Common Name(s): Pantothenic acid , D-pantothenic acid , pantethine , Vitamin B-5
Vitamin B-5 may be beneficial in lipid, ophthalmic, and skin disorders. It also has possible radioprotective and adaptogen effects.
Pantothenic acid is available in capsule, liquid, and tablet dosage forms from numerous commercial manufacturers. Clinical studies have used pantethine 600 to 1,200 mg per day for hyperlipidemias; however, most commercial Web sites document a typical dose of 300 mg 3 times a day. The US recommended daily allowance (RDA) for pantothenic acid in nutritional supplements and foods is 1 to 7 mg/day.
Avoid use if hypersensitive to pantothenic acid.
US Food and Drug Administration Pregnancy category A (Controlled studies show no risk. Adequate, well-controlled studies in pregnant women have failed to demonstrate risk to the fetus). Pantothenic acid is classified as category C (Risk cannot be ruled out. Human studies are lacking, and animal studies are either positive for fetal risk or lacking. However, potential benefits may justify the potential risks.) when dosed above the recommended dietary allowance. During pregnancy and lactation, the daily maximum dosages are 6 and 7 mg/day of pantothenic acid, respectively.
None well documented.
In high doses, pantothenic acid may inhibit the absorption of biotin produced by the microflora in the large intestine. Diarrhea may occur with large doses of pantothenic acid. Allergic contact dermatitis has been reported with topical use of dexpanthenol. A meta-analysis from 1966 to 2002 recorded an adverse reaction rate of 1.4 per 100 subjects. The majority of these reactions were mild GI complaints.
Overall, pantothenic acid is considered to be safe.
Pantothenic acid comes from the Greek pantothen , meaning “from all sides” or “everywhere.” It is found in all animal and plant tissues. Common sources of pantothenic acid include liver, queen bee jelly, yeast, rice bran, molasses, peanuts, nuts, whole grains, mushrooms, eggs, milk, and potatoes. 1 , 2 , 3 Pantothenic acid is a member of the B-complex of vitamins and is essential for the biosynthesis of coenzyme A (CoA), an important substance involved in energy release from carbohydrates, metabolism of amino acids and fatty acids, syntheses of compounds including sterols, steroid hormones, and acetylcholine, and other reactions. 1 , 2 , 4
Knowledge of pantothenic acid came about from experimentation on microorganisms and chicks. Chick dermatitis factor was the name given to purified concentrates of this substance, as was vitamin B-3, but these terms are now obsolete. 1
Vitamin B-5 is commercially available as D-pantothenic acid and its synthetic derivatives dexpanthenol and calcium pantothenate. Pantothenic acid is frequently seen in various vitamin B-complex formulations. Liquid preparations of pantothenic acid are commercially available as D-pantothenyl alcohol or panthenol. 1 In the body, pantothenic acid is converted to the related chemical pantethine, the biologically active form.
Pantothenic acid is an unstable, hygroscopic, viscous oil, sensitive to acids, bases, and heat. Its taste is sweet with a bitter aftertaste. 1 , 2 Pantothenic acid is optically active, with maximum biological activity only in the D-form. Pantothenic acid, its salts, and its and alcohol derivative can be assayed by chemical and microbiological methods. 1 High performance liquid chromatography methods have been used to determine synthetic pantethine. 5 , 6 , 7 At least one article reports pantethine to be the natural substrate for CoA biosyntheses. 8
The principal biologically active forms of pantothenic acid are CoA and acyl carrier protein. The primary marketed supplemental form of pantothenic acid is calcium D-pantothenate (D-calcium pantothenate). Dexpanthenol is considered a provitamin form and is the corresponding alcohol of pantothenic acid. Dexpanthenol is used in various cosmetic products and is available in topical dosage forms to promote wound healing.
