Pantothenic acid and pantethine as therapeutic supplements
Pantothenic acid, also known as vitamin B5, and its derivative, pantethine, are natural substances used as therapeutic supplements for various health conditions. Pantothenic acid plays a crucial role in the body's metabolism by aiding in the production of proteins, hormones, red blood cells, and neurotransmitters. As a supplement, it has been explored for potential benefits in managing high cholesterol and triglycerides, enhancing athletic performance, and alleviating symptoms of rheumatoid arthritis and stress.
Pantethine, which the body converts pantothenic acid into, has shown promise in reducing blood triglyceride levels and improving cholesterol profiles, particularly for individuals with elevated triglycerides. Both supplements are generally regarded as safe, although high doses may lead to gastrointestinal issues. While pantothenic acid is widely available in many foods, pantethine is less commonly found in the diet. The recommended daily intake varies by age and condition, and while some studies have hinted at their therapeutic effects, more extensive research is needed to fully understand their efficacy and safety.
Pantothenic acid and pantethine as therapeutic supplements
- PRINCIPAL PROPOSED USES: High cholesterol, high triglycerides
- OTHER PROPOSED USES: Performance enhancement, rheumatoid arthritis, stress
DEFINITION: Natural food substances used as supplements to treat specific health conditions.
Overview
The body uses pantothenic acid, better known as vitamin B5 , to make proteins and 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 neurotransmittersignal 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 and Sources
The Greek word pantothenic means “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 vary1.7 milligrams (mg) for infants up to six months, 1.8 mg for infants from seven to twelve months, 2 mg for children from one to three years old, 3 mg for children from four to eight years old, 4 mg for children nine to thirteen years old, 5 mg for those aged fourteen and older, 6 mg for pregnant women, and 7 mg for nursing women.
Brewer’s yeast, torulanutritionalyeast, and calf liver are excellent sources of pantothenic acid. Peanuts, corn, mushrooms, soybeans, cauliflower, split peas, pecans, oatmeal, buckwheat, sunflower seeds, legumes, rye flour, cashews, salmon, 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 three times daily. Dosages of pantothenic acid as high as 660 mg three times daily are sometimes recommended for people with rheumatoid arthritis. These supplements can be taken for two to three months. Some research indicates pantethine may be safe for forty-eight weeks at doses up to 1000 mg per day.
Pantothenic acid is available in B complex vitamins with other B vitamins or as tablets or capsules of pantothenic acid or calcium pantothenate.
Therapeutic Uses
Inconsistent evidence from small double-blind trials suggests that pantethine might lower blood levels of triglycerides and, to a lesser extent, cholesterol. High triglycerides, like high cholesterol, increase the 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. Pantothenic acid is also recommended as an athletic performance enhancer, but there is no evidence that it works. It is also sometimes referred to as an antistress nutrient because it plays a role in the function of the adrenal glands, but whether it helps the body withstand stress is not known.
Some research indicates that pantothenic acid may help maintain healthy skin, hair, and nails. The Food and Drug Administration (FDA) has approved vitamin B5 for use in cosmetics in the forms of panthenol and dexpanthenol. Though these products are widely used, some experts assert they have been underutilized and underresearched. These chemicals are purported to moisturize skin, help it retain moisture, and strengthen hair. They also may relieve itching and inflammation from insect bites, diaper rash, poison ivy, atopic dermatitis, and eczema. Other uses include treating acne and skin reactions in individuals undergoing radiation treatments for cancer. When taken orally or applied topically, this supplement may help heal skin damage and repair wounds after trauma or surgery. Large-scale research is needed to understand the full potential of vitamin B5 in treating and preventing skin and hair conditions.
Scientific Evidence
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. For example, a double-blind, placebo-controlled study followed twenty-nine people with high cholesterol and triglycerides for eight weeks. The dosage used was 300 mg three times daily, for a total daily dose of 900 mg. In this study, subjects taking pantethine experienced a 30 percent reduction in blood triglycerides, a 13.5 percent reduction in low-density lipoproteins (LDL)bad cholesteroland a 10 percent rise in high-density lipoproteins (HDL)good cholesterol. However, other small studies have found no benefit. 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, pantethine'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 without causing harmful effects. These findings are supported by experiments in rabbits, which show that pantethine may prevent the buildup of plaque in major arteries. However, it is not known 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 sixty-six people with rheumatoid arthritis had less pantothenic acid in their blood than twenty-nine healthy people. The more severe the arthritis, the lower the blood levels of pantothenic acid. However, this result does not 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 eighteen subjects to see whether pantothenic acid would help. This study found that 2 grams (g) daily of pantothenic acid (in the form of calcium pantothenate) reduced morning stiffness, pain, and disability significantly better than a placebo. However, a study this small does not mean much on its own.
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.
Very high doses, such as 10,000 mg daily, can cause gastrointestinal upset. Though uncommon, this supplement may interact with medications used for Alzheimer's disease, antibiotics, and blood thinners.
Bibliography
Gheita, Alaa A., et al. “The Potential Role of B5: A Stitch in Time and Switch in Cytokine.” Phytotherapy Research: PTR, vol. 34, no. 2, 2020, pp. 306-14. doi:10.1002/ptr.6537.
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