What is another name for vitamin B5?

Not to be confused with pantethine

Chemical compound

Pantothenic acid (vitamin B5) is a B vitamin and an essential nutrient.[6] All animals need pantothenic acid in order to synthesize coenzyme A (CoA), which is essential for cellular energy production and for the synthesis and degradation of proteins, carbohydrates, and fats.[6][7]

Pantothenic acid is the combination of pantoic acid and β-alanine. Its name comes from the Greek πάντοθεν pantothen, meaning "from everywhere", because pantothenic acid, at least in small amounts, is in almost all foods.[6][8][7] Deficiency of pantothenic acid is very rare in humans.[6][7] In dietary supplements and animal feed, the form commonly used is calcium pantothenate, because chemically it is more stable, and hence makes for longer product shelf-life, than sodium pantothenate and free pantothenic acid.[1]

Definition

[

edit

]

Structure of coenzyme A: 1: 3′-phosphoadenosine. 2: diphosphate, organophosphate anhydride. 3: pantoic acid. 4: β-alanine. 5: cysteamine.

Pantothenic acid is a water-soluble vitamin, one of the B vitamins. It is synthesized from the amino acid β-alanine and pantoic acid (see biosynthesis and structure of coenzyme A figures). Unlike vitamin E or vitamin K, which occurs in several chemically related forms known as vitamers, pantothenic acid is only one chemical compound. It is a starting compound in the synthesis of coenzyme A (CoA), a cofactor for many enzyme processes.[7][9][10]

Use in biosynthesis of coenzyme A

[

edit

]

Details of the biosynthetic pathway of CoA synthesis from pantothenic acid

Pantothenic acid is a precursor to CoA via a five-step process. The biosynthesis requires pantothenic acid, cysteine, and four equivalents of ATP (see figure).[11]

This pathway is suppressed by end-product inhibition, meaning that CoA is a competitive inhibitor of pantothenate kinase, the enzyme responsible for the first step.[12]

Coenzyme A is necessary in the reaction mechanism of the citric acid cycle. This process is the body's primary catabolic pathway and is essential in breaking down the building blocks of the cell such as carbohydrates, amino acids and lipids, for fuel.[13] CoA is important in energy metabolism for pyruvate to enter the tricarboxylic acid cycle (TCA cycle) as acetyl-CoA, and for α-ketoglutarate to be transformed to succinyl-CoA in the cycle.[14] CoA is also required for acylation and acetylation, which, for example, are involved in signal transduction, and various enzyme functions.[14] In addition to functioning as CoA, this compound can act as an acyl group carrier to form acetyl-CoA and other related compounds; this is a way to transport carbon atoms within the cell.[9] CoA is also required in the formation of acyl carrier protein (ACP),[15] which is required for fatty acid synthesis.[9][16] Its synthesis also connects with other vitamins such as thiamin and folic acid.[17]

Dietary recommendations

[

edit

]

The US Institute of Medicine (IOM) updated Estimated Average Requirements (EARs) and Recommended Dietary Allowances (RDAs) for B vitamins in 1998. At that time there was not sufficient information to establish EARs and RDAs for pantothenic acid. In instances such as this, the Board sets Adequate Intakes (AIs), with the understanding that at some later date, AIs may be replaced by more exact information.[10][18]

The current AI for teens and adults ages 14 and up is 5 mg/day. This was based in part on the observation that for a typical diet, urinary excretion was approximately 2.6 mg/day, and that bioavailability of food-bound pantothenic acid was roughly 50%.[10] AI for pregnancy is 6 mg/day. AI for lactation is 7 mg/day. For infants up to 12 months the AI is 1.8 mg/day. For children ages 1–13 years the AI increases with age from 2 to 4 mg/day. Collectively the EARs, RDAs, AIs and ULs are referred to as Dietary Reference Intakes (DRIs).[10][18]

Age group Age Adequate intake[10] Infants 0–6 months 1.7 mg Infants 7–12 months 1.8 mg Children 1–3 years 2 mg Children 4–8 years 3 mg Children 9–13 years 4 mg Adult men and women 14+ years 5 mg Pregnant women (vs. 5) 6 mg Breastfeeding women (vs. 5) 7 mg

While for many nutrients, the US Department of Agriculture uses food composition data combined with food consumption survey results to estimate average consumption, the surveys and reports do not include pantothenic acid in the analyses.[19] Less formal estimates of adult daily intakes report about 4 to 7 mg/day.[10]

