Pantethine is a dietary supplement that is related to vitamin B5 (pantothenic acid). Pantethine is used for lowering cholesterol, preventing inflammation, boosting the activity of the immune system, treating an inherited condition called cystinosis, treating gastrointestinal (GI) diseases, and improving athletic performance. It is also used for improving energy, lowering the risk of heart attack and stroke, improving adrenal function, protecting against mental and physical stress, and preventing allergy symptoms in people who are allergic to formaldehyde.
Pantethine might increase the concentrations of chemicals that lower blood cholesterol and triglycerides.

What is Pantethine ?
Pantethine is the active form of pantothenic acid. It has been shown to significantly reduce serum triglycerides, total cholesterol, and LDL-cholesterol (the so-called "bad cholesterol") levels while increasing HDL ("good cholestrerol") levels in several clinical trials. Pantethine has the advantage of being an effective treatment for high cholesterol while avoiding the undesirable side effects of synthetic lipid-lowering drugs. In fact, there appear to be no toxicity or side effects from to pantethine, making an attractive and natural treatment alternative. Pantethine has been used for the past 30 years in Japan, where it is approved as a pharmaceutical agent for the purpose of increasing HDL-C, the "good cholesterol" needed by the body to maintain a healthy heart.

A naturally occurring substance, Pantethine is produced as a byproduct when the body metabolizes pantothenic acid. Pantethine and pantothenic acid are found in most foods, including vegetables, dairy, eggs, grains, and meat. Liver, salmon and yeast have especially high concentrations of pantothenic acid, which the body uses to produce pantethine.

Although Pantethine is derived from pantothenic acid, pantethine is not the same as pantothenic acid, and it is important to remember that the two substances are not interchangeable. Structurally, pantethine is a more stable disulfide form (or a double bond) of pantothenic acid. It is also a more active metabolic substrate that is converted into an enzyme called "Co-Enzyme A," or simply, "CoA." CoA plays a critical role in the metabolism and breakdown of the three essential micronutrients namely proteins, carbohydrates and fats.

Pantothenic acid has its own benefits, including enhanced adrenal functions and the reduction of hypertension, or high blood pressure. Pantothenic acid is also known as vitamin B5, and is a member of the water-soluble B vitamin family. It is an essential ingredient of two substances, coenzyme A and acyl carrier protein, which are needed to metabolize carbohydrates and fats. The same coenzymes play a part in production of certain hormones, vitamin D, red blood cells, and the neurotransmitter acetylcholine. Pantothenic acid is necessary for proper growth and development.

Where it is found
Dairy products are a good source for Vitamin B5. Dairy products like milk can be consumed to increase pantothenic acid levels. Eggs, Yogurt and cheese are also a good source for pantothenic acid. Breads and grains are a good source of pantothenic acid. Broccoli is a dark green vegetable that has pantothenic acid and other nutrients. Sweet and white potatoes also have large amounts of pantothenic acid. Add mushrooms to salads and gravies for doses of pantothenic acid. Peas are starchy vegetables that are avoided in most low-carb diets, but they have essential nutrients, including pantothenic acid.

Benefits / uses
Helps Raise Co-Enzyme A (Coa) Levels
Pantethine is the immediate precursor to Co-Enzyme A (CoA). Supplemental pantethine raises the levels of CoA. CoA is a pivotal nutrient in at least 70 metabolic pathways, including those involved with the healthy metabolism of fats, carbohydrates, and amino acids. CoA is required for cell engines (mitochondria) to produce energy properly. CoA helps synthesize acetylcholine, an important compound for nerve function and memory. It supports Phase II detoxification and the enzyme aldehyde dehydrogenase that helps clear alcohol and related derivatives. And it helps synthesize glyconutrients like N-Acetyl-Glucosamine, needed for healthy joints and the lining of the GI tract.

