Pantothenic acid is a benign vitamin; preliminary evidence indicates promise in treating hyperlipidemia.
[ODFM ] Letter Key
Other Common Names
Pantethonate, panthenol, pantetheine, pantethine, and vitamin B5
Description
- Pantothenic acid, a B vitamin, is an important coenzyme involved in energy metabolism and lipid synthesis.
- Panthenol is the alcohol form.
- Pantetheine is a pantothenic acid derivative, of which pantethine is the disulfide form.
- Most vitamin supplements contain calcium or sodium salts of D-pantethonate or panthenol (which is more stable than pantethonate) (1).
Food Sources
Pantothenic acid is widely distributed in foods. Particularly good sources include yeast, liver, kidney, egg yolk, wheat germ, nuts, beans, avocados, bananas, and broccoli. Cooking destroys 15% to 50% of the vitamin in meat, and the processing of vegetables results in losses of 37% to 78% (1).
Main Functions/Pharmacokinetics
- Pantothenic acid is essential to respiratory metabolism. It is an integral component of coenzyme A and phosphopantetheine and is important as a carrier for acyl groups in various processes, including the first step of the Krebs cycle and the
-oxidation of fatty acids. - It is also involved in the synthesis of ketones, acetylcholine, and porphyrin (1).
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Clinical Trials
- Ulcerative colitis
- Dexpanthenol enemas administered to three patients in an open-label pilot study (1,000 mg nightly for 4 weeks) had no clinical or histologic benefits (2). Urinary pantothenic acid increased, but there were no significant changes in concentrations of colonic tissue coenzyme A or fecal short-chain fatty acids.
- Radiation-induced skin reactions
- A single-blind controlled study in 86 patients receiving radiation therapy tested topical dexpanthenol cream (Bepanthen, Roche) applied twice daily on randomly selected parts of treatment fields (3). Patients were assessed weekly during radiation treatment, 2 weeks after treatment ended, and 6 to 8 weeks later. This study is notable for the fact that the physicians, but not the patients, were blinded. There was no difference between treated and untreated areas in physician-assessed skin reactions nor was there any difference in itching or pain.
- Hyperlipidemia
- Pantethine may benefit hypercholesterolemia but appropriate controlled trials of reasonable size are lacking. A double-blind crossover study found that administration of 300 mg t.i.d. of pantethine for 8 weeks significantly reduced total and low density lipoprotein (LDL) cholesterol and increased high density lipoprotein (HDL) in 11 subjects with type IIB hypercholesterolemia; there was no effect on total cholesterol, LDL, or HDL in 15 subjects with type IV hypercholesterolemia (4). Both groups experienced a significant decrease in triglycerides.
- A small, controlled crossover study in 10 hyperlipidemic patients tested pantethine 300 mg q.i.d versus placebo (each given for 4 weeks with a 4-week washout period) (5). Total cholesterol, total phospholipids, and the sphingomyelin to phosphatidylcholine ratio decreased significantly during the treatment phase compared with the placebo phase.
- An uncontrolled study of 22 diabetic dialysis patients (8 on hemodialysis, 14 on peritoneal dialysis) found that 300 mg pantethine t.i.d. for 2 months resulted in significant reductions in total and LDL cholesterol as well as triglycerides; HDL was unchanged (6). In this study, total cholesterol was reduced from an average of 275 mg/dL to an average of 231 mg/dL; very low density lipoprotein (VLDL) cholesterol from 66 to 46 mg/dL, and triglycerides from 332 to 227 mg/dL. Additional treatment led to additional benefit with significant improvements at 4 and 6 months; the seven subjects who completed 6 months of treatment had normal cholesterol levels (a mean of 173 mg/dL), triglyceride levels (168 mg/dL), and VLDL levels (30 mg/dL).
- An uncontrolled trial in 31 hemodialysis patients found that 600 to 1,200 mg pantethine daily significantly reduced total cholesterol and triglycerides. There was no effect on levels of HDL or apolipoprotein A (7).
- Another uncontrolled 1-year trial in 24 hyperlipidemic patients, including six diabetics, found significant reductions in total cholesterol, LDL cholesterol, and apolipoprotein B as well as increases in HDL cholesterol and apolipoprotein A (8).
- Wound healing
- In one study, 49 subjects undergoing tattoos were randomized to placebo or a vitamin supplement containing 100 mg vitamin C and 200 mg pantothenic acid for 3 weeks. The supplemented patients showed changes in trace elements but no significant changes in number of fibroblasts or mechanical properties of scar tissue (9). The dose of pantothenic acid was low in this trial.
Animal/in Vitro Evidence
- Wound healing
- In cell culture, pantothenic acid increases fibroblast growth and proliferation and enhances collagen synthesis and release (9). In rabbits, pantothenic acid appears to aid wound healing (10).
- Endocrinologic effects
- In estrogen-primed hyperprolactinemic rats, orally administered pantethine (up to 1.0 g/kg) had no effect on plasma prolactin levels, but intraperitoneal and intravenous administration markedly decreased serum prolactin levels (11).
Other Claimed Benefits/Actions
- Wound healing
- Immune stimulation
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Adverse Reactions
Pantothenic acid has very low toxicity. Ingestion of 10 to 100 g resulted only in occasional diarrhea (12).
Drug Interactions
None identified
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L ] Letter Key
Gross deficiency is extremely rare.
Deficiency Signs and Symptoms
- Vomiting, abdominal distress
- Postural hypotension
- Paresthesias of hands and feet
- Heel tenderness
- Leg cramps and weakness
- Anorexia
- Constipation
- Insomnia
- Fatigue, malaise
- Headache
Factors Decreasing Availability/Absorption
None known
Laboratory Tests
Whole blood pantothenic acid (normal values 100 to 300 µg/dL)
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Adequate Intake
| Infants and Children |
| 0 to 6 months | 1.7 mg/day |
| 7 to 12 months | 1.8 mg/day |
| 1 to 3 years | 2 mg/day |
| 4 to 8 years | 3 mg/day |
| Males |
| 9 to 13 years | 4 mg/day |
| 14 to 50 years | 5 mg/day |
| 51+ years | 5 mg/day |
| Females |
| 9 to 13 years | 4 mg/day |
| 14 to 50 years | 5 mg/day |
| 51+ years | 5 mg/day |
| Pregnant | 6 mg/day |
| Lactating | 7 mg/day |
Correcting deficiency
5 to 20 mg/day
Total parenteral nutrition
15 µg/day
Q: Is it true that royal jelly is high in pantothenic acid?
A: Yes. The substance fed by bees to larvae that makes them turn into queens contains 511 µg/g pantothenic acid (1).