Pantothenic Acid And Pantethine
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The term "Pantos" means "everywhere" in Greek. It is from
this term that the name Pantothenic Acid or more commonly known as Vitamin B5
is derived.
Pantothenic acid is a form of vitamin manufactured by plants. Mammals do not manufacture
this vitamin intrinsically. But, fortunately, we can obtain substantial amounts
of this acid in our diet. If our bodies do not have enough of this acid,
we can develop a rare form of disease call Pantothenic acid deficiency.
The recommended daily dosage has yet to be established. However, some scientists
have given an estimation with regards to the safe and adequate daily dietary
intake as follows:-
|
Age |
Dosage level |
|
Infants below 6 months |
2 mg |
|
Infants 6 to 12 months |
3 mg |
|
Children 1 to 3 years |
3 mg |
|
Children 4 to 6 years |
3 to 4 mg |
|
Children 7 to 10 years |
4 to 5 mg |
|
Children 11 years and above |
4 to 7 mg |
What
type of food should we eat to obtain adequate levels of pantothenic acid? Doctors
say that Brewer's yeast, torula (nutritional) yeast and calf liver are excellent
sources of pantothenic acid. In addition, we can also eat peanuts, split peas,
pecan nuts, oatmeal, mushrooms, soybeans, buckwheat, sunflower seeds, red chilli
peppers, avocados, lentils, cashew nuts and other whole grains and nuts.
PROPERTIES
When pantothenic acid enters our bodies, it
forms a substance call pantethine. Pantethine is a more stable disulfide
form (or a double bond) of pantothenic acid. It is also a more
active metabolic substrate that is converted into an enzyme called "Co-Enzyme
A" (CoA). CoA plays a critical role in the metabolism and breakdown
of the three essential micronutrients namely proteins, carbohydrates and fats.
CoA is also a cofactor in more than 70 enzymatic pathways which includes the
following:-
1 Fatty acid oxidation
2 Carbohydrate metabolism
3 Pyruvate degradation
4 Amino acid catabolism
5 Heme synthesis
6 Acetylcholine synthesis
7 Phase II detoxification acetylationsin
CoA is also responsible for the initial steps of cholesterol synthesis, all
down-stream metabolites of cholesterol including steroids, Vitamin D and bile
acids.
As such, we can see that CoA is a very important enzyme. It also helps to breakdown
the carbon skeleton of most amino acids, which are metabolized to pyruvate and
enter the TCA cycle.
CoA directs acetyl groups to form all polyisoprenoid compounds, which include
ubiquinone (CoQ10), squalene and cholesterol. Our bodies also need CoA for the
transportation of long chain fatty acids into the mitochondria where fats are
converted into energy.
In a nutshell, CoA is the basis for the production
of hemoglobin, bile, sex and adrenal steroids, cholesterol, and a few brain
chemicals and neurotransmitters.
We can consume pantothenic acid through dietary means. However, it must be noted
that the more active form of pantethine, or its reduced-SH form pantetheine
that contains the SH molecule necessary for enzyme activity cannot be obtained
by consuming whole foods.
When we compare pantethine with pantothenic
acid, pantethine by far more active when it comes to the production of CoA.
This hypothesis has been proven true by many clinical trials. Although
taking pantothenic acid as a form of supplement will ultimately lead to the
creation of CoA, researchers have pointed out that pantethine creates twice
as much CoA than pantothenic acid. This is because structure of pantethine is
closer to the CoA production pathway.
Pantothenic acid also has its own benefits.
It enhances adrenal functions and inflammatory response modulation. Both pantothenic
acid as well as pantethine should be considered as one synergistical unit and
not as mutually exclusive nutrients.
THERAPEUTIC
USAGE
Many
people have been using pantethine as a supplement to treat cardiovascular
disease, autoimmune disorders, colitis and Crohn's disease and rheumatoid arthritis.
Sometimes, it is also used as an "anti-stress"
nutrient.
Pantethine is also well known for its effectiveness in reducing
total cholesterol, LDL cholesterol, and triglyceride level, while at the same
time raising the good HDL cholesterol.
Pantothenic acid, on the other hand is ideal
for enhancing adrenal functions and reducing reliance on steroids. It also reduces
elevated uric acid levels frequently associated with gout and reduces inflammatory
response. Sometimes, it can be used as substitute for non-steroidal
anti-inflammatory drugs.
LIPID
PROFILE DYSFUNCTION
About 40 percent of Americans suffer from abnormal lipid dysfunction. As such,
the recent focus has been on the use of pantethine as a therapeutic agent in
the treatment of this illness. Taking pantethine orally is effective for
reducing and normalizing a variety of risk factors in patients with hypercholesterolemia,
arteriosclerosis and diabetes.
