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Timing and Consistency: When and how the dose is administered can also play a role

This enzyme not only exhibits phosphatase activity, dephosphorylating thiamine phosphates in the lumen, but may also transphosphorylate extracellular thiamine to intracellular thiamine monophosphate (ThMP), at the expense of intracellular phosphate donors such as beta-glycerophosphate or creatine phosphate (101)

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18, 19, 65, 66 In addition, this offers a potential explanation for temporary behavioral improvements in some patients following vancomycin or metronidazole treatment, which eradicates these bacteria 18, 19, 66 and profoundly reduces stool PPA