Uses and Pharmacology
Review of the scientific literature documents the clinical use of pantothenic acid in skin and cardiovascular disorders.Acne
Acne vulgaris was effectively treated in 100 patients with both oral and topical pantothenic acid. Patients were treated orally with 10 g/day of pantothenic acid in 4 divided doses and topical pantothenic acid cream (20% by weight) applied 4 to 6 times a day. Outcome measures included decreased sebum secretion after 1 to 2 days of treatment; both acne lesions and eruptions regressed within 1 to 2 weeks. Thirty-five patients were monitored for 18 months, and a maintenance dose of 1 to 5 g/day was needed to control the acne. 9 The mucocutaneous adverse reactions of isotretinoin therapy were effectively treated with 5% dexpanthenol cream. 10Hyperlipidemia
Pantothenic acid is converted to pantethine in the body. It is essential for the biosynthesis of CoA, which plays a critical role in the metabolism of carbohydrates, proteins, and lipids. Some studies have evaluated pantothenic acid and pantethine as supplements and therapeutic agents in treating dyslipidemias.Animal data
Decreased cholesterol levels in the liver and plasma of growing chicks fed a cholesterol-supplemented diet with pantethine was observed. 11 Administration of pantothenic acid derivatives given to mice with induced hypothalamic obesity lowered food intake, body weight, insulin, glucose and triglyceride levels, as well as decreased cholesterol and improved other parameters. 12 Hypolipidemic effects were also observed in rats given certain pantethine preparations. 13 Pantethine administration in rats stimulated lipolytic activity, decreased free fatty acid levels, and inhibited lipid peroxidation. 14 Atheromatous lesions in aortas and coronary arteries of rabbits were lowered by diets containing pantethine. 15 Pantethine given to affected goats accelerated normalization of liver triglycerides. 16Clinical data
A review of pantethine use, which included other nutraceutical options, to treat hypertriglyceridemia 17 and a meta-analysis of pantethine's efficacy and tolerability covering reports from 1966 to 2002 have been published. The meta-analysis indicated that pantethine was an effective therapeutic option in treating individuals with cholesterol levels greater than 200 mg/dL and/or serum triacylglycerol levels greater than 150 mg/dL. The report also notes that the full benefit of pantethine may not be realized until at least 4 months of therapy have been completed. 18
Small, double-blind studies conducted in the early to mid-1980s document pantethine's efficacy in reducing the known risk factors of total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and apolipoprotein B in patients with hyperlipidemia. 19 , 20 , 21 , 22 One postmarketing surveillance study of over 1,000 subjects documented improved cholesterol and triglyceride levels with pantethine in diabetic patients. 23
A study of 24 hypercholesterolemic perimenopausal women supplemented with pantethine 900 mg/day demonstrated an efficacy rate of approximately 80% with marked reductions in total cholesterol, LDL cholesterol, and LDL/high-density lipoprotein ratios after 16 weeks. 24 Another study evaluated administration of pantethine 600 mg/day to 16 patients with hypertriglyceridemia and fatty liver. Nine of these patients were no longer diagnosed with fatty liver after the study period. In addition, visceral fat was reduced. 25 In another study, pantethine 600 mg/day in combination therapy with probycol improved certain cholesterol parameters. 26
The mechanism of action involves pantethine preventing the formation of insoluble proteins in the lens. 31Animal data
Several animal models 32 , 33 document that pantethine inhibits lens opacification and light scattering during cataract formation. The protective effect of pantethine was most efficacious when administered within 8 hours of exposure. 34Radioprotective and adaptogen effects
Pantothenic acid and its derivatives may act by increasing levels of CoA and glutathione, leading to protection from oxygen radical species and ionizing radiation. 35 Pantethine and other botanical substances may allow animals and humans to sustain an adaptive response and minimize effects of stress by enhancing adrenal cortex functioning. 36Animal data
In 2 studies, pantothenic acid protected rats against exposure to gamma radiation. 35 , 37 Pantothenic acid and related compounds make the plasma membrane of ascites tumor cells more resistant to the damaging effects of digitonin. 38 Pantethine offers a protective effect on the drug-metabolizing system in rat liver. 39 Pantethine versus pantothenic acid or cystamine provided the greatest protection against induced hepatotoxicity in rats. 40 A review concludes that pantethine plays a role in adaptive reactions in the myocardium as well as adaptation to deep hypothermia. 41Other pharmacologic effects
Pantethine stimulates GI motility in laboratory animals. 42 , 43 Interestingly, a patent from Japan describes the use of pantethine and derivatives as therapeutic agents for diarrhea. 44 Pantethine stimulates food intake in satiated rats, but is inhibitory to food intake in fasted animals. 45 In an open-label pilot study, 3 patients were administered a dexpanthenol 1,000 mg enema. No efficacy in treating ulcerative colitis was found. 46Wound healing
Several studies document the use of pantothenic acid and its derivatives in enhancing wound healing. 47 , 48 , 49 In one study, calcium D-pantothenate accelerated the wound-healing process by increasing the migration, proliferation, and synthesis of human dermal fibroblast cells. 49
Pantothenic acid is available in capsule, liquid, and tablet dosage forms from numerous commercial manufacturers. Clinical studies have used pantethine 600 to 1,200 mg per day for hyperlipidemias; typically, 300 mg 3 times a day is recommended. The US RDA for pantothenic acid, which is used for determining percent daily values on nutritional supplement and food labels, is 1 to 7 mg/day. 50
US Food and Drug Administration Pregnancy category A. Pantothenic acid is classified as category C when dosed above the recommended dietary allowance. During pregnancy and lactation, the daily maximum dose is 6 and 7 mg/day of pantothenic acid, respectively. 50
None well documented.
In high doses, pantothenic acid may inhibit the absorption of biotin produced by the microflora in the large intestine. Diarrhea may occur with large doses of pantothenic acid. Allergic contact dermatitis has been reported with topical use of dexpanthenol. Older sources report that deficiency of pantothenic acid in the diet results in neuromuscular disorders, loss of response to adrenocorticotropic hormone, fatigue, abdominal cramping, and other effects. 1 A meta-analysis from 1966 to 2002 recorded an adverse reaction rate of 1.4 per 100 subjects. The majority of these events were mild GI complaints.
Overall, pantothenic acid is considered to be safe.
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