If oxygen is not available (the body is in a state of anaerobic respiration), pyruvate is converted to ethanol or lactate and energy can be produced for a limited period of time with lactic acid being an unpleasant side effect. If oxygen is available, the two molecules of pyruvate enter the Krebs cycle. The first step in the process is the conversion of pyruvate into a form that can enter the citric acid cycle. For this to happen, pyruvate loses one carbon, as carbon dioxide, to form acetyl coenzyme A (Acetyl-CoA being the start of the cholesterol production process). Acetyl-CoA is effectively
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