Introduction:
Pantothenic acid, also called pantothenate or vitamin B5, is a water-soluble vitamin discovered by Roger J. Williams in 1919. For most animals, pantothenic acid is an essential nutrient for synthesizing coenzyme-A (CoA). It is further involved in metabolizing proteins, carbohydrates, and fats. Pantothenic acid is the structural amide between pantoic acid and β-alanine. Historically, during World War II, pantothenic acid deficiency was implicated in prisoners as ‘burning feet syndrome.’ The condition improved after pantothenic acid supplementation but not with other B-complex vitamins.
Where Is Pantothenic Acid Found?
Small quantities of pantothenic acid are found in most plant-based foods. It is usually synthesized in the chloroplasts of plants. Further, it is found in whole-grain cereals, legumes, avocados, eggs, meat, and yogurt. About 85 percent of dietary pantothenic acid is in the form of CoA, which is converted to pantothenic acid by digestive enzymes in the intestine. It is then delivered directly into the bloodstream by active transport. Pantothenic acid is also used commercially as an ingredient base in certain hair and skin care products. Out of the isometric forms of pantothenic acid, the dextrorotatory (D) isomer possesses biological activity, while the levorotatory (L) form function antagonizes the effects of the D isomer.
What Are the Metabolic Functions of Pantothenic Acid?
1. Pantothenic acid acts as a growth factor in metabolic cycles and is essential for various metabolic functions. It synthesizes cholesterol, lipids, neurotransmitters, steroid hormones, and hemoglobin. The synthesis of fatty acids, membrane phospholipids, amino acids, steroid hormones, vitamins A and D, and porphyrin is pertinent for metabolism.
2. It is an exclusive precursor in the synthesis of CoA and only affects this metabolic pathway. CoA plays a role in many biochemical reactions, such as cell growth and intermediary metabolism. The structure of CoA functions as a carbonyl-activating group and as an acyl group carrier to help facilitate these reactions. CoA is found in forms such as acetyl CoA and succinyl CoA, which are compounds important to the tricarboxylic acid cycle.
3. The acetylation and acylation of proteins and the synthesis of α-tubulin (amino acid) are also one of the major metabolic functions of pantothenic acid.
What Is the Importance of Pantothenic Acid in Body Metabolism and Health?
Humans require adequate amounts of pantothenic acid in their diet. Pantothenic acid is vital because it is an essential vitamin for cellular activity and coenzyme metabolism functions. Pantothenic acid is also crucial for phosphopantetheine production, as phosphopantetheine is involved in fatty acid metabolism. Pantothenic acid is widely distributed in foods, and studies reporting its deficiency are limited.
Pantothenic acid is available in dietary supplements alone or with other B-complex vitamins. Some supplements contain calcium pantothenate. The amount of pantothenic acid in dietary supplements ranges from 10 milligrams (mg) (0.00035274 ounces) to 1,000 mg (0.035 ounces). The primary criterion used to estimate the adequate intake for pantothenic acid is the intake adequate for its urinary excretion. Hence, the daily intake for adults varies around 5 mg (0.0017 ounces). Data on pantothenic acid intake shows that a typical mixed diet provides an estimated daily intake of about 6 mg (0.00021 ounces).
Because of its role in lipid synthesis and metabolism, studies suggest that pantothenic acid supplementation may decrease lipid levels in hyperlipidemia (increased blood lipid levels) patients. Several clinical trials show that pantethine (a form of pantothenic acid) reduces lipid levels when taken in large amounts. However, additional studies are required to determine whether pantethine supplementation alone has a beneficial effect on hyperlipidemia or together with a heart-healthy diet. Furthermore, more research is needed to determine the mechanism of pantethine on lipid levels.
What Are the Deficiencies Linked to Pantothenic Acid?
Pantothenic acid deficiency has most often been linked to individuals prone to weak dietary sources devoid of pantothenic acid. The deficiency can also occur in individuals who consume pantothenic acid metabolic antagonists such as ω-methyl pantothenic acid. When an individual has pantothenic acid deficiency, it is accompanied by other nutrient deficiencies. Hence, it is difficult to identify the effects specific to pantothenic acid deficiency. Still, individuals suffering from this deficiency may exhibit various clinical signs and symptoms that the healthcare provider should analyze based on dietary history.
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Irritability or restlessness.
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Malaise, weakness, or fatigue.
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Apathy (lack of enthusiasm).
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Sleep disturbances or sleep cycle disorders.
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Gastrointestinal issues may comprise generalized nausea, vomiting, and abdominal cramps.
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Alopecia (hair loss).
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Neurologic symptoms such as numbness or paresthesia (altered sensation).
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Muscle cramps and joint pain.
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Staggering gait (altered walking style).
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Hypoglycemia (low blood sugar).
Although pantothenic acid deficiency cannot be directly linked to any particular systemic disease, it results in a generalized malaise or fatigue with clinical implications. The deficiency can be attributed to the improper functioning of coenzyme A (CoA). The tissue transport of pantothenic acid into cells is for the synthesis of CoA. The enzyme pantothenate kinase regulates the synthesis. However, faulty CoA production does not reflect the amount of available pantothenate in the blood.
What Is the Management of Pantothenic Acid Deficiency?
After diagnosing the clinical symptoms, the physician should inquire about the drug or medication history. Drugs that interfere with pantothenic acid absorption, such as Azithromycin, Clarithromycin, and Erythromycin (all are antibiotics), should be investigated. The nutritionist may advise the dose based on the recommended daily intake (RDI). For patients more than 18 years, the RDI is around 0.0002 ounces per day. As the diagnosis of pantothenic acid deficiency is challenging, the same can be confirmed through blood tests or urine analysis.
Conclusion:
To conclude, pantothenic acid plays a vital role in many biochemical functions of the body and is essential for maintaining optimal health. Awareness of proper diet by consultation with the nutritionist allows the patient to consume adequate amounts of pantothenic acid. Also, adequate evaluation and classification of its deficiency can improve patient healthcare outcomes.
