Acetyl coenzyme A trilithium salt is a lithium salt of an essential cofactor and carrier of acyl groups in enzymatic acetyl transfer reactions. Acetyl coenzyme A is formed either by the oxidative decarboxylation of pyruvate in mitochondria, by the oxidation of long-chain fatty acids, or by the oxidative degradation of certain amino acids. Acetyl coenzyme A is a key precursor in lipid biosynthesis, and the source of all fatty acid carbons. Acetyl-coA is a positive regulator of pyruvate carboxylase and is a precursor of the neurotransmitter acetylcholine.