Pantethine lowers cholesterol and other lipid levels.
Pantethine supplements are helpful in reducing total cholesterol, LDL cholesterol, and triglyceride levels while at the same time raising the good HDL cholesterol in the body.High levels of LDL (low-density lipoprotein) - the "bad cholesterol" - is a major contributing factor of heart disease. The cholesterol forms plaque in the heart's blood vessels, which restricts or blocks the supply of blood to the heart, and causes a condition called atherosclerosis, which is a buildup of fatty substances in the inner layers of the arteries. Pantethine may be a good cholesterol-lowering alternative for people with diabetes, who cannot take niacin due to the potential side effects on blood sugar regulation.

Doctors who conducted another study in Italy tested the effectiveness of pantethine in treating high cholesterol in women. After 16 weeks of treatment, significant reductions of total cholesterol, LDL-cholesterol and LDL-C/HDL-C ratio could be observed. The authors of the study recommended that pantethine should be considered in the long-term treatment of high cholesterol occurring in the perimenopausal age.

Pantethine may lower triglyceride levels.
Studies in the effect of pantethine on triglycerides indicate that a daily dose of pantethine is more effective than daily doses of pantothenic acid or cystamine in lowering triglyceride levels. Triglycerides are one of the forms of fat stored by the body and used for energy and new cell formation. The break down of fats in the liver can be disrupted by alcoholism, malnutrition, pregnancy, or poisoning. In fatty liver, large droplets of fat, containing mostly triglycerides, collect within cells of the liver.

Pantethine may improve symptoms associated with having a fatty liver.
Also called steatosis, fatty liver can be a temporary or long-term condition. Left untreated, steatosis can contribute to other illnesses. The liver is the organ responsible for changing fats eaten in the diet to types of fat that can be stored and used by the body. In a study conducted in Japan, 600 mg/day of pantethine was administered to 16 outpatients with fatty liver and hypertriglyceridemia for six months or longer to examine whether the drug improved fatty liver using abdominal plain computed tomography (CT). Nine of the 16-pantethine patients were no longer diagnosed as having fatty liver after the study period.

Pantethine has been shown to enhance cognitive abilities. In rats that received daily injections of pantethine, the drug facilitated the learning process and activity level of the animals. Pantethine performed much better than Cysteamine, which only slightly increased the locomotion and rearing and did not influence the shuttle box learning. Other studies have confirmed that pantethine is beneficial to brain function.

Other possible uses: Pantethine may help rheumatoid arthritis One very small study indicated that large daily doses of pantothenic acid were helpful to relieve symptoms of rheumatioid arthritis. Consult a healthcare provider regarding use of supplements for this purpose. Pantethine has also been used successfully by some doctors for patients who experience heart burn, ulcers and candida infections and has been used with some success in the management of certain allergies. Experiments with rats have shown that a deficiency of pantothenic acid can cause hair to turn gray and fall out. Neither oral nor topical use of any form of pantothenic acid has been shown to prevent or treat gray hair or balding in humans. Some skin care products contain another form of pantothenic acid, called panthoderm, which may be helpful in treatment of minor skin injuries. It has also been said to have certain anti-aging properties.

The following doses have been studied in scientific research:

For treating too much fat in the blood (hyperlipoproteinemia): 300 mg of pantethine 3 to 4 times daily.

Possible Side effects / Precautions / Possible Interactions:
The only known side effect of high-dose pantethine supplementation is increased bowel activity and diarrhea in certain individuals. Human and animal studies have documented the low toxicity and safety of pantethine. Although digestive disturbances have occasionally been reported in the literature, the majority of researchers have commented on the complete freedom from side effects and subjective complaints experienced by individuals taking pantethine. During a one-year clinical trial with pantethine that was conducted in 24 patients with established dyslipidemia, The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus.

