Pantothenic Acid, Part 2 (Testing, Food, and Supplements)
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Pantothenic Acid, Part 2 (Testing, Food, and Supplements) | Mastering Nutrition #66

This is part 2 of the pantothenic acid Mastering Nutrition podcast. Pantothenate is also known as vitamin B5! It supports your mood, mental health, skin clarity, energy, sleep, and comfort.

Alex Leaf and I team up again, this time to how to get B5 from foods and supplements, and how to know when you’re getting enough.

When you aren’t getting enough, you may suffer from fatigue, apathy, discomfort, uneasiness, or pain. You may get numbness and tingling in the hands and feet. You may get depressed, quarrelsome, childish, or want to spend all day in bed. Your pulse may get higher than you’d expect after minor exertion. Your sleep gets trashed. You get muscle cramps and abdominal cramps, you fart more, and when things get real bad you might throw up.

The best test for measuring B5 status is urinary pantothenic acid. Currently, the only place I know where to get this is the Great Plains OAT test. Hopefully someone will offer it as a standalone. Blood tests are not very useful. 😔

Official recommendations suggest we only need about 5 milligrams per day. In the podcast we discuss why some people might need GRAMS per day. 

❗❗❗There aren’t ANY supplements on the market that have the major forms of B5 found in food. There is good reason to think that food B5 is superior to supplements such as pantothenic acid and pantethine.❗❗❗

I recommend shooting for 10 milligrams per day from food, and then supplementing more when necessary:

  •  2 heaping tablespoons of unfortified nutritional yeast gives you 10 mg.
  •  2 100-gram servings of roasted sunflower seeds or the livers of chicken, beef, lamb, or veal will give you this, but I recommend limiting liver to two servings per week.
  • 3 100-gram servings of gjetost cheese, black and red caviar, kidney from lamb imported from New Zealand, pork liver (and most products made from it), shiitake mushrooms, or canned grape leaves will do the trick.
  • Most fresh cuts of muscle meat give you enough in somewhere between 3-5 100-gram servings, though some require up to four pounds and the data is pretty messy.
  • Five 100-gram servings of any of the following will work: eggs, duck, goose, emu, fresh salmon or trout, raw avocado, canned chilli, peanuts, peanut butter, cashews, white or portabella mushrooms, liver pate (limit to 5 servings per week), giiblets or heart from chicken or turkey, beef thymus or heart, pork kidney or brain, or lamb brain.
  • The following can give you enough if you eat four pounds of them: whole grains, most natural dairy products besides butter, most seafood that isn’t canned, most beans that aren’t canned, raw coconut, most nuts and seeds, and most processed meats.

Here are a few reasons to supplement:

  • One gram of pantothenic acid from sodium or calcium pantothenate has been used for rheumatoid arthritis, and 2-10 grams per day have been used for acne. In acne, a topical cream containing dexpanthenol (a cream-soluble form of B5, the cream usually marketed as wound-healing cream) is combined with the oral dose.
  • 300 mg pantethine 3 times per day lowers cholesterol.

These doses appear extremely safe, with only a very small proportion of people experiencing minor side effects even at these very high doses.

More details in this huge podcast! Listen in below!

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This episode is brought to you by Ancestral Supplements' “Living” Collagen. Our Native American ancestors believed that eating the organs from a healthy animal would support the health of the corresponding organ of the individual. Ancestral Supplements has a nose-to-tail product line of grass-fed liver, organs, “living” collagen, bone marrow and more… in the convenience of a capsule. For more information or to buy any of their products, go to 

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Pantothenic Acid Part 2 Show Notes

01:14 Recap of Part 1

06:39 Cliff Notes

14:51 The case for why urinary pantothenic acid is the only legitimate marker of nutritional status and why blood concentration is not a useful marker

28:23 How the Adequate Intake for pantothenic acid was established

29:42 The idea of pantothenic acid balance and comparing it to nitrogen balance

41:38 What I think the recommended pantothenic acid intake should be

45:06 The effect of different forms of food processing on loss of B5 from foods

50:21 Dietary sources of B5, divided into five tiers

54:11 The contribution of the gastrointestinal microbiome to B5 status

01:06:12 Causes of suboptimal status or deficiency of pantothenic acid

01:11:59 Prevalence of suboptimal pantothenic acid status

01:12:32 When I think supplementation with high doses is warranted

01:13:10 What are some of the benefits, besides fixing deficiency, that we might get from supplementing with pantothenic acid or its derivatives?