The European Food Safety Authority (EFSA) refers to the collective set of information as Dietary Reference Values, with Population Reference Intake (PRI) instead of RDA, and Average Requirement instead of EAR. AI and UL are defined the same as in the US. For women and men over age 11 the Adequate Intake (AI) is set at 5 mg/day. AI for pregnancy is 5 mg/day, for lactation 7 mg/day. For children ages 1–10 years the AI is 4 mg/day. These AIs are similar to the US AIs.[20]

Safety

[

edit

]

As for safety, the IOM sets Tolerable upper intake levels (ULs) for vitamins and minerals when evidence is sufficient. In the case of pantothenic acid there is no UL, as there is no human data for adverse effects from high doses.[10] The EFSA also reviewed the safety question and reached the same conclusion as in United States – that there was not sufficient evidence to set a UL for pantothenic acid.[21]

Labeling requirements

[

edit

]

For US food and dietary supplement labeling purposes the amount in a serving is expressed as a percent of Daily Value (%DV). For pantothenic acid labeling purposes 100% of the Daily Value was 10 mg, but as of 27 May 2016 it was revised to 5 mg to bring it into agreement with the AI.[22][23] Compliance with the updated labeling regulations was required by 1 January 2020 for manufacturers with US$10 million or more in annual food sales, and by 1 January 2021 for manufacturers with lower volume food sales.[24][25] A table of the old and new adult daily values is provided at Reference Daily Intake.

Sources

[

edit

]

Dietary

[

edit

]

Food sources of pantothenic acid include animal-sourced foods, including dairy foods and eggs.[6][8] Potatoes, tomato products, oat-cereals, sunflower seeds, avocado are good plant sources. Mushrooms are good sources, too. Whole grains are another source of the vitamin, but milling to make white rice or white flour removes much of the pantothenic acid, as it is found in the outer layers of whole grains.[6][10] In animal feeds, the most important sources are alfalfa, cereal, fish meal, peanut meal, molasses, rice bran, wheat bran, and yeasts.[26]

Supplements

[

edit

]

Dietary supplements of pantothenic acid commonly use pantothenol (or panthenol), a shelf-stable analog, which is converted to pantothenic acid once consumed.[7] Calcium pantothenate – a salt – may be used in manufacturing because it is more resistant than pantothenic acid to factors that deteriorate stability, such as acid, alkali or heat.[9][26] The amount of pantothenic acid in dietary supplement products may contain up to 1,000 mg (200 times the Adequate Intake level for adults), without evidence that such large amounts provide any benefit.[7][6] According to WebMD, pantothenic acid supplements have a long list of claimed uses, but there is insufficient scientific evidence to support any of them.[27]

As a dietary supplement, pantothenic acid is not the same as pantethine, which is composed of two pantothenic acid molecules linked by a disulfide bridge.[7] Sold as a high-dose supplement (600 mg), pantethine may be effective for lowering blood levels of LDL cholesterol – a risk factor for cardiovascular diseases – but its long-term effects are unknown, requiring that its use be supervised by a physician.[7] Dietary supplementation with pantothenic acid does not have the same effect on LDL.[7]

Fortification

[

edit

]

According to the Global Fortification Data Exchange, pantothenic acid deficiency is so rare that no countries require that foods be fortified.[28]

Absorption, metabolism and excretion

[

edit

]

When found in foods, most pantothenic acid is in the form of CoA or bound to acyl carrier protein (ACP). For the intestinal cells to absorb this vitamin, it must be converted into free pantothenic acid. Within the lumen of the intestine, CoA and ACP are hydrolyzed into 4'-phosphopantetheine. The 4'-phosphopantetheine is then dephosphorylated into pantetheine. Pantetheinase, an intestinal enzyme, then hydrolyzes pantetheine into free pantothenic acid.[29] Free pantothenic acid is absorbed into intestinal cells via a saturable, sodium-dependent active transport system.[14] At high levels of intake, when this mechanism is saturated, some pantothenic acid may also be additionally absorbed via passive diffusion.[26] As a whole, when intake increases 10-fold, absorption rate decreases to 10%.[14]

