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TPP functions as a cofactor for several critical enzymes across three metabolic pathways: transketolase (TK) in the pentose phosphate pathway, pyruvate dehydrogenase (PDH) in glycolysis, and alpha-ketoglutarate dehydrogenase (AKD) in the Krebs cycle (33, 34)

Once tissues heal properly, they remain healed

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It facilitates cell migration to injury sites, promotes cell differentiation, supports actin-mediated tissue remodeling, and reduces scar tissue formation

Without concurrent attention to muscle maintenance, bone health, and long-term lifestyle change, patients risk losing critical lean mass and regaining weight as mostly fat, which can ultimately worsen joint pain, weaken bone density, and compromise recovery