Vitamin B5

Overview

Dr. Roger Williams discovered vitamin B₅ in 1933 and, since it is present in all cells studied, he named it pantothenic acid from the Greek word panthothen meaning “everywhere.” Pantothenic acid plays a number of essential metabolic roles including the production of some hormones and neurotransmitters, and is involved in the metabolism of all carbohydrates, fats, and proteins.

Chemically, pantothenic acid consists of a carboxylic acid group bound to beta-alanine, which is an isomer of the amino acid alanine. Vitamin B₅ as calcium pantothenate is most commonly available commercially. After absorption, pantothenic acid is converted to a sulfur-containing compound called pantetheine. Pantetheine is then converted into co-enzyme A, which is the only known biologically active form of pantothenic acid.

Pantethine, which is the stable and most active form of pantetheine, has been reported to be effective at improving abnormal lipid profiles in both adults and children. It reportedly lowers elevated triglycerides and LDL cholesterol while raising levels of the beneficial HDL cholesterol. (1) Pantethine has been reported to be especially effective at lowering elevated blood lipids in patients with diabetes without hindering blood sugar control. (2) , (3)

Dosage Info

Dosage Range

5-20mg daily. Doses as high as 2,000mg have been used for rheumatoid arthritis. (4)

Most Common Dosage

15mg daily

15mg pantothenic acid = 16.3mg calcium pantothenate

Dosage Forms

Tablets, capsules, liquids, liposomal sprays, and effervescent tablets. Dexpanthenol is available in injectable and topical dosage forms (Rx only).

Adult RDI

10mg

Adult ODA

10-50mg

RDA

• Infants < 6 months: 1.7mg (Adequate Intake, AI)
• Infants 7-12 months: 1.8mg (AI)
• Children 1-3 years: 2mg (AI)
• Children 4-8 years: 3mg (AI)
• Children 9-13 years: 4mg (AI)
• Adults >14 years: 5mg (AI)
• Pregnancy: 6mg (AI)
• Lactation: 7mg (AI)

Interactions and Depletions

Depletions

• Salicylates

Active Forms

Calcium pantothenate; dexpanthenol, which is the alcohol of pantothenic acid; and pantethine, the stable disulfide form of pantetheine, which is the biologically active form of pantothenic acid and the direct precursor to Coenzyme A (CoA). Pantethine and pantothenic acid are not necessarily clinically interchangeable.

Absorption

Most of the pantothenic acid that is ingested is in the form of coenzyme A. Coenzyme A is hydrolyzed by intestinal enzymes to pantetheine. If calcium pantothenate or pantothenic acid is ingested as nutritional supplements, they must first be converted to pantetheine by intestinal enzymes before being absorbed. Within cells throughout the body, pantetheine is synthesized into the various active coenzyme compounds.

Toxicities & Precautions

General

There are no known toxicities associated with pantothenic acid.

Side Effects

Ingestion of large amounts may cause diarrhea.

Functions in the Body

Biochemical Reactions

Co-enzyme A (CoA), which is the active form of pantothenic acid, helps transfer two-carbon units (acetyl groups) in a wide variety of biochemical reactions.

Energy Metabolism

Enhances the release of energy from carbohydrates in the Krebs cycle.

Anti-stress Effect

Synthesis of steroid hormones and proper functioning of the adrenal glands.

Fat Synthesis

Involved in synthesis of phospholipids, fats, cholesterol, and bile acids.

Neurotransmitter Synthesis

Involved in synthesis of acetylcholine

Red Blood Cells

Involved in synthesis of porphyrin in the hemoglobin of red blood cells.