Pantothenic acid is excreted in urine. This occurs after its release from CoA. Urinary amounts are on the order of 2.6 mg/day, but decreased to negligible amounts when subjects in multi-week experimental situations were fed diets devoid of the vitamin.[10]

Deficiency

[

edit

]

Pantothenic acid deficiency in humans is very rare and has not been thoroughly studied. In the few cases where deficiency has been seen (prisoners of war during World War II, victims of starvation, or limited volunteer trials), nearly all symptoms were reversed with orally administered pantothenic acid.[14][9] Symptoms of deficiency are similar to other vitamin B deficiencies. There is impaired energy production, due to low CoA levels, which could cause symptoms of irritability, fatigue, and apathy.[14] Acetylcholine synthesis is also impaired; therefore, neurological symptoms can also appear in deficiency;[30] they include sensation of numbness in hands and feet, paresthesia and muscle cramps. Additional symptoms could include restlessness, malaise, sleep disturbances, nausea, vomiting and abdominal cramps.[30]

In animals, symptoms include disorders of the nervous, gastrointestinal, and immune systems, reduced growth rate, decreased food intake, skin lesions and changes in hair coat, and alterations in lipid and carbohydrate metabolism.[31] In rodents, there can be loss of hair color, which led to marketing of pantothenic acid as a dietary supplement which could prevent or treat graying of hair in humans (despite the lack of any human trial evidence).[9]

Pantothenic acid status can be assessed by measuring either whole blood concentration or 24-hour urinary excretion. In humans, whole blood values less than 1 μmol/L are considered low, as is urinary excretion of less than 4.56 mmol/day.[9]

Animal nutrition

[

edit

]

Calcium pantothenate and dexpanthenol (D-panthenol) are European Food Safety Authority (EFSA) approved additives to animal feed.[1] Supplementation is on the order of 8–20 mg/kg for pigs, 10–15 mg/kg for poultry, 30–50 mg/kg for fish and 8–14 mg/kg feed for pets. These are recommended concentrations, designed to be higher than what are thought to be requirements.[1] There is some evidence that feed supplementation increases pantothenic acid concentration in tissues, i.e., meat, consumed by humans, and also for eggs, but this raises no concerns for consumer safety.[1]

No dietary requirement for pantothenic acid has been established in ruminant species. Synthesis of pantothenic acid by ruminal microorganisms appears to be 20 to 30 times more than dietary amounts.[32] Net microbial synthesis of pantothenic acid in the rumen of steer calves has been estimated to be 2.2 mg/kg of digestible organic matter consumed per day. Supplementation of pantothenic acid at 5 to 10 times theoretical requirements did not improve growth performance of feedlot cattle.[33]

Synthesis

[

edit

]

Biosynthesis

[

edit

]

Pantothenic acid biosynthesis

Bacteria synthesize pantothenic acid from the amino acids aspartate and a precursor to the amino acid valine. Aspartate is converted to β-alanine. The amino group of valine is replaced by a keto-moiety to yield α-ketoisovalerate, which, in turn, forms α-ketopantoate following transfer of a methyl group, then D-pantoate (also known as pantoic acid) following reduction. β-alanine and pantoic acid are then condensed to form pantothenic acid (see figure).[12]

Industrial synthesis

[

edit

]

The industrial synthesis of pantothenic acid starts with the aldol condensation of isobutyraldehyde and formaldehyde. The resulting hydroxypivaldehyde is converted to its cyanohydrin derivative. which is cyclised to give racemic pantolactone. This sequence of reactions was first published in 1904.[34]

Synthesis of the vitamin is completed by resolution of the lactone using quinine, for example, followed by treatment with the calcium or sodium salt of β-alanine.[35]

History

[

edit

]

The term vitamin is derived from the word vitamine, which was coined in 1912 by Polish biochemist Casimir Funk, who isolated a complex of water-soluble micronutrients essential to life, all of which he presumed to be amines.[36] When this presumption was later determined not to be true, the "e" was dropped from the name, hence "vitamin".[26] Vitamin nomenclature was alphabetical, with Elmer McCollum calling these fat-soluble A and water-soluble B.[26] Over time, eight chemically distinct, water-soluble B vitamins were isolated and numbered, with pantothenic acid as vitamin B5.[26]

The essential nature of pantothenic acid was discovered by Roger J. Williams in 1933 by showing it was required for the growth of yeast.[37] Three years later Elvehjem and Jukes demonstrated that it was a growth and anti-dermatitis factor in chickens.[9] Williams dubbed the compound "pantothenic acid", deriving the name from the Greek word pantothen, which translates as "from everywhere". His reason was that he found it to be present in almost every food he tested.[9] Williams went on to determine the chemical structure in 1940.[9] In 1953, Fritz Lipmann shared the Nobel Prize in Physiology or Medicine "for his discovery of co-enzyme A and its importance for intermediary metabolism", work he had published in 1946.[38]

References

[

edit

]

This is a fact sheet intended for health professionals. For a general overview, see our consumer fact sheet.

