Vitamin B5 (Pantothenic Acid)
Pantothenic acid
The coenzyme A vitamin — ubiquitous in food, deficiency almost unheard of
Moderate evidence
🍊Vitamin
Evidence tier
Moderate
Research weight
Citations
11 verified / 11
Classification
Vitamin
❝
What the evidence says. Several controlled trials; effects real but modest or context-dependent.
What is Vitamin B5 (Pantothenic Acid)?
Vitamin B5 (Pantothenic Acid) (Pantothenic acid) is a vitamin used for corrects true deficiency: reverses the rare 'burning feet' neuropathy, fatigue, irritability and gi symptoms seen in severe malnutrition or experimental depletion (no benefit if you are already replete). NutriDex grades the human evidence as Moderate. Pantothenic acid (vitamin B5) is the precursor of coenzyme A and acyl-carrier protein, making it essential for fatty-acid synthesis and oxidation, the citric-acid cycle, and synthesis of cholesterol, steroid hormones, and acetylcholine. Because it is present in virtually all plant and animal foods (its name comes from the Greek for "everywhere"), isolated dietary deficiency is exceedingly rare in humans and has mainly been documented in severe malnutrition or via experimental antagonists, producing the "burning feet" syndrome plus fatigue and GI upset. In well-nourished people, plain pantothenic acid supplements have no proven benefit; the better-studied claims involve the metabolite pantethine for lipids (modest LDL/triglyceride lowering, mostly small/older trials) and high-dose B5 for acne (one small 12-week RCT showed reduced lesion counts). No tolerable upper intake level is set because toxicity is negligible.
Purported Benefits
✓Corrects true deficiency: reverses the rare 'burning feet' neuropathy, fatigue, irritability and GI symptoms seen in severe malnutrition or experimental depletion (no benefit if you are already replete)
✓Essential cofactor: as coenzyme A and acyl-carrier protein it is indispensable for energy metabolism, fatty-acid synthesis/oxidation, and synthesis of cholesterol, steroid hormones and acetylcholine
✓Lipid lowering via pantethine (a B5 derivative, NOT plain pantothenic acid): small RCTs and a pooled review show roughly 10-20% reductions in LDL and total cholesterol and ~14-30% lower triglycerides in hyperlipidemic adults
✓Mild-to-moderate acne: one small 12-week double-blind RCT of a high-dose pantothenic-acid supplement reduced total and inflammatory lesion counts versus placebo (preliminary, single trial)
✓Adequate intake supports normal mental performance and reduced tiredness — an authorised EFSA health claim reflecting its metabolic role, applicable to maintaining adequacy rather than supra-physiologic dosing
Evidence by outcome
The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.
| Outcome | Evidence | Effect | Studies |
|---|---|---|---|
| Correction of true deficiency ('burning feet' syndrome)Authoritative reviews document reversal in rare severe malnutrition/experimental depletion; no benefit if already replete and deficiency is exceedingly rare. | Moderate | ↑ benefit · large | 2 |
| Lipid lowering (pantethine derivative)Small RCT (n=32) plus pooled analysis of 28 trials show ~10-20% LDL and ~14-33% triglyceride drops; pantethine specifically, NOT plain pantothenic acid; mostly small/older trials. | Moderate | ↑ benefit · moderate | 2 |
| Acne (high-dose oral pantothenic acid)One 12-wk RCT (~2.2 g/day) cut lesion counts (p=0.02), but a 2025 RCT of intramuscular dexpanthenol added to adapalene showed no benefit; conflicting, single positive trial. | Mixed | ↔ mixed · small | 2 |
| Mental performance / reduced tiredness (adequacy)An authorised EFSA health claim based on metabolic role; reflects maintaining adequacy, not a tested effect of supra-physiologic dosing. | Preliminary | ↑ benefit · small | 1 |
| Cardiovascular / mortality risk (plasma B5 levels)Observational only: one nested case-control linked higher plasma B5 to greater mortality, another found an L-shaped CHD association; not interventional, no causal claim. | Preliminary | ↔ mixed | 2 |
Dosing & Compounds
Typical Dose
Adult Adequate Intake (AI): 5 mg/day (US IOM and EFSA); 6 mg/day in pregnancy and 7 mg/day during lactation. No RDA exists (insufficient data). Typical multivitamin/B-complex supplements provide 5-10 mg; lipid-study pantethine doses were 600-1200 mg/day; the acne RCT used ~2.2 g/day. No Tolerable Upper Intake Level (UL) has been established by the IOM or EFSA.