In the past, taking niacin or Vitamin B3 would give the same effect. However,
today we know that niacin can lead to inflammations in the liver and possibly
raise blood sugar levels in diabetic patients. Furthermore, high doses of
niacin required for therapeutic effect often lead to an intolerable flush. But,
so far, pantothenic acid and pantethine do not have any of such negative side
effects.
While the exact mechanism of pantethine in normalizing parameters associated
with dyslipidemia is not clear, clinical studies have proven that when pantethine
is added to cultured cells, it causes an 80% inhibition in cholesterol synthesis,
most likely inhibiting the activity of HMG-CoA reductase.
Pantethine can also boost the production of enzymes that helps to break down
blood fats. It helps to enhance Vitamin E's action and prevents cholesterol
from building up in the blood. Pantethine also increases the amount of omega-3
fatty acids, which in turn stabilizes the cellular membrane. Furthermore,
it also enhances the production of Coenzyme Q10, leading to stronger
cardiac contraction force and increasing the efficiency of energy generation.
Over the years, numerous studies have validated the use of pantethine in management
of abnormal lipid profile.
· In a
study, 30 patients with dyslipidemia were examined. They were all given 900
mg of pantethine daily. Six patients in the subgroup of type IIa dyslipidemia
reported a decrease in total cholesterol level by 26%, triglycerides by 28%,
"bad" LDL-cholesterol by 38%, very low-density lipoprotein (VLDL)
cholesterol by 28%, and Apo-B by 16%. At the same time, their "good"
HDL-cholesterol was increased by 34%. Another nine patients with type IIb dyslipidemia
experienced a decrease of 25% for total cholesterol, 49% for triglycerides,
33% for LDL-cholesterol, 44% for VLDL-cholesterol, and 11% for Apo-B. At the
same time, there was a significant increase in their HDL-cholesterol by 43%. Another 15 individuals with type IV dyslipidemia reported that their total cholesterol
decreased by 13%, triglycerides by 68%, VLDL-cholesterol by 53%, and Apo-B by
18%. At the same time, their HDL cholesterol was increased by 25%.
· In another study, a
double-blind placebo-controlled study was conducted on 29 patients with high
cholesterol and triglycerides for a period of 8 weeks. They were given pentethine
at 300 mg 3 times daily. After eight weeks, the subjects reported a 30% reduction
in blood triglycerides, a 13.5% reduction in LDL ("bad") cholesterol,
and a 10% rise in HDL ("good") cholesterol.
· Bertolini et al treated seven
children and 65 adults who suffered from hypercholesterolemia or other diseases
associated with hypertriglyceridemia (types IIa and IIb of Fredrickson's classification).
Pentethine at 900 mg for children and 1,200 mg for adults were given daily for
a period of 3 years. The children reported a 20% reduction of total cholesterol
and a 27% decrease in LDL-cholesterol. The adults with type IIa hyperlipoproteinemia
reported a 25% decrease in total cholesterol, a 39% decrease in LDL-cholesterol,
a 34% decrease in Apo-B, and a slight increase in HDL-cholesterol. In the adult
patients with type IIb hyperlipoproteinemia, total cholesterol was reduced by
19.8%, LDL-cholesterol by 37%, triglycerides by 31%, and Apo-B by 6%. In this
subgroup, a 23% increase of HDL-cholesterol and a 15% increase in apolipoprotein
A-I were also observed.
· Donati
et al also tested the effectiveness and tolerability of pantethine in 31 patients
with dyslipidemia undergoing chronic hemodialysis. These patients were given
600 to 1,200 mg of pantethine daily for a period of 9 months. The results revealed
a significant improvement in total blood cholesterol for patients with basal
hypercholesterolemia, and a highly significant reduction of serum triglycerides
for the entire group. However, their HDL-cholesterol or total Apo-A did not
increase.
· In another
separate study, 600 mg/day of pantethine was given to 37 hypercholesterolemic
and/or hypertriglyceridemic patients for a three-month period. Out of all 37
patients, 21 of them were diabetic. After pantethine was given to these patients,
their total cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol
and apolipoprotein B (Apo-B) was decreased. At the same time, there was an increase
in high density lipoprotein (HDL) cholesterol and apolipoprotein A (Apo-A) in
all the groups. When pantethine was not given to these patients, a reversal
in the improvement of these parameters was observed.
Later on, a one-year follow up trial was again conducted in 24 patients with
established dyslipidemia of Fredrickson's types IIa, IIb, and IV, alone or associated
with diabetes mellitus. Blood lipid assays revealed consistent reductions in
total cholesterol, LDL-cholesterol, and Apo-B, along with an increase of HDL-cholesterol
and Apo-A in individuals with types IIa and IIb dyslipidemia. The results were
equally favorable in patients with uncomplicated dyslipidemia and in those with
associated diabetes mellitus. A marked reduction in triglycerides was also observed
in the patients with Fredrickson's type IV dyslipidemia.
