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vitamin
Vitamin B5 (Pantothenic acid)
Nutrition
definition
Vitamin B5 (Pantothenic acid):
» overview:
Water soluble part of the vitamin B complex; synthesized in the body by intestinal bacteria
Vitamin B5 was first identified as a substance essential for the growth of yeast in 1933.
In addition it was found to be essential both in the prevention of dermatitis in chicks and in the graying of hair in rats.
Roger Williams and his associates isolated it in 1938 and synthesized it in 1940.
It was named Pantothenic Acid (pantos means everywhere) because of its widespread occurrence in foods.
» chemistry:
Water soluble and stable in moist heat, Pantothenic Acid is unstable in dry heat and acid or basic pHs.
Little is lost during normal cooking, however, 50% loss occurs in vegetables when they are frozen and 65% when they are canned.
In addition, processed and refined grains lose about 50%, while processed meats lose up to 70% of vitamin B-5.
» metabolism:
Pantothenic acid is readily absorbed from the gastrointestinal tract.
About 70% of absorbed pantothenic acid is excreted in the urine.
Before pantothenic acid gets utilized it must first be converted to the sulfur containing pantotheine.
It is stored in high amounts in the adrenal glands.
» Chinese:
Regulates the Qi; relieves Liver Qi Constraint; harmonizes the Liver/Spleen/Stomach; raises Clear Yang; clears and eliminates Damp-Heat; clears Heat from the Liver (Flaws, 1991, p. 193)
» function:
The active form of B5, coenzyme A, is involved in the Krebs cycle in the production of ATP. It is required for proper functioning of adrenal glands.
Pantothenic acid, upon being converted to 4-phosphopantetheine, binds to a protein to form acyl carrier protein (ACP). This ACP is involved in the synthesis of fats including cholesterol.
Pantothenic Acid provides acetyl groups for the formation of acetylcholine which is needed in the transmission of nerve impulses and for the detoxification of certain drugs.
It is essential for the formation of porphyrin (hemoglobin synthesis).
Pantothenic Acid is required for the synthesis of certain steroids produced in the adrenal glands via the action of Coenzyme A.
» requirements:
RDA:
Infants and children: 1.7 to 4 mg
Adults: 5 mg
Pregnant and nursing women: 7 mg
Optimal daily intake: 100 mg
Note:
The average American intake is 5-20 mg per day
Average intake of teenagers is about 4.7 mg per day
Lab: normally whole blood=100-180mg%
» food sources:
Brewer's yeast, wheat germ, wheat bran, royal jelly, whole-grain breads and cereals, green vegetables, peas, beans, peanuts, crude molasses, liver and egg yolk
Best Food Sources of Pantothenic Acid:
Food Amount mg
Liver, beef 3 oz 4.8
Liver, chicken 3 oz 4.6
Kidney,beef 3 oz 2.6
Turkey, dark meat 3 oz 1.1
Brewers yeast 1 Tbsp 1.0
Peanuts or Peas, dried 1/4 cup 1.0
Chicken, dark meat 3 oz 0.9
Egg, hard cooked 1 large 0.9
Rice, brown, cooked 1 cup 0.8
Sweet corn 1 med ear 0.8
Beef, lean 3 oz 0.7
Sweet potato 1 med 0.7
Cashews 1/4 cup 0.6
Soy flour 1/4 cup 0.6
Buckwheat flour 1/4cup 0.4
Rye flour 1/4cup 0.4
(USDA: Composition of Foods. USDA Handbook #8 Washington DC, ARS, USDA, 1976-1986)
» deficiency:
A deficiency of pantothenic acid is uncommon because of its wide distribution in foods. Experimentally induced human Vitamin B-5 deficiency has caused insomnia, leg cramps, paresthesias of the hands and feet, mental depression, decreased antibody formation, easy fatigue, GI disturbance, and upper respiratory infections.
» therapeutics:
Allergies: Szorady conducted allergy skin tests on 24 children injecting them with histamine. Pantothenic acid reduced the intensity of skin reaction by 20-50% in all children. (Marz, p.209, 1997)
Anemia (McCurdy. J Am Geriatr Soc 21(2):88-91, 1973)
Contact dermatitis: 2% panthenol ointment improved symptoms of Lichen planus (vaginitis). (Wade Boyle, N.D. per R. Marz)
Eczema: Especially related to allergic atopic eczema.
Hyperlipidemia and Atherosclerosis: 300 mg three times per day. Several studies show an increase in HDL and an inhibition of platelet aggregation.
(Clin Ther 8:5637,1986; Cattin. Current Ther Res. 38(3):386-95,1985; Galeone. Current Ther Res 34:383-90,1983; Da Col, P.G.; Arsenio, L, et al. Acta Biomed Ateneo Parmense 1984;55(1):25-42)
Osteoarthritis
(General Practitioner Research Group. Practitioner 224:208-11,1980; Annand. J Coll Gen Practrs. and Lancet 2:1168,1963).
