Supplements

Pantothenic Acid (Vitamin B5)

Updated · 35 sources

Pantothenic acid, also called vitamin B5, is an essential water-soluble vitamin. The body uses it to make coenzyme A (CoA), a molecule needed to build and break down fatty acids and to run many other metabolic reactions. It is present in almost all foods, and deficiency is rare outside severe malnutrition or experimental diets.

In supplement and skin care marketing, “B5” covers three different things: oral pantothenic acid (usually calcium pantothenate), oral pantethine and topical dexpanthenol. The evidence differs by form, and the single most important point is that results do not carry over between them. Pantethine has the lipid data, topical dexpanthenol has the wound and skin data, and the popular use of high-dose oral B5 for acne rests on one small, company-sponsored trial.

This page summarizes what the NIH Office of Dietary Supplements, the National Academies, European food safety assessors and clinical trials report. It is for education only and is not medical advice.

Property Detail
Type Essential B vitamin; dietary supplement ingredient
Main forms Calcium pantothenate and pantethine (oral); dexpanthenol, also called D-panthenol (topical, and in IV multivitamins)
Adult Adequate Intake (US) 5 mg/day; 6 mg/day in pregnancy; 7 mg/day in lactation. No RDA has been set
Upper limit None set in the US or by the former EU Scientific Committee on Food
Typical US intake About 6 mg/day from a mixed diet (estimate; few data exist)
Amounts in supplements About 10 mg in multivitamins, up to 1,000 mg in B-complex or single-ingredient products
Doses in cited trials 2.2 g/day pantothenic acid (acne); 600–900 mg/day pantethine (lipids); 5% dexpanthenol ointment (wounds)
Half-life Not established in healthy adults; 28 h for pantothenate in 4 children on very high oral pantethine doses
WADA status Not on the 2026 Prohibited List

What it is

Pantothenic acid is N-(2,4-dihydroxy-3,3-dimethyl-1-oxobutyl)-β-alanine, molecular weight 219.23. The free acid and its sodium salt are chemically unstable, so the calcium salt is the usual preparation (SCF 2002).

Cells use it to make CoA and acyl carrier protein. CoA is needed for the citric acid (energy) cycle and for making fatty acids, membrane phospholipids, amino acids, steroid hormones, vitamins A and D, and neurotransmitters. Acyl carrier protein is part of the fatty acid synthase complex (IOM 1998).

More vitamin does not automatically mean more CoA. The first step of the pathway, pantothenate kinase, is inhibited by CoA and acyl-CoA, so CoA production “does not reflect the amount of available pantothenate” (IOM 1998). This matters for claims that extra B5 boosts energy metabolism in people who already get enough.

Forms and how the evidence differs

Form What it is Where the human evidence sits
Pantothenic acid or calcium pantothenate The vitamin, or its stable calcium salt Nutrition requirements; one placebo-controlled acne trial. Does not appear to share pantethine’s lipid effects
Pantethine A dimer of pantetheine; a conjugate of pantothenic acid and cysteamine Small lipid trials
Dexpanthenol (D-panthenol) The alcohol form, converted to pantothenic acid in the body Topical wound care and skin barrier studies

No studies have compared how well pantothenic acid is absorbed from calcium pantothenate and from pantethine (NIH ODS).

How it works in the body

About 85% of dietary pantothenic acid is bound as CoA or phosphopantetheine. Digestive enzymes release the free vitamin, which is absorbed by active transport and possibly by simple diffusion at higher doses. Limited data suggest that 40%–61% of the vitamin in food is absorbed (NIH ODS). Absorption is less efficient at higher intakes because the transporter saturates, but the intake at which this happens in people is unknown (IOM 1998).

The vitamin leaves the body intact in urine, at about 2.6 mg/day on a typical American diet. Excretion tracks intake. In a small feeding study, 100 mg/day for 7 days raised urinary output to about 60 mg/day (IOM 1998).

Oral pantethine does not reach the blood intact. In 4 children with cystinosis given 70–1,000 mg/kg/day, it was rapidly split into pantothenic acid and cysteamine, and pantethine itself could not be detected in plasma. Pantothenate had an elimination half-life of 28 h in that study, and plasma levels stayed about three times higher for months after treatment (Wittwer et al., J Clin Invest 1985). These doses and patients are far from ordinary supplement use, so the figure may not apply to healthy adults.

Topical dexpanthenol is absorbed through the skin and rapidly converted to pantothenic acid (Gorski et al., Pharmaceuticals 2020).

Shared transporter with biotin

Pantothenate and biotin use the same carrier, the sodium-dependent multivitamin transporter (SMVT), along with lipoate (Prasad et al., J Biol Chem 1998; Zhen et al., Nat Commun 2026). The competition has been shown directly in cell culture:

  • Human colon cells. Pantothenic acid competitively inhibited biotin uptake (inhibition constant 14.4 µM; biotin’s own apparent Km was 19.7 µM) (Said et al., Am J Physiol 1998).
  • Rat transporter expressed in HeLa cells. The Km was 4.9 µM for pantothenate and 15.1 µM for biotin (Prasad et al. 1998).
  • Inherited SMVT deficiency. Rare biallelic SLC5A6 mutations impair uptake of all three substrates, and the reported patient improved on combined biotin, pantothenate and lipoate replacement (Byrne et al., NPJ Genom Med 2019).

About biotin and B5 “competing.” A common online claim is that biotin causes acne by crowding out B5, or that high-dose B5 depletes biotin. The shared transporter is real, but we found no controlled human study showing that a high dose of either vitamin lowers the status of the other or changes acne. The National Academies said there is almost no information on interactions between pantothenic acid and other nutrients (IOM 1998).