· In another experiment conducted
by Binaghi et al, he used 24 hypercholesterolemic perimenopausal women as his
subjects. The women were supplemented with 900 mg/day of pantethine. After 16
weeks, they reported an efficacy rate of about 80% with significant reductions
in total cholesterol, LDL-cholesterol, and LDL/HDL ratios.
Many other studies have proven the effectiveness of using pantethine to improve
cholesterol and triglyceride levels in people with diabetes. The results were
all encouraging. In one study, oral administration of pantethine given to 31
diabetic patients with hyperlipidemia led to a decrease in their cholesterol
level from a mean value of 236 mg/dl to 217 mg/dl (10% reduction). Their HDL-cholesterol
level was also increased from a mean value of 40 mg/dl to 43 mg/dl (5% increase).
ADRENAL
FUNCTION ENHANCEMENT
Our adrenal glands need pantothenic acid to manufacturer anti-inflammatory
hormones such as cortisol. Pantothenic acid is therefore a potent natural
treatment for inflammatory related ailments such as arthritis, colitis, and
allergies. As such, we can deduce that inflammatory and infectious processes
lead to cardiovascular disease. The use of pantothenic acid has indeed been
broadening.
Pantethine seems to exert an influence over some indicators of adrenal function.
Several animal experiments have shown that a lack of pantothenic acid will affect
adrenal cortex function, most likely due to the reduction of adrenal corticosteroids.
When pantethine or CoA is injected into animals, there is a marked increase
in steroidogenous effect.
During
a study, it was reported that pantethine was given to 20 humans with a variety
of clinical diseases to buffer the increase in 24-hour urinary 17-hydroxycorticosteroids
and plasma 11-hydroxycorticosteroids stimulated by a loading dose of adrenocorticotropic
hormone.
We all know that pantothenic acid is an important nutrient to maintain an optimum
adrenal function. When the adrenal gland fails to function, our bodies will
not be able to produce progesterone. This will result in estrogen dominance
that can lead to cancer of the ovarian, breast and cervics.
People who are taking steroids such as prednisone
for treating health conditions such as asthma and autoimmune disease should
reduce their medication dosage. With the help of pantothenic acid, they can
be slowly wean off their dependency on anti-inflammatory drugs.
Therapeutic
Dosage
|
Disease |
Dosage |
|
Colitis and Crohn’s disease |
900 mg daily of both pantethine and pantothenic acid to reduce inflammation. |
|
Gout |
Pantothenic acid (in the form of calcium pantothenate) 200 mg four times a day |
|
Autoimmune and Allergic Disorders |
400 to 900 mg a day of both pantethine and pantothenic acid |
|
Wound healing |
900 mg of pantothenic acid daily |
|
Stress and adrenal gland enhancement |
400 to 900 mg a day of both pantethine and pantothenic acid |
|
Cholesterol, triglycerides stabilization |
400 to 1,200 mg daily of both pantethine and pantothenic acid |
There are no significant side effects for high dose of pantothenic acid
or pantethine, used by themselves or with other medications. Sometimes, minor
digestive disturbances may occur.
However, more caution should be exercised for young children, pregnant or
nursing women, or people with serious liver or kidney disease as the safe level
dosage had yet to be established.
Pantothenic acid is often sold in the form of calcium pantothenate. Regular
pantothenic acid cannot be used as a substitute for pantethine. They should
be used together.
About The Author
Michael Lam, M.D., M.P.H., A.B.A.A.M. is a specialist in Preventive and Anti-Aging Medicine. He is currently the Director of Medical Education at the Academy of Anti-Aging Research, U.S.A. He received his Bachelor of Science degree from Oregon State University, and his Doctor of Medicine degree from Loma Linda University School of Medicine, California. He also holds a Masters of Public Health degree and is Board Certification in Anti-aging Medicine by the American Board of Anti-Aging Medicine. Dr. Lam pioneered the formulation of the three clinical phases of aging as well as the concept of diagnosis and treatment of sub-clinical age related degenerative diseases to deter the aging process. Dr. Lam has been published extensively in this field. He is the author of The Five Proven Secrets to Longevity (available on-line). He also serves as editor of the Journal of Anti-Aging Research.
For More Information
For the latest anti-aging related health issues, visit Dr. Lam
at www.LamMD.com. Feel free to email
Dr. Lam at dr@LamMD.com if you have any questions.
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©2002 Michael Lam, M.D. All Rights Reserved.
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