Introduction

Pantothenic acid (also known as vitamin B5) is an essential nutrient that is naturally present in some foods, added to others, and available as a dietary supplement. The main function of this water-soluble B vitamin is in the synthesis of coenzyme A (CoA) and acyl carrier protein [1,2]. CoA is essential for fatty acid synthesis and degradation, transfer of acetyl and acyl groups, and a multitude of other anabolic and catabolic processes [3,4]. Acyl carrier protein’s main role is in fatty acid synthesis [2].

A wide variety of plant and animal foods contain pantothenic acid [1]. About 85% of dietary pantothenic acid is in the form of CoA or phosphopantetheine [2,4]. These forms are converted to pantothenic acid by digestive enzymes (nucleosidases, peptidases, and phosphorylases) 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) [1,2,4]. Pantetheine, the dephosphorylated form of phosphopantetheine, however, is first taken up by intestinal cells and converted to pantothenic acid before being delivered into the bloodstream [2]. The intestinal flora also produce pantothenic acid, but its contribution to the total amount of pantothenic acid that the body absorbs is not known [4]. Red blood cells carry pantothenic acid throughout the body [4]. Most pantothenic acid in tissues is in the form of CoA, but smaller amounts are present as acyl carrier protein or free pantothenic acid [1,4].

Pantothenic acid status is not routinely measured in healthy people. Microbiologic growth assays, animal bioassays, and radioimmunoassays can be used to measure pantothenic concentrations in blood, urine, and tissue, but urinary concentrations are the most reliable indicators because of their close relationship with dietary intake [1,4]. With a typical American diet, the urinary excretion rate for pantothenic acid is about 2.6 mg/day [3,5]. Excretion of less than 1 mg pantothenic acid per day suggests deficiency [1,6]. Like urinary concentrations, whole-blood concentrations of pantothenic acid correlate with pantothenic acid intake, but measuring pantothenic acid in whole blood requires enzyme pretreatment to release free pantothenic acid from CoA [1]. Normal blood concentrations of pantothenic acid range from 1.6 to 2.7 mcmol/L, and blood concentrations below 1 mcmol/L are considered low and suggest deficiency [1,4]. Unlike whole-blood concentrations, plasma levels of pantothenic acid do not correlate well with changes in intake or status [1].

Recommended Intakes

Intake recommendations for pantothenic acid and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine [3]. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and sex, include the following:

• Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals
• Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA
• Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals
• Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects

When the FNB evaluated the available data, it found the data insufficient to derive an EAR for pantothenic acid. Consequently, the FNB established AIs for all ages based on usual pantothenic acid intakes in healthy populations [3]. Table 1 lists the current AIs for pantothenic acid [3].

Table 1: Adequate Intakes (AIs) for Pantothenic Acid [3] Age Male Female Pregnancy Lactation Birth to 6 months 1.7 mg 1.7 mg 7–12 months 1.8 mg 1.8 mg 1–3 years 2 mg 2 mg 4–8 years 3 mg 3 mg 9–13 years 4 mg 4 mg 14–18 years 5 mg 5 mg 6 mg 7 mg 19+ years 5 mg 5 mg 6 mg 7 mg

Sources of Pantothenic Acid

Food

Almost all plant- and animal-based foods contain pantothenic acid in varying amounts. Some of the richest dietary sources are beef, chicken, organ meats, whole grains, and some vegetables [4]. Pantothenic acid is added to various foods, including some breakfast cereals and beverages (such as energy drinks) [4]. Limited data indicate that the body absorbs 40%–61% (or half, on average) of pantothenic acid from foods [5].

Edible animal and plant tissues contain relatively high concentrations of pantothenic acid. Food processing, however, can cause significant losses of this compound (20% to almost 80%) [1].