Rheumatoid Arthritis:
Note above study in Practitioner 1980 showed that of 18 patients with rheumatoid arthritis, there was a significant subjective reduction in the duration of morning stiffness, degree of disability, and severity of pain compared to baseline. Controls failed to report significant improvements.
(Barton-Wright, Elliott. Lancet 2:862-63,1963)
Stress: A study in the 30s revealed that rats fed deficient, adequate and high pantothenate levels could swim 16, 29 and 62 minutes respectively.
(Ralli, Dumm. NYU Bellevue Med Center 1952; Am J of Surg; Szorady U Med. School Szeged, Hungry Acta Paediatrica Hungarice)
Systemic Lupus Erythematous: 2 studies, 1 yes, the other no.
» dosage:
Therapeutic dose: 100-300 mg
Maintenance dose: 50 mg-3 g
» toxicity:
No known toxicity
Diarrhea with very large doses of Pantothenic Acid.
» antagonists:
Aspirin
Methylbromide
footnotes
Am J of Surg. 50 patients undergoing abdominal surgery were given 500mg of B5 the day of surgery and for 5 days afterwards. Another 50 patients were not given B5. The B5 group had a more benign postoperative course.
Annand. J. Coll Gen Practrs. Pantothenic acid and OA. Lancet 2:1168,1963.
Abstract: Patients treated with 12.5 mg 2x/day of pantothenate demonstrated a limited, variable improvement starting in 1-2weeks and ending upon discontinuation of the supplementation.
Arsenio L, Caronna S, Lateana M, Magnati G, Strata A, Zammarchi G. [Hyperlipidemia, diabetes and atherosclerosis: efficacy of treatment with pantethine]. Acta Biomed Ateneo Parmense 1984;55(1):25-42 [Article in Italian]
Abstract: The hypolipidemizing effects of Pantethine were investigated by the Authors in 37 hypercholesterolemic and/or hypertriglyceridemic patients. Of these, 21 were also diabetic, in a satisfying glucidic compensation, in order to verify the action of this drug also in this metabolic condition. The study was carried out for three months and during this period the patients were given Pantethine at the dose of 600 mg/die orally. At the 30th, the 60th, the 90th day of treatment the following parameters were controlled: cholesterolemia, HDL cholesterol, apolipoproteins A and B, triglyceridemia, systolic and diastolic arterial pressure, uricemia, body weight. Thirty days after suspending the treatment, the parameters were controlled again to detect a possible "rebound" effect. The results were analyzed on the whole case-record, subdividing the patients in dislipidemic and diabetic-dislipidemic, and on the basis of the Fredrickson's classification. Pantethine induced in all groups a quick and progressive decrease of cholesterolemia, triglyceridemia, LDL cholesterol and Apolipoproteins B with increased HDL cholesterol and Apolipoproteins A. After suspending the treatment, there is a clear inversion of the state of these parameters. The Authors conclude that the present work shows that Pantethine, a natural and atoxic substance, an important component of Coenzyme A, is efficacious in determining a clear tendency towards normalization of the lipidic values.
Avogaro P, Bon B, Fusello M. Effect of pantethine on lipids, lipoproteins and apolipoproteins in man. Curr Ther Res 1983;33;488-493.
Barton-Wright, Elliott. The pantothenic acid metabolism of rheumatoid arthritis. Lancet 2:862-63,1963.
Abstract: The mean level of whole blood pantothenic acid for 66 patients was significantly lower (45% lower) than that for 29 normals. Moreover, the lower the level of pantothenic acid, the greater the symptom severity (when pantothenate was 400% less than the mean level, patients showed the most severe symptoms; 2 were bedridden). Vegetarian normals had a much higher pantothenate level than did normals consuming a usual balanced diet. It should be noted that attempts to supplement pantothenic acid resulted in a short term improvement after 7 days but then stopped. 20 patients received 50mg Calcium-D-pantothenate IM daily which lead to a temporary alleviation of symptoms after 7 days along with an increase in whole blood pantothenate. Another 21 days of injections failed to result in further improvement. After discontinuation, blood levels fell to their initial values by the end of one month with concomitant reappearance of symptoms, suggesting that abnormal pantothenate metabolism is due to some other factor. Since royal jelly is rich in pantothenic acid in its free state as well as in other 10 carbon chain fatty acids, 20 patients received a mixture of royal jelly and pantothenic acid: 50mg of each IM daily. By 28 days, 14 patients noted an improvement in general condition and joint mobility along with a fall in ESR coincident with rising blood levels. This lasted until blood levels returned to previous values 2 months following discontinuation of the injections. 10 vegetarians with rheumatoid arthritis all improved on the same regime by 14 days with greater rise in whole blood pantothenate levels than in the nonvegetarian arthritics. Preliminary results with oral supplementation have been encouraging.
