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.
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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
- Fry PC, Fox HM, Tao HG. METABOLIC RESPONSE TO A PANTOTHENIC ACID DEFICIENT DIET IN HUMANSI. J Nutr Sci Vitaminol [Internet]. jstage.jst.go.jp; 1976;22(4):339–346. Available from: http://dx.doi.org/10.3177/jnsv.22.339
- Hodges RE, Ohlson MA, Bean WB. Pantothenic acid deficiency in man. J Clin Invest [Internet]. Am Soc Clin Investig; 1958 Nov;37(11):1642–1657. Available from: http://dx.doi.org/10.1172/JCI103756 PMCID: PMC1062846
- Bean WB, Hodges RE, Daum K. Pantothenic acid deficiency induced in human subjects. J Clin Invest [Internet]. Am Soc Clin Investig; 1955 Jul;34(7, Part 1):1073–1084. Available from: http://dx.doi.org/10.1172/JCI103156 PMCID: PMC438858
- Welsh AL. LUPUS ERYTHEMATOSUS: Treatment by Combined Use of Massive Amounts of Panthothenic Acid and Vitamin E. AMA Arch Derm Syphilol [Internet]. American Medical Association; 1954 Aug 1 [cited 2019 Mar 12];70(2):181–198. Available from: https://jamanetwork.com/journals/jamadermatology/article-abstract/524069
- 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: https://jamanetwork.com/journals/jamadermatology/article-abstract/523097
- Said HM, Ortiz A, McCloud E, Dyer D, Moyer MP, Rubin S. Biotin uptake by human colonic epithelial NCM460 cells: a carrier-mediated process shared with pantothenic acid. Am J Physiol [Internet]. 1998 Nov;275(5):C1365–71. Available from: http://dx.doi.org/10.1152/ajpcell.1998.275.5.C1365 PMID: 9814986
- Trumbo PA. Pantothenic Acid. In: Ross AC, editor. Modern Nutrition in Health and Disease [Internet]. Available from: chrismasterjohnphd.com/textbook
- Raman SB, Rathinasabapathi B. Pantothenate synthesis in plants. Plant Sci [Internet]. Elsevier; 2004 Nov 1;167(5):961–968. Available from: http://www.sciencedirect.com/science/article/pii/S016894520400278X
- Sim E, Abuhammad A, Ryan A. Arylamine N-acetyltransferases: from drug metabolism and pharmacogenetics to drug discovery. Br J Pharmacol [Internet]. 2014 Jun;171(11):2705–2725. Available from: http://dx.doi.org/10.1111/bph.12598 PMCID: PMC4158862
- Brunetti D, Dusi S, Giordano C, Lamperti C, Morbin M, Fugnanesi V, Marchet S, Fagiolari G, Sibon O, Moggio M, d’Amati G, Tiranti V. Pantethine treatment is effective in recovering the disease phenotype induced by ketogenic diet in a pantothenate kinase-associated neurodegeneration mouse model. Brain [Internet]. 2014 Jan;137(Pt 1):57–68. Available from: http://dx.doi.org/10.1093/brain/awt325 PMCID: PMC3891449
- Pietrocola F, Galluzzi L, Bravo-San Pedro JM, Madeo F, Kroemer G. Acetyl coenzyme A: a central metabolite and second messenger. Cell Metab [Internet]. 2015 Jun 2;21(6):805–821. Available from: http://dx.doi.org/10.1016/j.cmet.2015.05.014 PMID: 26039447
- Shibata K, Gross CJ, Henderson LM. Hydrolysis and absorption of pantothenate and its coenzymes in the rat small intestine. J Nutr [Internet]. academic.oup.com; 1983 Oct;113(10):2107–2115. Available from: http://dx.doi.org/10.1093/jn/113.10.2107 PMID: 6619987
- Srinivasan B, Baratashvili M, van der Zwaag M, Kanon B, Colombelli C, Lambrechts RA, Schaap O, Nollen EA, Podgoršek A, Kosec G, Petković H, Hayflick S, Tiranti V, Reijngoud D-J, Grzeschik NA, Sibon OCM. Extracellular 4′-phosphopantetheine is a source for intracellular coenzyme A synthesis. Nat Chem Biol [Internet]. Nature Publishing Group, a division of Macmillan Publishers Limited. All Rights Reserved.; 2015 Aug 31;11:784. Available from: https://doi.org/10.1038/nchembio.1906
- Tahiliani AG, Beinlich CJ. Pantothenic acid in health and disease. Vitam Horm [Internet]. 1991;46:165–228. Available from: https://www.ncbi.nlm.nih.gov/pubmed/1746161 PMID: 1746161
- Bunkoczi G, Pasta S, Joshi A, Wu X, Kavanagh KL, Smith S, Oppermann U. Mechanism and substrate recognition of human holo ACP synthase. Chem Biol [Internet]. Elsevier; 2007 Nov;14(11):1243–1253. Available from: http://dx.doi.org/10.1016/j.chembiol.2007.10.013 PMCID: PMC2148441
- 信悦小野, 欣也亀田, 雍史安孫子. METABOLISM OF PANTETHINE IN THE RAT. J Nutr Sci Vitaminol [Internet]. jstage.jst.go.jp; 1974;20(3):203–213. Available from: http://dx.doi.org/10.3177/jnsv.20.203
- Fenstermacher DK, Rose RC. Absorption of pantothenic acid in rat and chick intestine. Am J Physiol [Internet]. physiology.org; 1986 Feb;250(2 Pt 1):G155–60. Available from: http://dx.doi.org/10.1152/ajpgi.1986.250.2.G155 PMID: 3953793
- Eissenstat BR, Wyse BW, Hansen RG. Pantothenic acid status of adolescents. Am J Clin Nutr [Internet]. academic.oup.com; 1986 Dec;44(6):931–937. Available from: http://dx.doi.org/10.1093/ajcn/44.6.931 PMID: 3788840