Active Compounds
Safety & Cautions
Very low toxicity; no UL is set because adverse effects are not seen at normal or even high intakes. Very large doses (around 10 g/day) can cause GI upset and diarrhea. Pantethine is generally well tolerated (pooled adverse-event rate ~1.4 per 100 subjects, mostly mild GI). High-dose biotin and pantothenic acid can interfere with certain biotin-based immunoassays (e.g., troponin, thyroid panels), risking spurious lab results — clinically relevant interaction. No major drug interactions are established; theoretical additive lipid effects if pantethine is combined with statins. Unlike some other micronutrients (e.g., beta-carotene in smokers, preformed vitamin A teratogenicity, high-dose B6 neuropathy, niacin's HPS2-THRIVE null/harm), pantothenic acid carries no known excess-intake harm signal. Educational only — always check with your doctor or pharmacist before combining Vitamin B5 (Pantothenic Acid) with any medicine.
Key Studies ★ 11 studies
Agency / regulator
NIH ODS (Health Professional Fact Sheet)
✓ Source
Authoritative review: adult AI is 5 mg/day, deficiency is very rare because pantothenic acid is in nearly all foods, and no Tolerable Upper Intake Level has been established as adverse effects are not seen even at high intakes.
Systematic review / pooled analysis
McRae 2005 (Nutrition Research review)
✓ Full text
Pooled analysis of 28 trials (646 hyperlipidemic adults, median pantethine 900 mg/day) reported triglyceride falls of ~14% at 1 month and ~33% at 4 months, with LDL-C down ~10-20% and a low adverse-event rate (1.4 per 100 subjects).
RCT
Saki 2025
✓ PubMed
In a single-blind RCT (n=59) of acne vulgaris, adding intramuscular pantothenic acid (dexpanthenol) to topical adapalene produced no additional benefit over adapalene alone for lesion count, GAGS/IGA severity, or quality of life.
Agency / regulator
EFSA NDA Panel 2014
✓ Source
EU dietary reference value opinion set an Adequate Intake of 5 mg/day for adults (6 mg in pregnancy, 7 mg during lactation), with no Average Requirement derivable and no signs of deficiency in EU populations.
RCT
Evans 2014 (VHRM, RCT)
✓ Full text
Triple-blind, diet-controlled RCT (n=32) of pantethine 600-900 mg/day vs placebo in statin-eligible adults showed significant reductions in LDL-C at 8 and 16 weeks (P=0.020, P=0.006) and total and non-HDL cholesterol by week 16.
RCT
Yang 2014 (Dermatology and Therapy, RCT)
✓ PubMed
Randomized, double-blind, placebo-controlled trial (48 enrolled, 41 evaluable) of a high-dose (~2.2 g/day) pantothenic-acid supplement significantly reduced total lesion count at 12 weeks vs placebo (P=0.0197), with lower inflammatory lesions and DLQI scores.
Observational
Sci Rep 2025 (vanin-1/PA)
✓ Full text
Plasma pantothenic acid was significantly lower in type-2 diabetes patients; lowest PA tertile carried markedly higher odds of T2D in obesity (OR 7.61) and of diabetes with cardiovascular complications (OR up to 12.03), suggesting low PA as a candidate biomarker.
Observational
Hong 2022 (J Clin Hypertens)
✓ Full text
Nested case-control study (505 deaths, 505 controls; China Stroke Primary Prevention Trial) found higher plasma vitamin B5 associated with greater all-cause mortality in hypertensive patients (Q5 vs Q1 OR 1.77, 95% CI 1.06-2.95; Q4-Q5 vs Q1-Q3 OR 1.41, 95% CI 1.03-1.95).
Observational
Frontiers Cardiovasc Med 2022
✓ Full text
Hospital-based case-control study reported an L-shaped relationship between plasma vitamin B5 and coronary heart disease with a threshold near 40.95 ng/mL, with the association modified by smoking status.
Review
Linus Pauling Institute (Micronutrient Information Center)
✓ Source
Comprehensive monograph notes coenzyme A/ACP-dependent roles, that human deficiency occurs essentially only in severe malnutrition or with metabolic antagonists, and that lipid effects are specific to pantethine rather than pantothenic acid.
Authoritative report
IOM Dietary Reference Intakes (1998)
✓ Full text
The Institute of Medicine established the Adequate Intake of 5 mg/day for adults and explicitly set no UL for pantothenic acid owing to a lack of any reports of toxicity from high intakes.