Vitamin B5 — Functions, Health Benefits, Deficiency Symptoms
Introduction
Vitamin B5, also known as pantothenic acid, is a water-soluble vitamin essential for various physiological functions in the body, such as energy metabolism, neurotransmitter synthesis, skin health, and more.
Pantothenic acid was isolated in 1931 by American biochemist Roger J. Williams. It was named after the Greek word "pantos," meaning "everywhere," because small amounts of pantothenic acid are present in almost all foods (1).
In this article, we will delve into the nutritional and physiological aspects of vitamin B5, discussing its recommended intakes, food sources, functions, and impact on health.
Table of contents
Functions, Absorption, and Metabolism
Vitamin B5 is absorbed in the intestines, predominantly in the form of coenzyme A (CoA) or phosphopantetheine, after a series of chemical reactions that turn it into pantetheine or pantothenic acid by a sodium-dependent multivitamin transporter. When the transport system is saturated, some vitamin B5 can be absorbed through passive diffusion. As a result, if the intake of pantothenic acid increases, the absorption rate drops (1, 2).
Pantothenic acid is also produced by the intestinal microbiota, but it is unclear how much this contributes to the total amount of pantothenic acid absorbed by the body (2).
After absorption, red blood cells transport pantothenic acid throughout the body. In tissues, most pantothenic acid exists as CoA, with smaller amounts found as acyl carrier protein (ACP) or free pantothenic acid (2).
CoA can be found in higher amounts in the liver and heart muscle, followed by fat tissue, kidneys, and the brain. It is important for cell metabolism, gene expression, energy formation, and the synthesis of fatty acids, cholesterol, bile acids, red blood cells, and the neurotransmitter acetylcholine (3).
Fasting and diabetes (conditions characterized by low insulin levels) lead to an increase in the total content of CoA (4).
Pantothenic acid is excreted through urine, with the amount varying proportionally to dietary intake (2).
Food Sources of Vitamin B5
Vitamin B5 is naturally found in a variety of plant-based and animal-based foods, including eggs, milk, vegetables, beef, chicken, fish, legumes, nuts, seeds, whole grains, and fortified cereals.
Pantothenic acid is nutritionally essential, meaning food is its only source, as human cells cannot synthesize the pantoic acid portion of the vitamin.
The table below lists foods rich in vitamin B5 based on their average serving sizes.
| Food Sources | Vitamin B5 | Serving Size |
| Avocado (raw) | 2mg | 150g or 1 cup |
| Lentil (boiled) | 1.26mg | 198g or 1 cup |
| Salmon (Atlantic, dry heat) | 1.25mg | 85g or 3 ounces |
| Chicken (meat and skin, roasted) | 0.88mg | 85g or 3 ounces |
| Egg (hard-boiled) | 0.7mg | 50g or 1 large |
| Pork (broiled, loin) | 0.59mg | 85g or 3 ounces |
| Caviar | 0.56mg | 16g or 1 tablespoon |
| Sunflower seed (dried) | 0.52mg | 46g or 1 cup |
| Peanut (raw) | 0.5mg | 28.35 or 1 ounce |
| Shiitake (raw) | 0.29mg | 19g or 1 whole piece |
Other good sources of vitamin B5 include broccoli, mung beans, adzuki beans, chickpeas, peas, lentils, and more.
If interested, you can also find a list of foods high in vitamin B5 based on equal 100g serving sizes.
Recommended Intakes
Adequate Intake is a recommended average daily nutrient intake level based on observed or experimentally determined approximations of nutrient intake by a group of healthy people. It is used when a recommended dietary allowance cannot be determined.
The adequate intake values for vitamin B5 are presented below. These values are the same for men and women (2, 5).
| Up to 6 months | 7 to 12 months | 1 to 3 years | 4 to 8 years | 9 to 13 years | 19 and above |
| 1.7mg | 1.8mg | 2mg | 3mg | 4mg | 5mg |
The adequate intake value increases to 6mg for pregnant women and 7mg for lactating women.
Vitamin B5 & Human Health
Vitamin B5 has several important health impacts regarding energy metabolism, skin health, cholesterol and lipid metabolism, nervous system health, and more.
Cholesterol Metabolism
Oral intake of pantetheine, a metabolite of vitamin B5, has demonstrated beneficial effects on serum cholesterol levels. Research has shown that pantetheine, administered in doses between 500 and 1200 mg daily, can reduce total serum cholesterol, low-density lipoproteins (“bad” cholesterol), and triglycerides while increasing high-density lipoproteins (“good” cholesterol) in people with dyslipidemia, high cholesterol, and lipid disorders related to diabetes (4).
The results are very promising when compared to traditional lipid-lowering medications like lovastatin, which are commonly linked to notable side effects and potential liver toxicity (4).
Skin Health and Acne
Dexpanthenol, or panthenol, is the alcohol analog of vitamin B5. A study comparing the effectiveness of dexpanthenol (an alcoholic analog of D-pantothenic acid) to the standard treatment of hydrocortisone for atopic dermatitis (eczema) found that dexpanthenol may be a potential treatment for mild to moderate childhood atopic dermatitis (6).
Additionally, dexpanthenol cream has been suggested to be a safe and effective method of reducing side effects of isotretinoin acne treatments, such as scaling, dryness, and fissures of the lips and inner mucosa of the nose (7).
One study suggests that using a pantothenic acid-based dietary supplement in healthy adults with facial acne lesions is safe and well-tolerated. Over a 12-week period, the supplement led to a decrease in total facial lesion count and a notable reduction in inflammatory blemishes compared to the placebo (8). That being said, further research is necessary to validate these results.
