Pantothenic acid, also known as vitamin B5, is used in the production of coenzyme A (CoA) and acyl carrier proteins, both central components that are involved in the metabolism of carbohydrates and fat for energy, the production of adrenal hormones, and the production of red blood cells.(1,2) Supplemental pantothenic acid is most often found as the calcium salt.
Because of its association with the adrenal glands, it has historically been considered the anti-stress vitamin. Naturopathic physicians and nutritionally minded medical physicians seeking to provide optimal conditions in faltering adrenal function think of pantothenic acid as a key player and typically recommend 250 mg BID. This same amount is recommended for allergy because allergy is perceived to be related to a stress component. The efficacy of these high intakes for allergy has not been demonstrated or refuted by clinical trials.(1)
As far back as the early '60s it was observed that blood levels of pantothenic acid were lower in rheumatoid arthritis patients.(1,3) The researchers found that the lower the blood levels of pantothenic acid, the greater were the symptoms of the patients. Correction of the low levels resulted in some degree of symptom alleviation. In one double blind study, patients using up to 2 grams per day reported significant improvements in the duration of morning stiffness, degree of disability, and severity of pain.(1,4)
Calcium pantothenate was not found to be effective against osteoarthritis in this study.
It may be prudent when high doses of pantothenic acid are used for it be complemented with increased use of the general vitamin B complex to facilitate other related B vitamin interactions with the metabolic goals of pantothenic acid.
No significant adverse side effects or reactions have been reported with pantothenic acid(1), but we have to consider that no definitive toxicology studies for high dose use of pantothenic acid were made at least until 2005.
There is no established recommended daily amount (RDA) for pantothenic acid, however, 4 to 7 milligrams per day for 11+ years old is considered the safe and adequate intake.(1,2) Therefore a B complex providing 25 to 50 mg of pantothenic acid would be a source of optimal supply of this supplement.
For general adrenal support, 250 mg BID is recommended, for allergy, 250 mg BID is recommended, and for rheumatoid arthritis, 2 grams per day is recommended.(1)