Calcium pantothenate in arthritic conditions. A report from the General Practitioner Research Group. Practitioner 224:208-11,1980.
Abstract: 47/94 patients with arthritic conditions (63% with OA) who were previously untreated or who had not responded to previous drug treatment were randomly chosen to receive 2gms daily of Calcium pantothenate while the rest received placebo. Patients were permitted to take paracetamol to relieve pain but no other medications. After 2 months, daily records kept by patients failed to show significant reductions in the duration of morning stiffness or degree of disability in either the experimental or control groups. Both groups reported significant pain relief but neither resulted in any significant reduction in requirements for pain medication. There was no significant difference between groups and overall assessment by the doctors at the end of the trial gave similar results for active and placebo medications. There was, however, evidence that the subgroup of patients with rheumatoid arthritis may have benefited.
Cattin. Treatment of hypercholesterolemia with pantetheine and fenofibrate: An open randomized study on 43 patients. Current Ther Res. 38(3):386-95,1985.
Abstract: In an open randomized study of hypercholesterolemic patients pantetheine was as effective as fenofibrate in lowering total and LDL cholesterol levels but without the side effects of the drug.
Da Col, PG. Pantetheine in the treatment of hypercholesterolemia: A clinical investigation.
Abstract: Supplementation was ineffective for patients who had previously failed to respond to a combined drug/diet regime.
Donati C, Barbi G, Cairo G, Prati GF, Degli Esposti E. Pantethine improves the lipid abnormalities of chronic hemodialysis patients: results of a multicenter clinical trial. Clin Nephrol 1986 Feb;25(2):70-74.
Galeone F, Scalabrino A, Giuntoli F, et al. The lipid-lowering effect of pantethine in hyperlipidemic patients: a clinical investigation. Curr Ther Res 1983;34:383-90.
Abstract: Following supplementation normal values were obtained in 83% of hypercholesterolemic patients and 35.7% of hypertriglyceride patients.
Haslock DI, Wright V. Pantothenic acid in the treatment of osteoarthrosis. Rheumatol Phys Med 1971 Feb;11(1):10-13.
Kirschmann and Dunne, pp. 27-29
Marz, Russell. Medical Nutrition From Marz. Second Edition. Portland, OR. 1997.
McCurdy. Is there an anemia responsive to pantothenic acid? J AM Geriatr Soc 21(2):88-91, 1973.
Abstract: A 53 year old black female was admitted with anorexia, weight loss, lethargy, incontinence and hypochromic anemia with increased iron storage in the bone marrow. After an unsuccessful trial of B6, all symptoms and signs improved dramatically following administration of pantothenic acid 50-200mg IM daily. Several years later a similar clinical picture developed. There was a clinical, but probably not hema-tologic, response to a multivitamin preparation containing large amounts of B5 suggesting that lethargic patients with iron-loaded hypochromic anemia unresponsive to B6 might benefit from a trial of B5.
Miccoli R, Marchetti P, Sampietro T, et al. Effects of pantethine on lipids and apolipoproteins in hypercholesterolemic diabetic and non diabetic patients. Curr Ther Res 1984;36:545-549.
Pantetheine treatment of hyperlipidemia. Clin Ther 8:5637,1986.
Abstract: 24 patients (average age 51 years) with types llA, llB or IV hyperlipidemia received pantetheine 300mg three times per day. After one year there was a highly significant reduction of about 17% in mean serum cholesterol levels which had become evident within one month and persisted thereafter. Mean HDL cholesterol levels increased by about 15% and mean triglyceride levels fell by 48%. No significant side effects.
Ralli, Dumm. NYU Bellevue Med Center 1952.
Abstract: Men were immersed in 48 degree water for 8 minutes. White blood cells and vitamin C levels were measured and then the men received 10gms of B5 every day for 6 weeks. They were then subjected to the same dunking. The supplemented period resulted in a less pronounced drop in their white blood cells and vitamin C levels. Cholesterol levels were also lower in the pantothenic acid group.
Szorady U Med. School Szeged, Hungary Acta Paediatrica Hungarice
Abstract: 200 mice divided into 4 groups with one group receiving pantothenate for a week before total body irradiation. 1/2 were still alive after 21 days but of the non supplemented groups 1/2 were dead within 8 days.
USDA: Composition of Foods. USDA Handbook #8 Washington DC, ARS, USDA, 1976-1986
White-O'Connor B, Sobal J. Nutrient intake and obesity in a multidisciplinary assessment of osteoarthritis. Clin Ther 1986;9 Suppl B:30-42