Wound Healing
Administering pantothenic acid orally and applying pantothenol ointment to the skin have been demonstrated to speed up wound healing and enhance scar tissue strength in animals. Still, more research needs to be done on humans (4).
Rheumatoid Arthritis
Research has found that daily injections of calcium pantothenate normalized vitamin B5 levels and relieved symptoms in individuals with rheumatoid arthritis, with recurrence upon discontinuation. Oral calcium pantothenate intake also reduced morning stiffness, disability, and pain severity, specifically in rheumatoid arthritis patients (4).
However, these studies are decades old, and newer research is required to confirm these claims.
Nervous System Health
Lack of pantothenate may contribute significantly to acetylcholine deficiency, neurodegeneration, myelin loss, and age-related dementias such as Huntington's disease. Once again, additional research is necessary to assess the clinical effectiveness of vitamin B5 in treating these ailments (1).
Vitamin B5 Deficiency: Risk Groups, Symptoms
Pantothenic acid deficiency is uncommon because it is present in many foods. However, it can occur in individuals with severe malnutrition or in rare cases of genetic mutations that hinder pantothenic acid metabolism (9).
Common symptoms of vitamin B5 deficiency include headache, fatigue, irritability, sleep disturbances, insomnia, nausea, vomiting, abdominal pain, anorexia, muscle cramps, numbness or burning in extremities, and impaired immune response (1, 4).
Given that the adult human requirement for pantothenic acid is around 5mg per day, severe dietary deficiency is estimated to result in clear signs of deficiency after 5 to 6 weeks.
However, pantothenic acid deficiency typically occurs alongside other nutrient deficiencies, making it challenging to isolate the specific effects of pantothenic acid deficiency.
Vitamin B5 Toxicity
Vitamin B5 is considered safe overall, with no established upper limits because there have been no reports of toxicity in humans at high intake levels (9).
Nevertheless, its administration can still cause side effects, such as muscle and joint pain, new-onset diabetes, sore throat, headache, fatigue, dizziness, nausea, abdominal pain, constipation, hypersensitivity reactions, and more (1).
Doses exceeding 10g per day may lead to mild diarrhea or abdominal discomfort (1, 10). Additionally, there have been reports of allergic contact dermatitis from the topical use of panthenol cream and dexpanthenol (11).
Vitamin B5 Supplements
Vitamin B5 is found in various dietary supplements, either alone or in combination with other B-complex vitamins. Some supplements may contain pantethine or calcium pantothenate, although the relative bioavailability of pantothenic acid from these different forms has not been extensively studied (2).
The dosage of pantothenic acid in supplements can vary widely, ranging from approximately 10mg in multivitamin supplements to as high as 1g in B-complex or standalone pantothenic acid supplements (2).
Interactions With Medications and Contraindications
Vitamin B5 moderately interacts with certain macrolide antibiotics, such as Azithromycin, Erythromycin, Clarithromycin, and Roxithromycin (1).
Pantothenic acid has also been shown to have mild interactions with around 60 other drugs (1).
A report suggests that vitamin B5 intake may be linked to higher levels of cerebral amyloid-beta peptides in people with cognitive impairment. Thus, the current evidence indicates that individuals with cognitive impairment might need to be cautious with vitamin B5 intake (12).
Summary
Vitamin B5, also known as pantothenic acid, is a water-soluble vitamin essential for various physiological functions in the body. Its name derives from the Greek word "pantos," meaning "everywhere," because small amounts of pantothenic acid are present in almost all foods.
Vitamin B5 is mainly used in the body to synthesize coenzyme A, a compound that plays a role in cell metabolism, gene expression, and the synthesis of fatty acids, cholesterol, bile acids, red blood cells, and the neurotransmitter acetylcholine.
Vitamin B5 is naturally found in a variety of plant-based and animal-based foods, including eggs, milk, vegetables, beef, chicken, fish, legumes, nuts, seeds, whole grains, and fortified cereals.
The adequate intake for men and women above the age of 19 is 5mg per day. This value increases to 6mg for pregnant women and 7mg for lactating women.
Pantothenic acid plays a role in cholesterol metabolism, skin health, wound healing, and nervous system health.
Vitamin B5 deficiency and toxicity are rare in otherwise healthy individuals. 5 to 6 weeks of pantothenic acid deficiency may present as headaches, fatigue, irritability, sleep and gastrointestinal disturbances, and numbness or tingling in hands and feet. Conversely, doses exceeding 10g daily may lead to mild diarrhea or abdominal discomfort.
Vitamin B5 moderately interacts with certain macrolide antibiotics, such as Azithromycin, Erythromycin, Clarithromycin, and Roxithromycin.
References
- https://www.ncbi.nlm.nih.gov/books/NBK563233/
- https://ods.od.nih.gov/factsheets/PantothenicAcid-HealthProfessional/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392065/
- https://www.researchgate.net/publication/278315738
- https://www.efsa.europa.eu/en/efsajournal/pub/3581
- https://pubmed.ncbi.nlm.nih.gov/22395588/
- https://pubmed.ncbi.nlm.nih.gov/12220290/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065280/
- https://www.hsph.harvard.edu/nutritionsource/pantothenic-acid-vitamin-b5/
- https://pubmed.ncbi.nlm.nih.gov/24365359/
- https://pubmed.ncbi.nlm.nih.gov/24117747/
- https://pubmed.ncbi.nlm.nih.gov/30574044/
