Comprehensive Guide to Pantothenic Acid

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Pantothenic AcidDr. James Meschino DC, MS, ND
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Introduction
Its name "Pantothenic Acid" reflects its widespread (pan-) distribution in plant and animal foods. All foods contain this B-vitamin, thus an overt pantothenic acid deficiency is rare, unless induced by starvation or by consuming a purified diet in combination with pantothenic acid antagonists for experimental reasons.

Absorption and Metabolism

Pantothenic acid is absorbed in the small intestine (passive diffusion is considered to be the mechanism). In the body tissues, the vitamin is converted to its important coenzyme form, Coenzyme A. Pantothenic acid is also a component of acyl-carrier protein (ACP), used in fatty acid synthesis.
Functions

As a component of coenzyme A, the subsequent formation of Acetyl CoA is central to the production of ATP in the Kreb's cycle, fatty acid synthesis, cholesterol synthesis, ketone formation and the production of the neurotransmitter acetylcholine.

Recommended Dietary Allowance (Pantothenic Acid)
GroupMilligrams
Under 6 months2
6-12 months3
1-6 years 3-4
7-10 years 4-5
11+ years 4-7

 

Clinical Deficiency
Experimentally-induced deficiency of pantothenic acid results in insomnia, fatigue, irritability, numbness and tingling of the hands and feet, muscle cramps, and impaired production of antibodies. Administration of pantothenic acid eliminates all of these symptoms.

Supplementation Studies

Pantothenic acid has been used successfully to treat neurologic symptoms in patients who have received streptomycin.

Pantothenic acid is sometimes used to stimulate the gastrointestinal tract following surgery.1

Cholesterol and Triglyceride Lowering

Pantethine is a more active form of pantothenic acid (and more expensive) has been shown to lower cholesterol and triglyceride levels. Preliminary clinical trails demonstrate that taking 300 mg of pantethine, three times per day (900 mg dose) can reduce serum triglyceride levels by 32 per cent and total cholesterol levels by 19 per cent. In contrast to many cholesterol-lowering drugs it exhibits very little toxicity and appears to be safe for this application. Pantethine acts by inhibiting cholesterol synthesis and accelerating the utilization of fat as an energy source.2,3 Several studies have shown that pantethine produces impressive lipid-lowering effects without side effects in diabetics.4,5,6

Author's Note: 900 mg of pantethine is a very high dose. Long term studies are likely needed to establish the true safety of this B-vitamin like substance if doses in this range are to be used for lowering lipids. Other natural agents can be used to lower lipids, such as gugulipid, policosanol, soy, garlic extract, soluble fibre, reduced intake of saturated fat, psyllium and flax seed powder. All of these have established safety for this application. Pantethine should still be considered experimental until further studies evaluating its safety are completed.

Adverse Side Effects and Toxicity of Pantothenic Acid

No toxic effects are known other than at doses of 10 to 20 grams, which may cause diarrhea.

Drug-Nutrient Interactions

Salicylates

ASA and salicylate-containing drugs are reported to cause a decrease in pantothenic acid levels in the body.7

Standard Textbooks of Nutritional Science:

   - Shils M, Shike M, Olson J, Ross C. Modern Nutrition in Health and Disease. 9th ed. Baltimore, MD: Lippincott Williams & Wilkins; 1993.

   - Escott-Stump S, Mahan LK, editors. Food, Nutrition and Diet Therapy. 10th ed. Philadelphia, PA: W.B. Saunders Company; 2000.

   - Bowman B, Russell RM, editors. Present Knowledge in Nutrition, 8th ed. Washington, DC:.ILSI Press; 2001.

   - Kreutler PA, Czajka-Narins DM, editors. Nutrition in Perspective. 2nd ed. Upper Saddle River, NJ: Prentice Hall Inc.; 1987.

Arsenio L, Bodria P, Magnati G, Strata A, Trovato R. Effectiveness of long-term treatment with Pantethine in patients with dyslipidemias. Clin Ther 1986;8:537-45.

Gaddi A, Descovich GC, Noseda G, Fragiacomo C, Colombo L, Craveri A, et al. Controlled evaluation of Pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia. Atherosel 1984;50:73-83.

Coronel F,Tornero F,Torrente J,Naranjo P,De Oleo P,Macia M, et al. Treatment of hyperlipidemia in diabetic patients on dialysis with a physiological substance. Am J Nephrol 1991;11(1):32-6.

Donati C, Bertieri RS, and Barbi G. Pantethine, diabetes mellitus and atherosclerosis: clinical study of 1,045 patients. Clin Ter 1989;128;411-22.

Hiramatsu K, Nozaki H, Arimori S. Influence of Pantethine on platelet volume, microviscosity, lipid composition and functions in diabetes mellitus with hyperlipidemia. Tokai J Exp Clin Med 1981;6(1):49-57.

Montenero AS. Drugs producing vitamin deficiencies. Acta Vitaminol Enzymol 1980;2(1-2):27-45.

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