Herbs & Supplements:
Pantothenic Acid and Pantethine

Principal Proposed Uses
  • High Triglycerides/High Cholesterol
Other Proposed Uses
  • Rheumatoid Arthritis, Performance Enhancement, Stress

Note: Pantothenic acid is often sold as calcium pantothenate. Pantethine, a special form of pantothenic acid, appears to have some unique properties. Regular pantothenic acid cannot be used as a substitute for pantethine.

The body uses pantothenic acid (better known as vitamin B₅) 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, an athletic performance enhancer, and an "antistress" nutrient.

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 levels of both triglycerides and cholesterol in the blood.

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 U.S. 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 cholesterol and 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 arthritis.

Therapeutic Uses

Quite a few small studies suggest that pantethine may lower blood levels of triglycerides and, to a lesser extent, cholesterol.^1,2,3 In general, elevated cholesterol is believed to be more harmful than elevated triglycerides. However, some people have only modestly elevated cholesterol but very high triglycerides, so pantethine may be especially useful for them. It also may be helpful for people with diabetes who need to lower their triglyceride and/or cholesterol levels.^4–7

Pantothenic acid has been proposed as a treatment for rheumatoid arthritis, but the evidence for this use is quite weak.^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 antistress 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

Several small studies suggest (but do not prove) that pantethine can reduce total blood triglycerides and perhaps cholesterol as well.^10,11,12For 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, for reasons that are unclear, some studies have found no benefit.^14,15

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

These findings are supported by experiments in rabbits, which show that pantethine may prevent the buildup of plaque in major arteries.²⁰ We don't know how pantethine works in the body.

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. However, maximum safe dosages for young children, pregnant or nursing women, or people with serious liver or kidney disease have not been established.

Last reviewed March 2002 by Medical Review Board

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