Several food sources of pantothenic acid are listed in Table 2.

Table 2: Pantothenic Acid Content of Selected Foods [7] Food Milligrams
(mg) per
serving Percent
DV* Beef liver, boiled, 3 ounces 8.3 166 Breakfast cereals, fortified with 100% of the DV 5 100 Shitake mushrooms, cooked, pieces, ½ cup 2.6 52 Sunflower seeds, ¼ cup 2.4 48 Chicken, breast meat, skinless, roasted, 3 ounces 1.3 26 Tuna, fresh, bluefin, cooked, 3 ounces 1.2 24 Avocado, raw, ½  1.0 20 Milk, 2% milkfat, 1 cup 0.9 18 Mushrooms, white, sliced, stir fried, ½ cup  0.8 16 Potatoes, russet, flesh and skin, baked, 1 medium 0.7 14 Egg, hard boiled, 1 large 0.7 14 Greek yogurt, vanilla, nonfat, 5.3-ounce container 0.6 12 Ground beef, 85% lean meat, broiled, 3 ounces 0.6 12 Peanuts, roasted in oil, ¼ cup 0.5 10 Broccoli, boiled, ½ cup 0.5 10 Pita, whole wheat, 1 large 0.5 10 Chickpeas, canned, ½ cup 0.4 8 Rice, brown, medium grain, cooked, ½ cup 0.4 8 Oats, regular and quick, cooked with water, ½ cup 0.4 8 Cheese, cheddar, 1.5 ounces 0.2 4 Carrots, chopped, raw, ½ cup 0.2 4 Cabbage, boiled, ½ cup 0.1 2 Clementine, raw, 1  0.1 2 Tomatoes, raw, chopped or sliced, ½ cup 0.1 2 Cherry tomatoes, raw, ½ cup 0 0 Apple, raw, slices, ½ cup 0 0

*DV = Daily Value. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. The DV for pantothenic acid is 5 mg for adults and children age 4 years and older [8]. FDA does not require food labels to list pantothenic acid content unless pantothenic acid has been added to the food. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.

The U.S. Department of Agriculture’s (USDA’s) FoodData Central [7] lists the nutrient content of many foods and provides a comprehensive list of foods containing pantothenic acid arranged by nutrient content.

Dietary supplements

Pantothenic acid is available in dietary supplements containing only pantothenic acid, in combination with other B-complex vitamins, and in some multivitamin/multimineral products [9]. Some supplements contain pantethine (a dimeric form of pantetheine) or more commonly, calcium pantothenate [4,9-11]. No studies have compared the relative bioavailability of pantothenic acid from these different forms. The amount of pantothenic acid in dietary supplements typically ranges from about 10 mg in multivitamin/multimineral products to up to 1,000 mg in supplements of B-complex vitamins or pantothenic acid alone [9].

Pantothenic Acid Intakes and Status

Few data on pantothenic acid intakes in the United States are available. However, a typical mixed diet in the United States provides an estimated daily intake of about 6 mg, suggesting that most people in the United States consume adequate amounts [12]. Some intake information is available from other Western populations. For example, a 1996–1997 study in New Brunswick, Canada, found average daily pantothenic acid intakes of 4.0 mg in women and 5.5 mg in men [13].

Pantothenic Acid Deficiency

Because some pantothenic acid is present in almost all foods, deficiency is rare except in people with severe malnutrition [1,4]. When someone has a pantothenic acid deficiency, it is usually accompanied by deficiencies in other nutrients, making it difficult to identify the effects that are specific to pantothenic acid deficiency [1]. The only individuals known to have developed pantothenic acid deficiency were fed diets containing virtually no pantothenic acid or were taking a pantothenic acid metabolic antagonist [3].

On the basis of the experiences of prisoners of war in World War II and studies of diets lacking pantothenic acid in conjunction with administration of an antagonist of pantothenic acid metabolism, a deficiency is associated with numbness and burning of the hands and feet, headache, fatigue, irritability, restlessness, disturbed sleep, and gastrointestinal disturbances with anorexia [1,4,6,14,15].

Groups at Risk of Pantothenic Acid Inadequacy

The following group is most likely to have inadequate pantothenic acid status.

