Pantothenic acid, also known as vitamin B5, is an essential water-soluble B vitamin naturally present in some foods, added to others, and available as a dietary supplement. Its primary role lies in the synthesis of coenzyme A (CoA) and acyl carrier protein, crucial for various metabolic processes.
Understanding Pantothenic Acid
The Role of CoA
CoA is essential for fatty acid synthesis and degradation, the transfer of acetyl and acyl groups, and numerous anabolic and catabolic processes. This highlights the importance of pantothenic acid in energy production and metabolism.
Dietary Sources and Absorption
Pantothenic acid is found in a wide variety of plant and animal foods. About 85% of dietary pantothenic acid is in the form of CoA or phosphopantetheine. These forms are converted to pantothenic acid by digestive enzymes in the intestinal lumen and intestinal cells. Pantothenic acid is absorbed in the intestine and delivered directly into the bloodstream by active transport, and possibly simple diffusion at higher doses.
Measuring Pantothenic Acid Status
Pantothenic acid status is not routinely measured in healthy people. Urinary concentrations are the most reliable indicators of pantothenic acid levels because of their close relationship with dietary intake.
Recommended Intakes
Intake recommendations for pantothenic acid are provided in the Dietary Reference Intakes (DRIs). An Adequate Intake (AI) level is established based on usual pantothenic acid intakes in healthy populations due to insufficient data for an Estimated Average Requirement (EAR).
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Food Sources of Pantothenic Acid
Almost all plant- and animal-based foods contain pantothenic acid in varying amounts. Rich dietary sources include:
- Beef
- Chicken
- Organ meats
- Whole grains
- Some vegetables
Pantothenic acid is also added to some breakfast cereals and beverages.
Daily Value (DV)
The Daily Value (DV) for pantothenic acid is 5 mg for adults and children age 4 years and older. Food labels are not required to list pantothenic acid content unless it has been added to the food.
Pantothenic Acid Supplements
Pantothenic acid is available in dietary supplements, either alone, in combination with other B-complex vitamins, or in multivitamin/multimineral products. Some supplements contain pantethine or calcium pantothenate.
Pantothenic Acid Deficiency
Because pantothenic acid is present in almost all foods, deficiency is rare, except in people with severe malnutrition. Symptoms of deficiency may include:
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- Numbness and burning in the hands and feet
- Headache
- Fatigue
- Irritability or restlessness
- Trouble sleeping
- Gastrointestinal issues and loss of appetite
- Muscle cramps and impaired muscle coordination
- Personality changes
These symptoms generally resolve with adequate pantothenic acid intake.
Pantothenate Kinase-Associated Neurodegeneration (PKAN)
Mutations in the pantothenate kinase 2 (PANK2) gene cause PKAN, a rare, inherited disorder characterized by dystonia, spasticity, and pigmentary retinopathy.
Pantothenic Acid and Lipid Levels
Pantethine, a form of pantothenic acid, has shown promise in reducing lipid levels in some clinical trials.
Clinical Trial Evidence
A 2005 review of 28 small clinical trials found that pantethine supplements were associated with declines in triglyceride, total cholesterol, and LDL cholesterol levels in adults with hyperlipidemia. Additional studies have supported these findings, suggesting that pantethine may have a beneficial effect on hyperlipidemia.
Further Research Needed
Additional studies are needed to determine whether pantethine supplementation has a beneficial effect on hyperlipidemia independently of, and together with, eating a heart-healthy diet.
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Safety and Tolerability
No Tolerable Upper Intake Level (UL) has been established for pantothenic acid because there are no reports of toxicity in humans at high intakes.
Pantothenic Acid and Weight Loss: Exploring the Connection
The role of pantothenic acid in fat metabolism has led to interest in its potential for weight loss.
The Proposed Theory
It has been proposed that pantothenic acid deficiency may contribute to the formation of ketone bodies during fasting or aggressive dieting, leading to a wastage of energy. Supplementation with pantothenic acid may facilitate complete catabolism of fatty acids, potentially relieving dieters of hunger and weakness.
Addressing Weight Loss
Currently, there is not enough evidence in humans to suggest that pantothenic acid supplements benefit weight loss. However, eating a balanced, nutritious diet, which may also provide the recommended intake of pantothenic acid, may support weight loss.
Pantothenic Acid in Cosmetics
Pantothenic acid, in the form of panthenol and dexpanthenol, is approved for use in cosmetics by the FDA. Dexpanthenol is often added to hair and skin products and may help moisturize the skin, relieve itchiness, and promote healing from skin conditions.
Potential Benefits
Dexpanthenol may help treat mild to moderate childhood atopic dermatitis and skin-related side effects of the acne medication isotretinoin. Some research suggests it may have a potential benefit in wound healing, though more research is needed.
Practical Considerations
Who Should Supplement?
Most people do not need to supplement their diet with pantothenic acid, as it naturally occurs in many foods. However, people with severe malnutrition or certain genetic conditions may require supplementation.
Potential Side Effects
Taking large doses of vitamin B5 supplements may cause gastrointestinal side effects, including diarrhea.
Food Preparation
Vitamin B5 is sensitive to heat, and boiling foods can reduce the amount of vitamin B5 by up to 67%.
Pantothenic Acid and Brown Adipose Tissue
Recent research has explored the connection between pantothenic acid and brown adipose tissue (BAT), which burns calories to produce heat.
Activating Brown Fat
A study published in the American Journal of Physiology-Endocrinology and Metabolism found that pantothenic acid stimulated the production of brown fat in both cell cultures and mice. The vitamin B5-treated high-fat mice showed reduced fat not only overall but, specifically, less fat just under the skin and in the liver compared to those not given vitamin B5.
The Role of Vitamins in Adipogenesis
Research indicates that choline and pantothenic acid are uniquely required for adipogenesis and adipocyte browning, respectively.
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