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Pantothenic Acid and Pantethine

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Principal Proposed UsesOther Proposed Uses


Supplement Forms / Alternate Names

  • Pantothenate; Vitamin B5
The body uses pantothenic acid (better known as vitamin B 5 ) to make proteins as well as other important chemicals needed to metabolize fats and carbohydrates. Pantothenic acid is also used in the manufacture of hormones, red blood cells, and acetylcholine, an important neurotransmitter (signal carrier between nerve cells).
As a supplement, pantothenic acid has been proposed as a treatment for rheumatoid arthritis , enhancing sports performance , and fighting stress in general.
In the body, pantothenic acid is converted to a related chemical known as pantethine. For reasons that are not clear, pantethine supplements (but not pantothenic acid supplements) appear to reduce blood levels of triglycerides and possibly also improve the cholesterol profile.

Requirements/Sources

The word pantothenic comes from the Greek word meaning "everywhere," and pantothenic acid is indeed found in a wide range of foods. For this reason, pantothenic acid deficiency is rare. The official US and Canadian recommendations for daily intake of pantothenic acid are as follows:
  • Infants
    • 0-6 months: 1.7 mg
    • 7-12 months: 1.8 mg
  • Children
    • 1-3 years: 2 mg
    • 4-8 years: 3 mg
    • 9-13 years: 4 mg
  • Males and Females
    • 14 years and older: 5 mg
  • Pregnant Women : 6 mg
  • Nursing Women : 7 mg
Brewer's yeast, torula (nutritional) yeast, and calf liver are excellent sources of pantothenic acid. Peanuts, mushrooms, soybeans, split peas, pecans, oatmeal, buckwheat, sunflower seeds, lentils, rye flour, cashews, and other whole grains and nuts are good sources as well, as are red chili peppers and avocados. Pantethine is not found in foods in appreciable amounts.

Therapeutic Dosages

For lowering triglycerides , the typical recommended dosage of pantethine is 300 mg 3 times daily. Dosages of pantothenic acid as high as 660 mg 3 times daily are sometimes recommended for people with rheumatoid arthritis .

Therapeutic Uses

Inconsistent evidence from small double-blind trials suggest that pantethine might lower blood levels of triglycerides and, to a lesser extent, cholesterol . 1-3,14,15 High triglycerides, like high cholesterol, increase risk of heart disease and strokes. Some people have only modestly elevated cholesterol but very high triglycerides, so pantethine may be especially useful for them.
Weak evidence hints that pantothenic acid might be helpful for rheumatoid arthritis . 8,9
Pantothenic acid is also recommended as an athletic performance enhancer , but there is no evidence at all that it works. It is also sometimes referred to as an anti-stress nutrient because it plays a role in the function of the adrenal glands, but whether it really helps the body withstand stress is not known.

What Is the Scientific Evidence for Pantothenic Acid and Pantethine?

High Triglycerides/High Cholesterol

Three small double-blind, placebo-controlled studies suggest that pantethine can reduce total blood triglycerides and perhaps improve cholesterol levels as well. 10-12 For example, a double-blind placebo-controlled study followed 29 people with high cholesterol and triglycerides for 8 weeks. 13 The dosage used was 300 mg 3 times daily, for a total daily dose of 900 mg. In this study, subjects taking pantethine experienced a 30% reduction in blood triglycerides, a 13.5% reduction in LDL ("bad") cholesterol, and a 10% rise in HDL ("good") cholesterol. However, other small studies have found no benefit. 14,15 These contradictory results do not necessarily mean that pantethine is ineffective, as chance plays a considerable role in the outcome of small studies. Rather, they suggest that larger studies need to be performed to establish (or disprove) panthethine’s potential efficacy.
Several open studies have specifically studied the use of pantethine to improve cholesterol and triglyceride levels in people with diabetes and found it effective 16-19 without causing harmful effects
These findings are supported by experiments in rabbits, which show that pantethine may prevent the build-up of plaque in major arteries. 20 However, we don't know how pantethine acts in the body to reduce triglycerides.

Rheumatoid Arthritis

There is weak evidence for using pantothenic acid to treat rheumatoid arthritis . One observational study found 66 people with rheumatoid arthritis had less pantothenic acid in their blood than 29 healthy people. The more severe the arthritis, the lower the blood levels of pantothenic acid were. 21 However, this result doesn't prove that pantothenic acid supplements can effectively reduce any of the symptoms of rheumatoid arthritis.
To follow up on this finding, researchers then conducted a small placebo-controlled trial involving 18 subjects to see whether pantothenic acid would help. This study found that 2 g daily of pantothenic acid (in the form of calcium pantothenate) reduced morning stiffness, pain, and disability significantly better than placebo. 22 However, a study this small doesn't mean much on its own. More research is needed.

