
TakeawayPyruvate dehydrogenase cofactors: thiamine pyrophosphate, lipoic acid, CoA, FAD, NAD⁺.
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Reviewed 2026-11-05 by a medical student. Spot an error? Report it with question ID bb65.