Thiamine pyrophosphate = the carbanion chemistry PDH needs to decarboxylate pyruvate → acetyl-CoA
The glycolysis→TCA gateway; without it pyruvate dead-ends as lactate
Deficiency phenotype: lactic acidosis, wet beriberi, Wernicke when brain glucose can't enter the cycle
Drugs with this mechanism (1)
Thiamine pyrophosphate — Active thiamine coenzyme required for carbohydrate metabolism; deficiency impairs energy production and contributes to Wernicke encephalopathy.