Pyruvate can be metabolized in many different reactions by the body. The four most important reactions include its conversion into (1) oxaloacetate, (2) alanine, (3) lactate, and (4) acetyl-CoA. The first is the conversion of pyruvate into oxaloacetate, a reaction catalyzed by pyruvate carboxylase with the co-factor, biotin. Second, pyruvate can undergo transamination into alanine, using Vitamin B6 or pyroxidine as a cofactor. Third, pyruvate is turned into lactate by lactate dehydrogenase, which uses the niacin-derived NADH, generating NAD+ in the process. Finally, pyruvate gets converted into Acetyl-CoA by pyruvate dehydrogenase. This reaction is catalyzed by the pyruvate dehydrogenase complex, which requires 5 cofactors: Vitamins B1, B2, B3, B5, and lipoic acid. It also converts NAD+ to NADH in the process.