Pantothenic acid (also known as vitamin B5 or pantothenate)

Pantothenic acid, also known as vitamin B5, is one of the eight B-complex vitamins. Pantothenic acid cannot be manufactured by humans and is thus a true vitamin, obtained exclusively from the diet.

Pantothenic acid is an enzyme cofactor, which means that it is a necessary component for enzyme function. Furthermore, coenzyme A (CoA) is synthesized from pantothenic acid. CoA is itself a cofactor in a wide range of enzymes in energy metabolism, including in carbohydrate, protein, and lipid metabolism, as well as in the Krebs cycle. CoA is also an important cofactor for enzymes in the biosynthesis fatty acids, cholesterol, and acetylcholine, among multiple other compounds. Pantothenic acid is also a cofactor of the acyl-carrier protein associated with complex I of the electron transport chain.

Pantothenic acid deficiency is rare today outside of cases of extreme malnutrition or substantial GI malabsorption such as chronic diarrhea. Symptoms can include acne, fatigue, depression, irritability, insomnia, abdominal pain, vomiting, burning and tingling feet, muscle cramps, and frequent upper respiratory infections.

The role of pantothenic acid in the treatment of autism is not well studied. Children with ASD often have diets that are relatively deficient in many nutrients, including pantothenic acid. At least one dietary supplement is taken by about half of children with ASD (56% in one study), however, “the most common micronutrient deficits were not corrected”, which included pantothenic acid (https://www.ncbi.nlm.nih.gov/pubmed/26052041), as few multivitamins contain sufficient quantities of this vitamin. Pantothenic acid and CoA were decreased in ASD in one study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121959/pdf/13229_2016_Article_109.pdf).

Pantothenic acid is sometimes recommended for a variety of uses, including acne, adrenal insufficiency, aging, alcoholism, allergies, anxiety, athletic performance, asthma, attention deficit-hyperactivity disorder, autism, burning feet syndrome, carpal tunnel syndrome, celiac disease, chronic fatigue syndrome, colitis, conjunctivitis, convulsions, cystitis, dandruff, depression, diabetic nerve pain, dizziness, growth deficiency, immune dysfunction, infections (frequent), insomnia, hair loss or greying, headache, heart failure, hyperactivity, low blood sugar, irritability, low blood pressure, multiple sclerosis, muscular dystrophy, muscular cramps, nerve pain, obesity, osteoarthritis, Parkinson disease, premenstrual syndrome, prostate enlargement, respiratory disorders, rheumatoid arthritis, salicylate toxicity, shingles, skin disorders, tongue infections, wound healing, and yeast infections.

Pantothenic acid is a water-soluble vitamin and thus considered to be generally non-toxic. Doses as high as 10 grams are frequently given for acne, whereas nausea can occur, but is generally otherwise well tolerated.

Laboratory testing can reveal the presence of a deficiency of this nutrient, but is generally not likely to have clinically utility.