Alcohol Detoxification

Participates in the metabolism of acetaldehyde. (5) , (6)

Clinical Applications

Acne Vulgaris

Pantothenic acid deficiency may be a primary cause of acne vulgaris. (7)

Adrenal Support

Pantothenic acid is required for the synthesis of adrenal steroid hormones. (8)

Allergies

Some allergic individuals respond well to pantothenic acid therapy. (9)

Constipation

At therapeutic doses peristalsis is stimulated. (10)

Surgery And Wound Healing

In combination, pantothenic acid and ascorbic acid significantly enhance postsurgical therapy and wound healing. (11) Another study found that vitamin B5 accelerated the healing process of conjunctiva and the cornea after reconstructive surgery of the epithelium. (12)

Hyperlipidemia

Elevated cholesterol and triglycerides are lowered by pantethine, but not pantothenic acid. (13)

Arthritis

Rheumatoid arthritis patients with low B5 levels have more severe disease symptoms. (14)

Symptoms and Causes of Deficiency

Pantothenic acid is so widely available in foods that a deficiency in humans is rare. Experimentally induced deficiencies manifest as problems related to the skin, liver, thymus, and nerves.

Dietary Sources

Pantothenic acid is present in all plant and animal tissues. The best sources of this vitamin include eggs, liver, fish, chicken, whole grain breads, and cereals, and legumes. Other good sources are cauliflower, broccoli, lean beef, white and sweet potatoes, and tomatoes.

References

1. View Abstract: Bertolini S, et al. Lipoprotein Changes Induced by Pantethine in Hyperlipoproteinemic Patients: Adults and Children. Int J Clin Pharmacol Ther Toxicol. Nov1986;24(11):630-37.
2. View Abstract: Donati C, et al. Pantethine, Diabetes Mellitus and Atherosclerosis. Clinical Study of 1045 Patients. Clin Ter. Mar1989;128(6):411-22.
3. View Abstract: Coronel F, et al. Treatment of hyperlipemia in diabetic patients on dialysis with a physiological substance. Am J Nephrol. 1991;11(1):32-6.
4. Calcium pantothenate in arthritic condtions. A report from the General Practitioner Research Group. Practitioner. 1980;224:208-211.
5. View Abstract: Moiseenok AG, et al. The Protective Effect of Pantothenic Acid Derivatives and Changes in the System of Acetyl CoA Metabolism in Acute Ethanol Poisoning. Farmakol Toksikol. Oct1988;51(5):82-86.
6. View Abstract: Chernikevich IP, et al. Possible ways of regulating detoxifying processes in the alcohol dehydrogenase reaction with pantothenic acid derivatives. Vopr Med Khim. Mar1993;39(2):38-40.
7. View Abstract: Leung LH. Pantothenic Acid Deficiency as the Pathogenesis of Acne Vulgaris. Medical Hypothesis. Jun1995;44(6):490-92.
8. View Abstract: Tarasov I, et al. Adrenal Cortex Functional Activity in Pantothenate Deficiency and the Administration of the Vitamin or Its Derivatives. Vopr Pitan. Aug1985;(4):51-54.
9. View Abstract: Biederman J. Family-environmental risk factors for attention deficit hyperactivity disorder. Arch Gen Psychiatry. 1995;52:464-470.
10. Guillard O, et al. Treatment of Constipation with Vitamin B5 or Dexpanthenol. Med Chir Dig. 1979;8(7):671-74.
11. View Abstract: Lacroix B, et al. Role of Pantothenic and Ascorbic Acid in Wound Healing Processes: In Vitro Study on Fibroblasts. Int J Vitam Nutr Res. 1988;58(4):407-13.
12. View Abstract: Raczynska K, Iwaszkiewicz-Bilikiewicz B, Stozkowska W, Sadlak-Nowicka J. Clinical evaluation of provitamin B5 drops and gel for postoperative treatment of corneal and conjuctival injuries. Klin Oczna. 2003;105(3-4):175-8.
13. View Abstract: Arsenio L, et al. Effectiveness of Long-term Treatment with pantethine in patients with Dyslipidemia. Clin Ther. 1986;8(5):537-45.
14. General Practitioner Research Group. Calcium Pantothenate in Arthritic Conditions. Practitioner. Feb1980;224(1340):208-11.