Dr C P Ravikumar

Vitamin B5 Deficiency
Introduction:
Vitamin B5 or pantothenic acid is present in almost all foods in small quantities and was therefore named after the Greek word “pantos” which means “from everywhere.” It helps with the metabolism of fats and carbohydrates in our bodies, which in turn produces energy to perform many bodily functions, including growth and repair.
Required Daily amount
The daily recommended dietary allowances (RDAs) of Vitamin B5 are:
Age Male Female Pregnancy Lactation
0 – 6 months 1.7 mg 1.7 mg
7 – 12 months 1.8 mg 1.8 mg
1 – 3 years 2 mg 2 mg
4 – 8 years 3 mg 3 mg
9 – 13 years 4 mg 4 mg
14 – 18 years 5 mg 5 mg 6 mg 7 mg
19+ 5 mg 5 mg 6 mg 7 mg

Sources of Vitamin B5 
Natural Sources of Vitamin B5 Vitamin B5 is present in:
  • Beef, poultry, seafood, and organ meats
  • Eggs and milk
  • Vegetables such as mushrooms, avocados, potatoes, and broccoli
  • Whole grains, such as whole wheat, brown rice, and oats
  • Peanuts, sunflower seeds, and chickpeas
In India, Vitamin B5 rich foods include
  • Paneer and curd
  • Bajra, jowar and ragi
  • Lentils like moong dal, masoor dal, urad dal, chana dal, toovar dal

Supplements of Vitamin B5:
Pantothenic acid is added to fortify several foods  including cereals and energy drinks . It is available as dietary supplements containing only vitamin b5 or as a combination with other B Complex vitamins and minerals. Some supplements contain pantetheine or  calcium d- pantothenate. 

Health Benefits of Vitamin B5
Vitamin B5 is required by the body for the production of Co-enzyme A and acyl carrier proteins which are responsible for the synthesis and breaking down of food into fatty acids and cholesterol in the body.
Co enzyme A is also needed to produce sphingosine, which helps in the transmission of signals between nerve cells .
It may be used to promote healthy skin and hair and is therefore found in many cosmetic products. The use of pantothenic acid and compounds of vitamin B5 for acne and hair loss is common.
There are studies that indicate that vitamin B5 has the ability to lower lipid levels (bad cholesterol and triglycerides) in blood, while raising good cholesterol or HDL levels, if taken in higher concentrations as a supplement, although additional research is required.

Deficiency of Vitamin B5
  • Heating, cooking, and processing foods, and boiling them in water, destroys Vitamin B5. As it is water-soluble, it dissolves into cooking water.
  • General nutritional deficiency will lead to lowered levels of vitamin B5.
  • Malabsorption syndromes, or conditions of the gut or liver that inhibit the absorption and metabolism of vitamin B5 can also lead to deficiency.
a. Initial symptoms
  • numbness and burning of the hands and feet
  • headache
  • fatigue
  • irritability
  • restlessness
  • disturbed sleep
  • gastrointestinal disturbances with anorexia
b. Severe cases are usually individuals who have a genetic mutation in the PANK 2 gene (pantothenate kinase 2) which produces Pantothenic acid kinase, an enzyme responsible for the conversion of pantothenic acid to co-enzyme A. This in turn is essential for fatty acid synthesis. Deficient synthesis of co-enzyme A leads to Neurodegeneration which presents as dystonia and spasticity of muscles as well as  pigmentation in the retina of the eye.  Its progression is rapid and leads to physical disability and loss of functions. Although the mainstay of treatment is to alleviate the symptoms, research is on-going regarding the effect of supplementation of vitamin b5 in these cases.

Diagnosis of Thiamine Deficiency
Blood tests can determine the amount of vitamin b5 in serum. There are quantitative estimations done from urine as well.

Management of Thiamine Deficiency
Oral supplements of Vitamin B5 are usually taken after food. It is  commercially available as D-pantothenic acid, as well as dexpanthenol and calcium pantothenate, which are chemicals made in the lab from D-pantothenic acid. It may also be taken as part of a vitamin B complex or multi-vitamin and is generally considered safe. Excessive supplementation with pantothenic acid may increase bleeding tendencies.

Disclaimer: The above information is for awareness and education purposes only and cannot be used for diagnosis or treatment of any condition. Please consult with a physician for any concerns or questions

References :
Dr C P Ravikumar

Dr C P Ravikumar

CONSULTANT – PEDIATRIC NEUROLOGY
Aster CMI Hospital, Bangalore