Vitamin B5 (pantothenic acid) deficiency diseases

   ›      ›   Vitamin B5 (pantothenic acid) deficiency diseases.

What is vitamin B5?

Vitamin B5 (pantothenic acid) is a water-soluble micronutrient belonging to the B-complex group of vitamins.
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Vitamin B5 deficiency results in metabolic and neurological disorders and diseases. Pantothenic acid is a component of coenzyme A (CoA), which is essential for several biochemical, enzymatic and physiological functions of the body.

The three components required for the synthesis of coenzyme-A are, pantothenic acid, adenosine triphosphate (ATP) and cysteine. Both adenosine triphosphate and cysteine are synthesized by the body. The human body cannot produce pantothenic acid and it has to be sources through diet. Actually, the name of vitamin B5 originates from the Greek word ‘pantos’, meaning ‘everywhere’. Pantothenic acid can be found in all living cells and is present in all food sources.

Food sources of vitamin B5

A whole range of food products of both plant and animal origins contain pantothenic acid. The richest vitamin B5 sources are yeast and organ meats including liver, kidney, heart, brain and spleen.
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Other common vitamin B5 sources include eggs, milk, yoghurt, cheese, whole grains flours and vegetables. The gut bacteria also synthesizes pantothenic acid. The recommended dietary allowance of vitamin B5 for adults is 5 mg. per day.

Functions of vitamin B5

Vitamin B5 is an essential precursor for the synthesis of coenzyme A. The foremost function of coenzyme A is initiation of the tricarboxylic acid cycle (TCA cycle). The importance of pantothenic acid can be understood by considering the fact that coenzyme A is involved in producing nearly 90% of the energy required for the life processes.

Pantothenic acid, as a component of coenzyme-A is involved in the manufacture of a wide variety of essential substances like acetylcholine, aldosterone, hydrocortisone, androgens, estrogen and progesterone.
  • Acetylcholine has functions both in the peripheral nervous system and in the central nervous system as a neuromodulator, neurotransmitter and neuromuscular messenger. Low levels of pantothenic acid affects acetylcholine synthesis.
  • Aldosterone plays a central role in the regulation of blood pressure by regulating sodium, potassium and water balance in the body. Low levels of vitamin B5 affects aldosterone synthesis.
  • Hydrocortisone (cortisol) primarily regulates blood sugar. It is also responsible for stress responses and anti-inflammatory responses. Low levels of vitamin B5 acid affects cortisol synthesis.
  • The androgens, estrogen and progesterone support the reproductive functions and the continued existence of the species.
  • Vitamin B5, being the precursor of coenzyme-A, may act as an acyl group carrier to form acetyl-CoA. Acetyl coenzyme A brings about several biochemical reactions, including conveying the carbon atoms within the acetyl group to the citric acid cycle (Krebs cycle) for oxidation and energy production.
  • The pantothenic acid derivative is essential to maintain the balance between carbohydrate metabolism and fat metabolism.
  • The biosynthesis of fatty acids and cholesterol and metabolism of fatty acids are coenzyme A and Acetyl coenzyme A dependant.
  • The vitamin B5 drived coenzyme A is essential for pyruvate oxidation and other acetylation reactions.
  • Vitamin B5 also supports the formation of the hemoglobin, repair of RNA and DNA and injury healing process.
  • The pantothenic acid dependant coenzyme-A initiates the process known as protein nitrosylation, which releases nitric oxide to alter the shape and function of proteins within cells.
  • Researchers have identified hundreds of proteins regulated by pantothenic acid dependant coenzyme A-driven protein nitrosylation.

Vitamin B5 deficiency causes

Pantothenic acid being a water-soluble, is continuously excreted in the urine. Ordinarily, dietary deficiency and diseases of pantothenic acid do not occur in healthy individuals. Vitamin B5 deficiency usually arises along with that of other water-soluble vitamins. In certain situations such as chronic alcoholism, use of oral contraceptives, diuretics or antacids, use of anticonvulsants and certain antibiotics, pregnancy, decreased absorption in elderly, inflammatory bowel disease and presence of malabsorption diseases can give rise to deficiency of pantothenic acid.

Vitamin B5 deficiency symptoms

Deficiency of pantothenic acid causes several neurological, metabolic, gastrointestinal and reproductive symptoms. Some of the signs and symptoms of low levels of vitamin B5 are:
  • fatigue and weakness,
  • nausea and vomiting,
  • stomachache.
  • sleeplessness and restlessness,
  • depression,
  • irritability,
  • apathy,
  • loss of libido,
  • burning sensation,
  • tingling sensation,
  • susceptibility to infection,
  • dermatitis,
  • muscle cramps,
  • numbness and
  • hypoglycemia.

Vitamin B5 deficiency diseases

Vitamin B5 deficiency diseases affect the nervous system, gastrointestinal system, metabolism, energy production and cause paresthesia and hypoglycemia.

Impaired energy production

Low levels of pantothenic acid impairs coenzyme-A (CoA) production. Low levels of CoA affects pyruvate oxidation, fatty acid metabolism and energy production. Low levels of vitamin B5 lead to low energy levels and the patient suffers from fatigue, weakness, lethargy, irritability, apathy, muscle pains, muscle cramps, body aches, tiredness and weariness.

Neurological syndromes

Low levels of pantothenic acid impairs coenzyme-A (CoA) production, which in turn affects acetylcholine synthesis. Acetylcholine is a neuromodulator and a major neurotransmitter in the autonomic nervous system. The inadequate functioning of neurotransmitter can cause problems with focus, concentration, remembrance, memory, mood, cravings and sleep. Low levels of vitamin B5 caused acetylcholine insufficiency is believed to be associated with Alzheimer’s disease, dementia and multiple sclerosis. Other neurological symptoms include paresthesia (burning or tingling sensation in hands and feet), numbness and muscle cramps.

Treatment of Vitamin B5 Deficiency

Pantothenic acid insufficiency is treated by oral vitamin B5 supplementation in the form of calcium pantothenate or pantothenol (panthenol).
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References:
1.Sweetman, L. (2005). Pantothenic Acid. Encyclopedia of Dietary Supplements. 1: 517-525.
2.Kobayashi D, Kusama M, Onda M, Nakahata N. The effect of pantothenic acid deficiency on keratinocyte proliferation and the synthesis of keratinocyte growth factor and collagen in fibroblasts. J Pharmacol Sci. 2011;115(2):230-4.
3.Leung LH. Pantothenic acid deficiency as the pathogenesis of acne vulgaris. Med Hypotheses. 1995 Jun;44(6):490-2.
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