Pantethine

More than 100 million Americans— 18 percent of the U.S. population— have high cholesterol, according to the National Center for Health Statistics. Elevated blood lipid levels are a primary risk factor in development of cardiovascular disease (CVD), the No. 1 cause of death in the United States. However, managing cholesterol—by increasing levels of HDL (“good”) cholesterol and lowering levels of LDL (“bad”) cholesterol and triglycerides— through lifestyle choices can play an important role in avoiding CVD. There are many pharmaceutical options to treat hyperlipidemia; however, nutritional compounds offer both efficacious, scientifically supported results and minimal side effects. One such nutrient is pantethine, also known as vitamin B5. A derivative of pantothenic acid, pantethine is converted to coenzyme A in the body, which converts fat, protein and carbohydrates to energy. It has been reported to be effective at improving abnormal lipid profiles in both adults and children. It also reportedly lowers elevated triglycerides and LDL cholesterol while raising levels of beneficial HDL cholesterol, and is used as a pharmaceutical treatment for hyperlipidemia in Japan. More than 35 years of basic research support the safety and efficacy of Pantesin in blood lipid metabolism. Pantethine works by slowing production of cholesterol in the liver and by boosting the rate at which metabolism burns fat. Typically, dosage starts at 600 mg/d to achieve cholesterol reduction, with maintenance doses between 400 mg/d and 1,200 mg/d. Pantethine has a mild laxative effect, which can be more pronounced at higher intakes; however, serious gastrointestinal side effects are rare. Pantethine activity is two-fold. First, it lowers levels of LDL and triglycerides. LDL oxidation contributes to plaque build-up—a sign of atherosclerosis, which reduces arterial blood flow and can impact kidney and liver function. Elevated triglyceride levels are an independent risk factor for developing coronary heart disease (CHD), and such levels are often observed in patients with metabolic syndrome, a state characterized by abdominal obesity, high blood pressure and insulin resistance. Second, pantethine increases blood lipid levels of protective HDL. While many nutraceutical agents such as plant sterols or fiber can help lower LDL and triglyceride levels, there are few that increase HDL levels. HDL protects against the build-up of cholesterol plaques associated with free radical damage caused by oxidized LDL. Many studies support panthethine’s ability to positively impact blood lipid profiles through these actions. Researchers led by Antonio Gaddi, Ph.D., conducted a double blind, eight-week study that included 29 patients given 900 mg/d of pantethine.¹ They found supplementation lowered total and LDL cholesterol levels by approximately 15 percent, decreased plasma triglyceride levels up to 30 percent and increased HDL levels by up to 10 percent. A study of 24 perimenopausal women with elevated total and LDL cholesterol indicated 900 mg/d of pantethine significantly reduced total and LDL cholesterol levels and the LDL-to-HDL ratio.² Another study comparing treatment with probucol—a cholesterol-lowering drug—and pantethine demonstrated that while both reduced LDL levels, the drug reduced HDL levels and pantethine increased HDL levels.³ Finally, it appears pantethine can be used to safely treat both adults and children with hypercholesterolemia. A study of 65 adults and seven children with high cholesterol alone, or associated with hypertriglyceridemia, showed 900 mg/d to 1,200 mg/d of pantethine significantly reduced total and LDL cholesterol levels, in addition to triglyceride levels, while significantly increasing HDL levels.⁴ The authors discussed the possible role of pantethine in the treatment of hyperlipoproteinemia—a family of metabolic disorders linked to LDL— reporting it had “perfect tolerability and demonstrated therapeutic effectiveness.” Pantethine’s benefits on lipid levels extend beyond heart health. A recent review noted pantethine’s efficacy as a hypolipidemic agent may be attributed to its ability to inhibit liver acetyl-CoA carboxylase, a factor in fatty acid synthesis, offering possible opportunities in the treatment of obesity.⁵ Another clinical review of studies on diabetic, hyperlipidemic patients found pantethine significantly improves lipid metabolism and should be considered as a treatment for lipid abnormalities in those with diabetes.⁶ Also, because pantethine stimulates coenzyme A production, it may be helpful in sports nutrition and energy applications.

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Scientific References

1. Gaddi A et al. “Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia.” Atherosclerosis. 50, 1:73-83, 1984. 2. Binaghi P et al. “Evaluation of the cholesterol-lowering effectiveness of pantethine in women in perimenopausal age.” Minerva Med. 81, 6:475-9, 1990. 3. Tawara K et al. “Effect of probucol, pantethine and their combinations on serum lipoprotein metabolism and on the incidence of atheromatous lesions in the rabbit.” Jpn J Pharmacol. 41, 2:211- 22, 1986. 4. Bertolini S et al. “Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children.” Int J Clin Pharmacol Ther Toxicol. 24, 11:630-7, 1986. 5. McCarty MF. “Inhibition of acetyl-CoA carboxylase by cystamine may mediate the hypotriglyceridemic activity of pantethine.” Med Hypotheses. 56, 3:314-7, 2001. 6. Donati C, Bertieri RS, Barbi G. “Pantethine, diabetes mellitus and atherosclerosis.” Clin Ter. 128, 6:411-22, 1989.