Vitamin B₅

Pantothenic acid is a water-soluble vitamin that is also referred to as vitamin B₅.^1-3 Pantothenic acid and its derivatives are found in all cells as an integral part of the acylation carriers, coenzyme A (CoA) and acyl carrier protein.^1-3 CoA is required for the synthesis of essential fats, cholesterol, and steroid hormones, as well as acetylcholine and melatonin.¹ CoA is integral to the Krebs' cycle and the catabolism of fatty acids and proteins.¹ It is also used in the manufacture of heme, a component of hemoglobin, and in the catabolism of a number of drugs by the liver.¹ Protein acetylation is also thought to play a roll in cell division, DNA replication, and in cell signaling.¹

In recent times, fulminate vitamin B₅ deficiency has only been observed in individuals who have been fed semisynthetic diets devoid of pantothenic acid or individuals who have ingested a metabolic antagonist to the vitamin, ω-methyl-pantothenic acid.² In these cases, symptoms included irritability, fatigue, sleep disturbances, nausea, vomiting, abdominal cramps, numbness, paresthesias, muscle cramps, a staggering gait, hypoglycemia, and an increased sensitivity to insulin.^2,3 Historically, severe vitamin B₅ deficiency was associated with the "burning feet" syndrome that affected prisoners of war in the Philippines, Burma, and Japan during World War II.²

Vitamin B₅ supplements often contain pantothenol, a relatively stable alcohol derivative of pantothenic acid, which is rapidly converted to pantothenic acid after ingestion.¹ The calcium salt of pantothenic acid is also available in supplements.¹ Pantethine, a dimeric form of pantothenic acid, is used as a cholesterol-lowering agent in Europe and Japan and is available in the US as a dietary supplement that is converted to vitamin B₅ after ingestion.¹