Safety Issues

No significant side effects have been reported for pantothenic acid or pantethine, used by themselves or with other medications. As noted above, pantethine has been used in people with diabetes, without apparent adverse effects. However, maximum safe dosages for young children, pregnant or nursing women, or people with serious liver or kidney disease have not been established.

References

1 Gaddi A, Descovich GC, Noseda G, et al. Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia. Atherosclerosis . 1984;50:73-83.

2 Angelico M, Pinto G, Ciaccheri C, et al. Improvement in serum lipid profile in hyperlipoproteinaemic patients after treatment with pantethine: a crossover, double-blind trial versus placebo. Curr Ther Res . 1983;33:1091-1097.

3 Bertolini S, Donati C, Elicio N, et al. Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children. Int J Clin Pharmacol Ther Toxicol . 1986;24:630-637.

4 Arsenio L, Caronna S, Lateana M, et al. Hyperlipidemia, diabetes and atherosclerosis: Efficacy of treatment with pantethine [in Italian, English abstract]. Acta Biomed Ateneo Parmense . 1984;55:25-42.

5 Donati C, Barbi G, Cairo G, et al. Pantethine improves the lipid abnormalities of chronic hemodialysis patients: Results of a multicenter clinical trial. Clin Nephrol . 1986;25:70-74.

6 Donati C, Bertieri RS, Barbi G. Pantethine, diabetes mellitus and atherosclerosis. Clinical study of 1045 patients [in Italian, English abstract]. Clin Ter . 1989;128:411-422.

7 Coronel G, Tornero F, Torrente J, et al. Treatment of hyperlipidemia in diabetic patients on dialysis with a physiological substance. Am J Nephrol . 1991;11:32-36.

8 [No authors listed]. Calcium pantothenate in arthritic conditions. A report from the General Practitioner Research Group. Practitioner. 1980;224:208-211.

9 Barton-Wright EC, Elliott WA. The pantothenic acid metabolism of rheumatoid arthritis. Lancet. 1963;2:862-863.

10 Gaddi A, Descovich GC, Noseda G, et al. Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia. Atherosclerosis . 1984;50:73-83.

11 Angelico M, Pinto G, Ciaccheri C, et al. Improvement in serum lipid profile in hyperlipoproteinaemic patients after treatment with pantethine: a crossover, double-blind trial versus placebo. Curr Ther Res . 1983;33:1091-1097.

12 Bertolini S, Donati C, Elicio N, et al. Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children. Int J Clin Pharmacol Ther Toxicol . 1986;24:630-637.

13 Gaddi A, Descovich GC, Noseda G, et al. Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia. Atherosclerosis . 1984;50:73-83.

14 Rubba R, Postiglione A, De Simone B, et al. Comparative evaluation of the lipid-lowering effects of fenofibrate and pantethine in type II hyperlipoproteinemia. Curr Ther Res . 1985;38:719-727.

15 Da Col PG, Cattin L, Fonda M, et al. Pantethine in the treatment of hypercholesterolemia: a randomized double-blind trial versus tiadenol. Curr Ther Res. 1984;36:314-322.

16 Arsenio L, Caronna S, Lateana M, et al. Hyperlipidemia, diabetes and atherosclerosis: Efficacy of treatment with pantethine [in Italian, English abstract]. Acta Biomed Ateneo Parmense . 1984;55:25-42.

17 Donati C, Barbi G, Cairo G, et al. Pantethine improves the lipid abnormalities of chronic hemodialysis patients: Results of a multicenter clinical trial. Clin Nephrol . 1986;25:70-74.

18 Donati C, Bertieri RS, Barbi G. Pantethine, diabetes mellitus and atherosclerosis. Clinical study of 1045 patients [in Italian, English abstract]. Clin Ter . 1989;128:411-422.

19 Coronel G, Tornero F, Torrente J, et al. Treatment of hyperlipidemia in diabetic patients on dialysis with a physiological substance. Am J Nephrol . 1991;11:32-36.

20 Carrara P, Matturri L, Galbussera M, et al. Pantethine reduces plasma cholesterol and the severity of arterial lesions in experimental hypercholesterolemic rabbits. Atherosclerosis . 1984;53:255-264.

21 Barton-Wright EC, Elliott WA. The pantothenic acid metabolism of rheumatoid arthritis. Lancet. 1963;2:862-863.

22 [No authors listed]. Calcium pantothenate in arthritic conditions. A report from the General Practitioner Research Group. Practitioner. 1980;224:208-211.

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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