tuneTypical Dose
900 mg pantethine for cholesterol, or 2,500–10,000 mg pantothenic acid (acne mega-dose)
Vitamin
Vitamin B5
Pantothenic acid
Evidence TierBWADA NOT PROHIBITED
watchEffect Window
4–12 weeks for lipid shifts. 8–12 weeks for acne assessment
check_circleCompliance
WADA NOT PROHIBITED
Overview
Clinical Summary
Vitamin B5 (pantothenic acid) is a precursor to coenzyme A, central to fatty acid and energy metabolism. It is used mainly to ensure adequacy, with occasional use for acne claims.
Deficiency is rare, but adequate B5 supports fatty acid metabolism, energy production, and steroid hormone synthesis via coenzyme A. High-dose pantothenic acid has limited evidence for reducing acne lesions in small studies. Minority topical uses include wound healing support, with sparse data. For most people, benefits come from adequacy rather than high dosing, and effects are generally modest.
Vitamin B5 is the essential precursor for Coenzyme A, required for oxidative metabolism and fatty acid synthesis. Pantethine modulates lipid metabolism via HMG-CoA reductase and fatty acid synthase inhibition. Acne mega-dosing is hypothesized to increase CoA-driven sebum metabolism.
Outcomes
What This Is Expected To Influence
Primary Outcomes
- Pantethine 900 mg/day reduces total and LDL cholesterol
Secondary Outcomes
- Pantothenic acid mega-dosing may reduce acne lesions
- Essential precursor for Coenzyme A synthesis
Safety
Contraindications and Interactions
Contraindications
- None established
Side effects
- GI distress/diarrhea at mega-doses
Interactions
- No significant drug interactions known
Avoid if
- No populations need to avoid pantothenic acid
Evidence
Study-level References
vitamin-b5-SRC-001Meta-analysis / Review
Sourceopen_in_newMcRae MP. *Treatment of hyperlipoproteinemia with pantethine: a review and analysis of efficacy and tolerability.* Nutr Res. 2005;25(4):319-333.
Population: Adults with hyperlipidemia across multiple small studies
Dose protocol: Pantethine 600–1,200 mg/day (most commonly 900 mg/day)
Key findings: Pantethine consistently lowered total and LDL cholesterol across studies. Effect magnitude ~10% for total cholesterol.
Notes: Promising but limited by small sample sizes and heterogeneous study designs.
Paper content
Pantethine consistently lowered total and LDL cholesterol across studies; effect magnitude ~10% for total cholesterol.
vitamin-b5-SRC-002Randomized controlled trial
Sourceopen_in_newYang M, et al. *A randomized, double-blind, placebo-controlled study of a novel pantothenic acid-based dietary supplement in subjects with mild to moderate facial acne.* Dermatol Ther (Heidelb). 2014;4(1):93-101.
Population: Adults with mild to moderate facial acne
Dose protocol: Pantothenic acid-based supplement (high dose) for 12 weeks
Key findings: Significant reduction in total acne lesion count vs placebo and was well-tolerated.
Notes: Small sample. The only RCT for pantothenic acid acne mega-dosing.
Paper content
Significant reduction in total acne lesion count vs placebo; well-tolerated.
vitamin-b5-SRC-003Hypothesis / Case series
Sourceopen_in_newLeung LH. *Pantothenic acid deficiency as the pathogenesis of acne vulgaris.* Med Hypotheses. 1995;44(6):490-492.
Population: Acne patients (case observations)
Dose protocol: Mega-dose pantothenic acid (up to 10,000 mg/day)
Key findings: Proposed that B5 mega-dosing increases CoA availability, accelerating sebum metabolism and reducing acne. Reported clinical improvement in case observations.
Notes: Foundational hypothesis paper, not a controlled trial. Influenced subsequent RCT design.
Paper content
Proposed that B5 mega-dosing increases CoA availability, accelerating sebum metabolism and reducing acne; reported clinical improvement in case observations.
vitamin-b5-SRC-004Cross-sectional observational study.
Sourceopen_in_newShoura NK, Elbatreek MH, Mousa MM, et al. Biomarker potential of vanin-1-derived pantothenic acid in diabetes and its associated cardiovascular complications. Sci Rep. 2025;15. doi:10.1038/s41598-025-19271-5. PMID:40954177.
Population: Patients with type 2 diabetes and matched controls.
Dose protocol: Observational measurement of plasma pantothenic acid levels in T2D patients versus controls
Key findings: Diabetic patients had significantly lower plasma pantothenic acid. Lowest tertile had 76.6% T2D prevalence. Positive correlation with HDL cholesterol.
Notes: Cross-sectional design limits causal inference. Raises hypothesis that B5 status may be a metabolic biomarker.
Paper content
This observational study measured plasma pantothenic acid (vitamin B5) levels in patients with type 2 diabetes compared to non-diabetic controls. Diabetic patients had significantly lower pantothenic acid levels that negatively correlated with glycemic markers and positively correlated with HDL cholesterol. Individuals in the lowest pantothenic acid tertile had a markedly higher diabetes prevalence of 76.6%. Low levels were also associated with higher odds of diabetes combined with cardiovascular disease. While this is observational and cannot prove causation, it raises the possibility that pantothenic acid status may serve as a biomarker for metabolic and cardiovascular risk in diabetic populations, and it suggests future investigation of supplementation may be warranted.
vitamin-b5-SRC-005Systematic review.
Sourceopen_in_newOctarica SG, Ellistasari EY, Dewi AK, et al. Preventive and curative approaches to diaper dermatitis in children: a systematic review. Acta Dermatovenerol Alp Pannonica Adriat. 2025. doi:10.15570/actaapa.2025.24. PMID:41014074.
Population: Children with diaper dermatitis across 13 included studies totaling 2,935 participants.
Dose protocol: Topical dexpanthenol-containing emollients for diaper dermatitis across 13 studies with 2,935 children
Key findings: Dexpanthenol emollients were highly effective for diaper dermatitis treatment with minimal side effects.
Notes: Supports the topical wound-healing and skin-barrier role of pantothenic acid derivatives. Topical rather than oral application.
Paper content
This systematic review analyzed 13 studies involving 2,935 children to evaluate prevention and treatment strategies for diaper dermatitis. Among topical interventions, emollients containing zinc oxide or dexpanthenol (a derivative of pantothenic acid/vitamin B5) were found to be highly effective with minimal side effects. The review recommended a combined approach of proper diaper selection, gentle skincare, and judicious use of topical emollients. While this is a topical application rather than oral supplementation, it supports the established wound-healing and skin-barrier role of pantothenic acid derivatives in pediatric dermatology.