Pyruvat: the pathway in the body

Pyruvat is part of the pathway “Lactate and pyruvate”. This page shows the whole pathway; the station of Pyruvat is highlighted.

Where this laboratory value sits: Pyruvate — end of glycolysis. Glycolysis ends with pyruvate. Along the way, the cell gains ATP, and NAD⁺ picks up hydrogen, becoming NADH. Source 1

In brief

Pyruvate stands at the end of glycolysis; lactate forms from it when hydrogen is transferred from NADH. Both travel between tissues, and the liver builds glucose from lactate again.

The pathway step by step

1. Glucose → Pyruvate Glycolysis · NAD⁺, ADP Glycolysis ends with pyruvate. Along the way, the cell gains ATP, and NAD⁺ picks up hydrogen, becoming NADH. Source 1
2. Pyruvate → Lactate Lactate dehydrogenase · NADH Lactate dehydrogenase transfers hydrogen from NADH to pyruvate; this forms lactate and frees NAD⁺ again. The reaction runs in both directions. Source 1
3. Lactate → Lactate in the blood MCT1, MCT4 Transporters of the MCT family move lactate out of the cell together with a proton. Other tissues, such as heart muscle and brain, absorb it again via the same transporters. Source 3, 1
4. Lactate in the blood → Glucose in the liver Gluconeogenesis · ATP The liver rebuilds glucose from lactate and releases it into the blood. This loop of release and new formation is called the Cori cycle. Source 4, 1
5. Pyruvate in mitochondria → Acetyl-CoA PDH complex · Thiamine (B1), Lipoic acid The pyruvate dehydrogenase complex removes carbon dioxide and attaches the remainder to coenzyme A. It works with five helpers: thiamine, lipoic acid, FAD, NAD and coenzyme A. Source 2
6. Pyruvate in mitochondria → Oxaloacetate Pyruvate carboxylase · Biotin, ATP Pyruvate carboxylase adds carbon dioxide to pyruvate. In the liver, this substance is also the starting point of new glucose formation. Source 4
7. Acetyl-CoA → Citric acid cycle Citrate synthase Acetyl-CoA and oxaloacetate together form citrate. In the cycle, the carbon is broken down step by step to carbon dioxide; NAD⁺ and FAD pick up hydrogen along the way. Source 2, 4
8. Oxaloacetate → Citric acid cycle Citrate synthase Acetyl-CoA and oxaloacetate together form citrate. In the cycle, the carbon is broken down step by step to carbon dioxide; NAD⁺ and FAD pick up hydrogen along the way. Source 2, 4
9. Citric acid cycle → Respiratory chain · NADH, FADH₂ NADH and FADH₂ pass their electrons to the respiratory chain. At the end, oxygen accepts them; the cell uses the energy of this route to form ATP. Source 2

Cofactors in this pathway

• NAD⁺ — Accepts hydrogen during glycolysis; lactate dehydrogenase releases it again Source 1, 2In the ORY catalogue as a laboratory value: NAD⁺ (Nicotinamidadenindinukleotid)
• Thiamine (vitamin B1) — As thiamine diphosphate, cofactor within the pyruvate dehydrogenase complex Source 2
• Lipoic acid — Carries the acetyl group from one subunit to the next in the PDH complex Source 2
• Coenzyme A — Accepts the acetyl group, forming acetyl-CoA Source 2
• FAD (vitamin B2) — Cofactor of dihydrolipoyl dehydrogenase within the PDH complex Source 2
• Biotin — Cofactor of pyruvate carboxylase, which converts pyruvate into oxaloacetate Source 5
• Magnesium — Pyruvate carboxylase works with MgATP and bicarbonate Source 5In the ORY catalogue as a laboratory value: Magnesium
• Coenzyme Q10 — Carries the electrons from complex I and II onwards in the respiratory chain Source 6In the ORY catalogue as a laboratory value: CoQ10 (Coenzym Q10)

Sources

1. Brooks GA. The Science and Translation of Lactate Shuttle Theory. Cell Metab 2018 · PubMed 29617642
2. Patel MS, Nemeria NS, Furey W et al. The pyruvate dehydrogenase complexes: structure-based function and regulation. J Biol Chem 2014 · PubMed 24798336
3. Halestrap AP. The monocarboxylate transporter family—Structure and functional characterization. IUBMB Life 2012 · PubMed 22131303
4. Rui L. Energy metabolism in the liver. Compr Physiol 2014 · PubMed 24692138
5. Jitrapakdee S, St Maurice M, Rayment I et al. Structure, mechanism and regulation of pyruvate carboxylase. Biochem J 2008 · PubMed 18613815
6. Wang Y, Lilienfeldt N, Hekimi S. Understanding coenzyme Q. Physiol Rev 2024 · PubMed 38722242

Whole pathway: Lactate and pyruvate

Related pathways

• Citric acid cycle — oxaloacetate
• NAD⁺ — respiratory chain
• Alanine — NAD⁺ (Nicotinamidadenindinukleotid), Magnesium
• Estradiol — NAD⁺ (Nicotinamidadenindinukleotid), Magnesium
• Fructose absorption — NAD⁺ (Nicotinamidadenindinukleotid), Magnesium

As of 2026-09-16. Draft, written by Claude to schema v2; sources checked in PubMed; expert approval pending
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