01:13:26 The use of pantethine as a therapeutic for dyslipidemia

01:23:01 Comparison of pantethine supplementation to high-dose niacin for lowering blood lipids

01:25:33 Topical dexpanthenol for skin health and wound healing

01:29:13 The effect of pantothenic acid supplementation on acne

01:32:42 The effect of pantothenic acid supplementation on sports performance

01:40:58 The effect of pantothenic acid supplementation on hair health

01:42:34 The effect of pantothenic acid supplementation on arthritis

01:48:31 Summary of pantothenic acid supplementation

01:52:28 Is there any reason to use pantothenic acid specifically versus other forms such as pantethine?

01:54:49 Does it matter if you take pantothenic acid in divided doses or all at once?

01:57:08 Does it matter if you take pantothenic acid with food?

01:58:51 Two insightful quotes from papers on pantothenic acid

02:04:08 Pantothenate should be known as the B vitamin that we know the least about, not the B vitamin that we are least likely to become deficient in.

Pantothenic Acid Links and Research

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  5. Welsh AL. LUPUS ERYTHEMATOSUS: Treatment by Combined Use of Massive Amounts of Calcium Pantothenate or Panthenol® with Synthetic Vitamin E. AMA Arch Derm Syphilol [Internet]. American Medical Association; 1952 Feb 1 [cited 2019 Mar 12];65(2):137–148. Available from:
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  17. Fenstermacher DK, Rose RC. Absorption of pantothenic acid in rat and chick intestine. Am J Physiol [Internet].; 1986 Feb;250(2 Pt 1):G155–60. Available from: PMID: 3953793
  18. Eissenstat BR, Wyse BW, Hansen RG. Pantothenic acid status of adolescents. Am J Clin Nutr [Internet].; 1986 Dec;44(6):931–937. Available from: PMID: 3788840
  19. Cohenour SH, Calloway DH. Blood, urine, and dietary pantothenic acid levels of pregnant teenagers. Am J Clin Nutr [Internet]. 1972 May;25(5):512–517. Available from: PMID: 5021930
  20. Baker H, Frank O, Thomson AD, Feingold S. Vitamin distribution in red blood cells, plasma, and other body fluids. Am J Clin Nutr [Internet].; 1969 Nov;22(11):1469–1475. Available from: PMID: 5356512
  21. Reibel DK, Wyse BW, Berkich DA, Neely JR. Coenzyme A metabolism in pantothenic acid-deficient rats. J Nutr [Internet].; 1982 Jun;112(6):1144–1150. Available from: PMID: 7086543
  22. Kathman JV, Kies C. Pantothenic acid status of free living adolescent and young adults. Nutr Res [Internet]. Elsevier; 1984 Mar 1;4(2):245–250. Available from:
  23. Leung LH. Pantothenic acid deficiency as the pathogenesis of acne vulgaris. Med Hypotheses [Internet]. Elsevier; 1995 Jun;44(6):490–492. Available from: PMID: 7476595
  24. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, its Panel on Folate, Vitamins OB, Choline. Pantothenic Acid [Internet]. National Academies Press (US); 1998. Available from:
  25. Song WO, Chan GM, Wyse BW, Hansen RG. Effect of pantothenic acid status on the content of the vitamin in human milk. Am J Clin Nutr [Internet]. 1984 Aug;40(2):317–324. Available from: PMID: 6465063
  26. Hogarth P, Kurian MA, Gregory A, Csányi B, Zagustin T, Kmiec T, Wood P, Klucken A, Scalise N, Sofia F, Klopstock T, Zorzi G, Nardocci N, Hayflick SJ. Consensus clinical management guideline for pantothenate kinase-associated neurodegeneration (PKAN). Mol Genet Metab [Internet].; 2017 Mar;120(3):278–287. Available from: PMID: 28034613
  27. Di Meo I, Carecchio M, Tiranti V. Inborn errors of coenzyme A metabolism and neurodegeneration. J Inherit Metab Dis [Internet]. Wiley Online Library; 2019 Jan;42(1):49–56. Available from: PMID: 30740736
  28. Aggarwal A, Schneider SA, Houlden H, Silverdale M, Paudel R, Paisan-Ruiz C, Desai S, Munshi M, Sanghvi D, Hardy J, Bhatia KP, Bhatt M. Indian-subcontinent NBIA: unusual phenotypes, novel PANK2 mutations, and undetermined genetic forms. Mov Disord [Internet]. 2010 Jul 30;25(10):1424–1431. Available from: PMID: 20629144
  29. Zano SP, Pate C, Frank M, Rock CO, Jackowski S. Correction of a genetic deficiency in pantothenate kinase 1 using phosphopantothenate replacement therapy. Mol Genet Metab [Internet]. Elsevier; 2015 Dec;116(4):281–288. Available from: PMCID: PMC4764103
  30. Di Meo I, Colombelli C, Srinivasan B, de Villiers M, Hamada J, Jeong SY, Fox R, Woltjer RL, Tepper PG, Lahaye LL, Rizzetto E, Harrs CH, de Boer T, van der Zwaag M, Jenko B, Čusak A, Pahor J, Kosec G, Grzeschik NA, Hayflick SJ, Tiranti V, Sibon OCM. Acetyl-4’-phosphopantetheine is stable in serum and prevents phenotypes induced by pantothenate kinase deficiency. Sci Rep [Internet].; 2017 Sep 12;7(1):11260. Available from: PMCID: PMC5595861
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  33. Gominak SC. Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a “pro-inflammatory” state associated with atherosclerosis and autoimmunity. Med Hypotheses [Internet]. Elsevier; 2016;94:103–107. Available from:
  34. Schroeder HA. Losses of vitamins and trace minerals resulting from processing and preservation of foods. Am J Clin Nutr [Internet]. 1971 May;24(5):562–573. Available from: PMID: 5578515
  35. Cheng TS, Eitenmiller RR. EFFECTS OF PROCESSING AND STORAGE ON THE PANTOTHENIC ACID CONTENT OF SPINACH AND BROCCOLI. J Food Process Preserv [Internet]. Wiley Online Library; 1988 Jun;12(2):115–123. Available from:
  36. Friend BA, Shahani KM, Long CA, Vaughn LA. The effect of processing and storage on key enzymes, B vitamins, and lipids of mature human milk. I. Evaluation of fresh samples and effects of freezing and frozen storage. Pediatr Res [Internet].; 1983 Jan;17(1):61–64. Available from: PMID: 6835716
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  40. Stein ED, Diamond JM. Do dietary levels of pantothenic acid regulate its intestinal uptake in mice? J Nutr [Internet].; 1989 Dec;119(12):1973–1983. Available from: PMID: 2621490
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  43. Koyanagi T, Hareyama S, Kikuchi R, Takanohashi T, Oikawa K. Effect of administration of thiamine, riboflavin, ascorbic acid and vitamin A to students on their pantothenic acid contents in serum and urine. Tohoku J Exp Med [Internet]. 1969 Aug;98(4):357–362. Available from: PMID: 5346207
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  1. Hi,