- 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: http://dx.doi.org/10.1093/ajcn/25.5.512 PMID: 5021930
- Baker H, Frank O, Thomson AD, Feingold S. Vitamin distribution in red blood cells, plasma, and other body fluids. Am J Clin Nutr [Internet]. academic.oup.com; 1969 Nov;22(11):1469–1475. Available from: http://dx.doi.org/10.1093/ajcn/22.11.1469 PMID: 5356512
- Reibel DK, Wyse BW, Berkich DA, Neely JR. Coenzyme A metabolism in pantothenic acid-deficient rats. J Nutr [Internet]. academic.oup.com; 1982 Jun;112(6):1144–1150. Available from: http://dx.doi.org/10.1093/jn/112.6.1144 PMID: 7086543
- 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: http://www.sciencedirect.com/science/article/pii/S0271531784800093
- Leung LH. Pantothenic acid deficiency as the pathogenesis of acne vulgaris. Med Hypotheses [Internet]. Elsevier; 1995 Jun;44(6):490–492. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7476595 PMID: 7476595
- 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: https://www.ncbi.nlm.nih.gov/books/NBK114311/
- 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: http://dx.doi.org/10.1093/ajcn/40.2.317 PMID: 6465063
- 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]. discovery.ucl.ac.uk; 2017 Mar;120(3):278–287. Available from: http://dx.doi.org/10.1016/j.ymgme.2016.11.004 PMID: 28034613
- 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: http://dx.doi.org/10.1002/jimd.12026 PMID: 30740736
- 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: http://dx.doi.org/10.1002/mds.23095 PMID: 20629144
- 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: http://dx.doi.org/10.1016/j.ymgme.2015.10.011 PMCID: PMC4764103
- 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]. nature.com; 2017 Sep 12;7(1):11260. Available from: http://dx.doi.org/10.1038/s41598-017-11564-8 PMCID: PMC5595861
- Fox HM, Linkswiler H. Pantothenic acid excretion on three levels of intake. J Nutr [Internet]. academic.oup.com; 1961 Dec;75(4):451–454. Available from: http://dx.doi.org/10.1093/jn/75.4.451 PMID: 13894371
- Tarr JB, Tamura T, Stokstad EL. Availability of vitamin B6 and pantothenate in an average American diet in man. Am J Clin Nutr [Internet]. 1981 Jul;34(7):1328–1337. Available from: http://dx.doi.org/10.1093/ajcn/34.7.1328 PMID: 7258123
- 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: https://www.sciencedirect.com/science/article/pii/S0306987716303504
- 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: http://dx.doi.org/10.1093/ajcn/24.5.562 PMID: 5578515
- 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: http://doi.wiley.com/10.1111/j.1745-4549.1988.tb00071.x
- 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]. nature.com; 1983 Jan;17(1):61–64. Available from: https://www.ncbi.nlm.nih.gov/pubmed/6835716 PMID: 6835716
- Khalil AH, Mansour EH. The effect of cooking, autoclaving and germination on the nutritional quality of faba beans. Food Chem [Internet]. Elsevier; 1995 Jan 1;54(2):177–182. Available from: http://www.sciencedirect.com/science/article/pii/030881469500024D
- Greenwood DA, Kraybill HR, Feaster JF, Jackson JM. Vitamin Retention in Processed Meat. Ind Eng Chem [Internet]. American Chemical Society; 1944 Oct 1;36(10):922–927. Available from: https://doi.org/10.1021/ie50418a012
- Sibon OCM, Strauss E. Coenzyme A: to make it or uptake it? Nat Rev Mol Cell Biol [Internet]. Nature Publishing Group; 2016;17(10):605. Available from: https://www.nature.com/articles/nrm.2016.110.pdf?origin=ppub
- Stein ED, Diamond JM. Do dietary levels of pantothenic acid regulate its intestinal uptake in mice? J Nutr [Internet]. academic.oup.com; 1989 Dec;119(12):1973–1983. Available from: http://dx.doi.org/10.1093/jn/119.12.1973 PMID: 2621490
- Ebino KY. Studies on Coprophagy in Experimental Animals. Exp Anim [Internet]. 1993;42(1):1–9. Available from: https://pdfs.semanticscholar.org/1521/10265da0c30aa769c51dff14af11579fb953.pdf
- Ebino KY, Suwa T, Kuwabara Y, Saito TR, Takahashi KW. [Analyses of constituents of feces and the effect of a vitamin B12 fortified diet on coprophagy in the mouse]. Jikken Dobutsu [Internet]. 1986 Oct;35(4):381–386. Available from: https://www.ncbi.nlm.nih.gov/pubmed/3803425 PMID: 3803425
- 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: https://www.ncbi.nlm.nih.gov/pubmed/5346207 PMID: 5346207
- Koch MA. Chapter 18 – Experimental Modeling and Research Methodology. In: Suckow MA, Weisbroth SH, Franklin CL, editors. The Laboratory Rat (Second Edition) [Internet]. Burlington: Academic Press; 2006. p. 587–625. Available from: http://www.sciencedirect.com/science/article/pii/B9780120749034500212