Research studies / References

arw Binaghi, P; Cellina, G; Lo Cicero, G; Bruschi, F; Porcaro, E; Penotti, M (1990). "Evaluation of the cholesterol-lowering effectiveness of pantethine in women in perimenopausal age". Minerva medica 81 (6): 475-9. PMID 2359503.

arw Arsenio, L; Bodria, P; Magnati, G; Strata, A; Trovato, R (1986). "Effectiveness of long-term treatment with pantethine in patients with dyslipidemia". Clinical therapeutics 8 (5): 537-45. PMID 3094958.

arw Gaddi, A; Descovich, GC; Noseda, G; Fragiacomo, C; Colombo, L; Craveri, A; Montanari, G; Sirtori, CR (1984). "Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia". Atherosclerosis 50 (1): 73-83. doi:10.1016/0021-9150(84)90009-1. PMID 6365107.

arw McCarty MF (2001). "Inhibition of acetyl-CoA carboxylase by cystamine may mediate the hypotriglyceridemic activity of pantethine". Medical Hypotheses 56 (3): 314-317. doi:10.1054/mehy.2000.1155.

arw Angelico M, Pinto G, Ciaccheri C, et al. Improvement in serum lipid profile in hyperlipoproteinemic patients after treatment with pantethine: crossover, double blind trial versus placebo. Current Therapeutic Research 1983;33(June Sec 2):1091-1097.

arw Berni Canani M, Berni Canani R. Evaluation of the efficacy and tolerability of an association of cyproheptadine, carnitine and pantethine in the treatment of anorexia in children. Double blind clinical trial vs. cyproheptadine. Toxicologica et Therapeutica 1988;9(1):81-100.

arw Braverman ER. Nutrition for the heart. Part 2. Natural Pharmacy 1999;3:22-24.

arw Cattin L, Da Col PG, Fonda M, et al. Treatment of hypercholesterolemia with pantethine and fenofibrate; open randomized study on 43 subjects. Current Therapeutic Research 1985;38(Sep):386-395.

arw Da Col PG, Cattin L, Fonda M, et al. Pantethine in the treatment of hypercholesterolemia: a randomized double-blind trial versus tiadenol. Current Therapeutic Research 1984;38:719-727.

arw Harding JJ. Can drugs or micronutrients prevent cataract? Drugs Aging 2001;18(7):473-486.

arw Hiraoka T Clark JI. Inhibition of lens opacification during the early stages of cataract formation. Invest Ophthalmol.Vis.Sci. 1995;36(12):2550-2555.

arw Kelly GS. Nutritional and botanical interventions to assist with the adaptation to stress. Altern.Med.Rev. 1999;4(4):249-265.

arw McCarty MF. Inhibition of acetyl-CoA carboxylase by cystamine may mediate the hypotriglyceridemic activity of pantethine. Med.Hypotheses 2001;56(3):314-317.

arw Miller AL, Kelley GS. Homocysteine metabolism: nutritional modulation and impact on health and disease. Altern.Med.Rev. 1997;2(4):234-255.

arw Nomura H, Kimura Y, Okamoto O, et al. Effects of antihyperlipidemic drugs and diet plus exercise therapy in the treatment of patients with moderate hypercholesterolemia. Clin.Ther. 1996;18(3):477-482.

arw Osono Y, Hirose N, Nakajima K, et al. The effects of pantethine on fatty liver and fat distribution. J.Atheroscler.Thromb. 2000;7(1):55-58.

arw Pocecco, M. Treatment of infantile nephropathic cystinosis with cysteamine: 2. New England Journal of Medicine 1986;314(May 15):1320.

arw  Slyshenkov VS, Rakowska M, Moiseenok AG, et al. Pantothenic acid and its derivatives protect Ehrlich ascites tumor cells against lipid peroxidation. Free Radic.Biol.Med. 1995;19(6):767-772.

arw  Webster MJ. Physiological and performance responses to supplementation with thiamin and pantothenic acid derivatives. Eur.J Appl.Physiol Occup.Physiol 1998;77(6):486-491.