    First, I want to thank you Chris for the superb job you always do!

    Just like with all the other episodes I was enjoying this one too. However, I believe the issue of considering the calcium content when going into the region of grams with calcium pantothenate wasn’t mentioned.

    Note that calcium pantothenate is 8.4 % calcium, presumably with a high bioavailability. So if you supplement with say 5 grams of calcium pantothenate per day, you automatically get 400 mg of calcium. Of course, not everything will be absorbed. Still it’s worth keeping in mind.

    I wonder if the studies with megadoses of calcium pantothenate were looking at this issue too…


  2. Hi there,

    Thank you so much for the hugely indepth work that you do, I struggled to fully follow and understand it all but what a journey of discovery! I am wanting to supplement with Pantothenic acid or calciu Pantethene… I am a little confused as to which supplement I should be aiming to purchase to treat acne?

    Many thanks for you advice

  3. Hi! After hearing you speak about this subject on the wellness mama podcast, I have listen to both parts one and two of your Podcasts on the five.

    Question: I have a teenager with hormonal acne. I know from genetic testing that he is not a methylator. Would the active form of B5 (pantethine) be preferable to take in multi-gram doses for acne, or should we stick with Pantothenic Acid?

    Thanks in advance!! I’ve been a longtime fan of your teachings.


  4. Thank you for your amazing insight into nutrition. It is refreshing and thought provoking. Keep up the good work.

    Are you familiar with Coenzyme-A Technologies product, “Coenzyme-A?” Any thoughts on using it as a pantothenic acid, or pantethine alternative?

    Supplement Facts
    Serving Size: 1 Capsule
    Servings per Container: 90
    Amount Per Serving % Daily Value
    Calcium (as calcium pyruvate) 45 mg 5%
    Magnesium (as dimagnesium malate) 20 mg 5%
    Coenzyme A Modulator Matrix I™ blend: Calcium Pyruvate,Pantethine Powder, Dimagnesium Malate, Acetyl L-Carnitine HCI, L-Cysteine HCI 700 mg

    Website is currently inactive:


    Thank you!


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