Known as the "antistress" vitamin, vitamin B5 (or pantothenic acid) plays an important role in adrenal function and cellular metabolism. This water-soluble B vitamin is converted into a substance called coenzyme A. Coenzyme A is essential to the metabolism of fats, carbohydrates, and proteins for energy. It is required in the synthesis of fatty acids, cholesterol, steroids, bile, phospholipids, red blood cells, hormones, and neurotransmitters. Vitamin B5 as coenzyme A is needed for proper adrenal cortex function. It supports the adrenal glands in the making of cortisone and other adrenal hormones that counteract the stress response and enhance metabolism. Also extremely important, coenzyme A is needed to convert choline, a nutrient, into acetylcholine, an important neurotransmitter involved with neuromuscular reactions. Vitamin B5 is necessary for proper functioning of the immune system. Research has demonstrated that a deficiency of this nutrient impairs immune system function and is therefore necessary for proper immune response. Another important discovery about vitamin B5 is that it seems to help decrease the painful symptoms of rheumatoid arthritis.

The most well known research on the role of vitamin B5 in combatting stress occurred more than 30 years ago. This study showed that rats given large doses of vitamin B5 survived twice as long when forced to remain in cold water than did rats who did not receive the vitamin. Other animal and human studies trying to support the claim that vitamin B5 increases endurance and stamina have been too few to positively confirm this theory. There is no argument over the fact that vitamin B5 is needed for proper adrenal function, but whether or not supplementation can enhance adrenal function is not yet proven.

The most promising recent study in this area showed that athletes who received vitamin B5 supplements performed better than those who received placebos. Those who received vitamin B5 used 8% less oxygen and had 17% less lactic acid buildup. These differences are significant, but need to be confirmed by further studies.

In 1980, the General Practitioner Research Group conducted a double-blind study showing that calcium pantothenate supplementation significantly reduced the severity of rheumatoid arthritis symptoms. This supports the use of vitamin B5 supplementation along with herbs and other natural therapies in the treatment of this disease.

Pantothenic acid derives its name from the Greek word pantos, meaning "everywhere," referring to its wide availability in foods. Deficiency is very uncommon, but possible for those who have diets dominated by highly processed foods. Large amounts of vitamin B5 are lost in the milling and refining of grains and in canning, freezing, cooking, or otherwise processing of vegetables and other foods. Vitamin B5 is not replaced in the "enrichment" of refined flour, bread, rice, and noodles, and these are poor sources of the vitamin. The best dietary sources are brewer's yeast, liver, eggs, fish, chicken, cheese, milk, mushrooms, whole-grain breads and cereals, dried beans and peas, nuts (peanuts, pecans, hazelnuts), potatoes, avocados, cauliflower, oranges, and bananas.

Vitamin B5 is most commonly available as calcium pantothenate. Recently, a metabolite of pantothenic acid, called pantethine, has become available. Research has shown this substance to have significant cholesterol- and lipid-lowering activity, and research continues in the areas of cardiovascular disease prevention, and immune system stimulation.

Vitamin B5 is available in supplement form as calcium pantothenate, which is 92% pantothenic acid and 8% calcium. It is available in 100, 250, and 500 mg capsules. It is also usually included in vitamin B complex formulas.

Vitamin B5 has become increasingly popular as a nutritional supplement due to claims that it boosts energy, increases stamina and athletic performance, rejuvenates skin and hair, and decreases the symptoms of allergies, asthma, and psoriasis (due to its support of corticosteroid synthesis).

Some of these claims arise from studies that have shown that vitamin B5 deficiency in rats caused increased graying of fur, decreased growth, and destruction of adrenal glands.

Human studies have shown that a deficiency of vitamin B5 results in fatigue, depression, digestive problems, problems with blood sugar metabolism (most commonly hypoglycemia), loss of nerve function, and depressed cellular and antibody immune response. These problems may manifest symptoms such as vomiting, abdominal cramps, tingling or burning hands or feet, skin problems, muscle cramps, recurring infections, and worsening of allergy or asthma symptoms.

Some health care providers recommend the use of vitamin B5 to treat allergies (to support the manufacture of adrenocorticosteroids, thereby reducing allergy symptoms). There are no clinical trials that judge the validity of this application.

There is documented clinical evidence to support the following uses of vitamin B5.

Pantothenic acid:

• To reduce pain and swelling of rheumatoid arthritis
• To improve wound healing

Pantethine:

• To significantly lower blood cholesterol levels
• Particularly beneficial for diabetics—to lower blood lipids without negatively affecting blood sugar control and to improve platelet function
• To speed up the detoxification of alcohol

There is no RDA for vitamin B5, but the 1989 Safe and Adequate Intakes are as follows:

• Birth to 6 months: 2 mg
• 6 months to 1 year: 3 mg
• 1 to 6 years: 3 to 4 mg
• 7 to 10 years: 4 to 5 mg
• 11 years and older: 4 to 7 mg

Americans consume an average of 4 to 10 mg/day. Individual needs vary according to food intake and the amount of stress (physical, environmental, or emotional/mental) one is undergoing.

Therapeutic dosages range from 250 to 500 mg of pantothenic acid daily for general adrenal support to 2,000 mg daily for rheumatoid arthritis. The recommended dose of pantethine for lowering cholesterol and triglycerides is 300 mg three times daily (900 mg/day).

There is no documented toxicity with even large doses of vitamin B5.

There are no significant safety issues documented for vitamin B5. However, research has not been adequate enough to assess the safety of large doses over the long term. It is recommended that vitamin B5 be supplemented along with the rest of the B vitamin family to prevent metabolic imbalance.

No clinically significant interactions between pantothenic acid and conventional medications are known to have been reported in the literature to date.

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