Pantothenic Acid (B5)

Mechanism of Action

Pantothenic acid is converted to Coenzyme A (CoA), the universal acyl-group carrier essential for >100 metabolic reactions. CoA is required for: fatty acid synthesis and beta-oxidation, citric acid cycle (acetyl-CoA entry), steroid hormone synthesis (pregnenolone from cholesterol), acetylcholine synthesis, melatonin synthesis, and Phase II detoxification (acetylation reactions). Pantethine (the active form) supports healthy lipid metabolism by inhibiting hepatic HMG-CoA reductase and fatty acid synthase, while stimulating fatty acid oxidation.

Dosing Protocol

Notes

The CoA connection means B5 is fundamentally required for energy production, hormone synthesis, and detoxification. Pantethine has specific lipid-lowering evidence (LDL reduction, triglyceride reduction) that standard pantothenic acid does not. 'Anti-stress vitamin' designation relates to its role in adrenal cortisol synthesis. Acne treatment at high doses (5-10g/day) has anecdotal support but limited clinical evidence and GI side effects are common at those doses.

Stacking

• B-Complex
• Vitamin C
• L-Carnitine
• CoQ10

Interactions

• Cholinesterase inhibitors (donepezil) [LOW] — B5 supports acetylcholine synthesis — potentially synergistic

Contraindications

• Hemophilia (theoretical concern: pantethine may have mild antiplatelet effect at high doses)

Side Effects

• Diarrhea at high doses
• GI discomfort
• Contact dermatitis (topical dexpanthenol)

Key Papers

• 10.1016/j.nutres.2011.02.001
• 10.1016/j.atherosclerosis.2005.01.027
• 10.1177/0884533614524406

Source Quality

Pantethine is the active derivative with lipid-modulating evidence; calcium-D-pantothenate is the standard supplement form. For lipid support: pantethine 600-900mg/day. Brands: Jarrow Pantethine, NOW Pantothenic Acid, Thorne (in B-complex formulas).

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