People with a pantothenate kinase-associated neurodegeneration 2 mutation

Pantothenic acid kinase is an enzyme that is essential for CoA and phosphopantetheine production. It is the principle enzyme associated with the metabolic pathway that is responsible for CoA synthesis. Mutations in the pantothenate kinase 2 (PANK2) gene cause a rare, inherited disorder, pantothenate kinase-associated neurodegeneration (PKAN). PKAN is a type of neurodegeneration associated with brain iron accumulation [4]. A large number of PANK2 mutations reduce the activity of pantothenate kinase 2, potentially decreasing the conversion of pantothenic acid to CoA and thus reducing CoA levels [2].

The manifestations of PKAN can include dystonia (contractions of opposing groups of muscles), spasticity, and pigmentary retinopathy [2,4,16]. Its progression is rapid and leads to significant disability and loss of function [16]. Treatment focuses primarily on reducing symptoms [17]. Whether pantothenate supplementation is beneficial in PKAN is not known, but some anecdotal reports indicate that supplements can reduce symptoms in some patients with atypical PKAN [18].

Pantothenic Acid and Health

Hyperlipidemia

Because of pantothenic acid’s role in triglyceride synthesis and lipoprotein metabolism, experts have hypothesized that pantothenic acid supplementation might reduce lipid levels in patients with hyperlipidemia [19].

Several clinical trials have shown that the form of pantothenic acid known as pantethine reduces lipid levels when taken in large amounts [20], but pantothenic acid itself does not appear to have the same effects [1]. A 2005 review included 28 small clinical trials (average sample size of 22 participants) that examined the effect of pantethine supplements (median daily dose of 900 mg for an average of 12.7 weeks) on serum lipid levels in a total of 646 adults with hyperlipidemia [20]. On average, the supplements were associated with triglyceride declines of 14.2% at 1 month and 32.9% at 4 months. The corresponding declines in total cholesterol were 8.7% and 15.1%, and for low-density lipoprotein (LDL) cholesterol were 10.4% and 20.1%. The corresponding increases in high-density lipoprotein (HDL) cholesterol were 6.1% and 8.4%.

A few additional clinical trials have assessed pantethine’s effects on lipid levels since the publication of the 2005 review. A double-blind trial in China randomly assigned 216 adults with hypertriglyceridemia (204–576 mg/dl) to supplementation with 400 U/day CoA or 600 mg/day pantethine [21]. All participants also received dietary counseling. Triglyceride levels dropped by a significant 16.5% with pantethine compared with baseline after 8 weeks. Concentrations of total cholesterol and non-HDL cholesterol also declined modestly but significantly from baseline. However, these declines might have been due, at least in part, to the dietary counseling that the participants received.

Two randomized, blinded, placebo-controlled studies by the same research group in a total of 152 adults with low to moderate cardiovascular disease risk found that 600 mg/day pantethine for 8 weeks followed by 900 mg/day for 8 weeks plus a therapeutic lifestyle change diet resulted in small but significant reductions in total cholesterol, LDL cholesterol, and non-HDL cholesterol compared with placebo after 16 weeks [19,22]. Increasing the amount of pantethine from 600 to 900 mg/day did not increase the magnitude of reduction in the lipid measures.

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. Research is also needed to determine the mechanisms of pantethine’s effects on lipid levels.

Health Risks from Excessive Pantothenic Acid

The FNB was unable to establish ULs for pantothenic acid because there are no reports of pantothenic acid toxicity in humans at high intakes. Some individuals taking large doses of pantothenic acid supplements (e.g., 10 g/day) develop mild diarrhea and gastrointestinal distress, but the mechanism for this effect is not known [1,23].

Interactions with Medications

Pantothenic acid is not known to have any clinically relevant interactions with medications.

Pantothenic Acid and Healthful Diets

The federal government's 2020–2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. ... In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy)."

For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the USDA's MyPlate.

The Dietary Guidelines for Americans describes a healthy dietary pattern as one that

• Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils.
  • Many vegetables, whole grains, and dairy products contain pantothenic acid.
• Includes a variety of protein foods such as lean meats; poultry; eggs; seafood; beans, peas, and lentils; nuts and seeds; and soy products.
  • ​​​​​​​Fish, beef, poultry, eggs, beans, and nuts contain pantothenic acid.
• Limits foods and beverages higher in added sugars, saturated fat, and sodium.
• Limits alcoholic beverages.
• Stays within your daily calorie needs.

Disclaimer

This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. We encourage you to talk to your health care providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.