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[4] For example, biotin-dependent enzymes facilitate the conversion of pyruvate to oxaloacetate (an important step in gluconeogenesis), the synthesis of malonyl-CoA from acetyl-CoA (the first step in fatty acid biosynthesis), and the catabolism of certain amino acids into Krebs cycle intermediates

It is worth noting that whilst some improvement may be rapid, complete resolution of symptomsparticularly neurological onescan take months of regular treatment

Serious adverse effects are rare but have been reported, particularly with IV administration of thiamine

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