Intake, food and deficiency

The US Food and Nutrition Board could not estimate an average requirement, so it set Adequate Intakes based on usual intakes in healthy people (NIH ODS; IOM 1998):

Group AI (mg/day)
Infants 0–6 months 1.7
Infants 7–12 months 1.8
Children 1–3 years 2
Children 4–8 years 3
Ages 9–13 years 4
Ages 14 years and older 5
Pregnancy 6
Lactation 7

The FDA Daily Value is 5 mg for adults and children aged 4 and older. Some of the richest sources are listed below. Food processing can remove from 20% to almost 80% of the vitamin (NIH ODS).

Food Pantothenic acid per serving
Beef liver, boiled, 3 ounces 8.3 mg
Shiitake mushrooms, cooked, ½ cup 2.6 mg
Sunflower seeds, ¼ cup 2.4 mg
Chicken breast, roasted, 3 ounces 1.3 mg
Avocado, raw, ½ 1.0 mg
Milk, 2%, 1 cup 0.9 mg
Egg, hard-boiled, 1 large 0.7 mg

Deficiency has been documented only in people fed diets almost free of the vitamin or given a metabolic antagonist, and in severe malnutrition. Reported signs include numbness and burning of the hands and feet, headache, fatigue, irritability, disturbed sleep and gastrointestinal upset. Urinary excretion under 1 mg/day suggests deficiency, but status is not routinely measured in healthy people (NIH ODS).

Mutations in the PANK2 gene cause pantothenate kinase-associated neurodegeneration (PKAN), a rare inherited disorder that can reduce CoA production. Whether pantothenate supplements help in PKAN is not known (NIH ODS).

What the research shows

Acne

The idea traces largely to a 1995 paper in Medical Hypotheses proposing that acne is caused by pantothenic acid deficiency and claiming “a complete cure” with very liberal replacement (Leung 1995). A hypothesis journal article is not trial evidence, and the proposal conflicts with the finding that documented deficiency is confined to near-zero diets, antagonist use and severe malnutrition.

The only placebo-controlled trial of oral pantothenic acid for acne that we found randomized adults with mild to moderate facial acne to a “pantothenic acid-based” supplement providing 2.2 g/day, or placebo, for 12 weeks (Yang et al., Dermatol Ther 2014):

Outcome at week 12 Supplement Placebo P
Total lesions (primary) Reported 68.21% reduction vs placebo — 0.0197
Downgraded to almost clear (investigator assessment) 42.85% 14.28% 0.045
Dermatology Life Quality Index (lower is better) 1.93 5.3 0.022

This is weak evidence, for several reasons:

  • Small. 48 people were randomized and 41 were evaluable (20 vs 21), and 36 of the 41 were women.
  • Sponsored. Funding came from the product’s marketer, Avilan Marketing. The article charge was paid by Nutraceutical Medical Research, the corresponding author’s affiliation. The authors declared no conflict of interest.
  • Unbalanced at baseline. Mean total lesions were 51.3 vs 71.8 (P = 0.071). The published subtotals also do not add up to those totals (41.2 + 15.3 in the supplement group, 48.9 + 17.3 in the placebo group).
  • Unreplicated and short. The authors themselves called for further trials. We found no independent replication, no trial in steroid-related acne and no long-term data.

The 2024 American Academy of Dermatology guideline abstract lists its strong and conditional recommendations, and pantothenic acid is not among them. Strong recommendations go to benzoyl peroxide, topical retinoids such as adapalene, topical antibiotics and oral doxycycline, with oral isotretinoin for severe or treatment-resistant acne (Reynolds et al., JAAD 2024).

The topical panthenol acne studies we found used combination products. Reports of gels combining 4% D-panthenol with hydrogen peroxide and salicylic acid, in 30 and 20 patients with no placebo arm, cannot separate its effect from that of the other ingredients (Ricci et al. 2016; Fabbrocini & Panariello 2016). A brief 2002 letter also reported that dexpanthenol cream improved the mucocutaneous (skin and mucous membrane) side effects of isotretinoin (Romiti & Romiti 2002). That is a use for side effects, not an acne treatment.

Pantethine and blood lipids

Lipid results apply to pantethine, not to ordinary pantothenic acid, which does not appear to have the same effects (NIH ODS). Rapid breakdown of pantethine suggests that pantothenate or cysteamine may be responsible, but the mechanism is unsettled (Wittwer et al. 1985).

Study Who Dose and comparison Result
Gaddi et al., Atherosclerosis 1984 29 patients with hyperlipoproteinemia; double-blind 300 mg three times daily vs placebo, 8 weeks Type IIB: total and LDL cholesterol −13.5%. Triglycerides fell about 30% when pantethine came first, but only 13%–18% when it followed placebo
McRae, Nutr Res 2005, as summarized by NIH ODS 28 small trials, 646 adults (average 22 per trial) Median 900 mg/day, average 12.7 weeks At 4 months: triglycerides −32.9%, total cholesterol −15.1%, LDL −20.1%, HDL +8.4%
Rumberger et al., Nutr Res 2011 120 low- to moderate-risk North American adults on a lifestyle diet 600 mg/day, then 900 mg/day, vs placebo, 16 weeks Compared with placebo: total cholesterol −6 mg/dL (3%), LDL −4 mg/dL (4%), apolipoprotein B −4 mg/dL (5%)
Evans et al., Vasc Health Risk Manag 2014 32 statin-eligible, low- to moderate-risk adults Same schedule vs placebo, 16 weeks LDL −11% from baseline vs +3% on placebo at week 16 (P = 0.010 between groups)
Chen et al., J Clin Lipidol 2015 216 Chinese adults with triglycerides of 2.3–6.5 mmol/L Pantethine vs coenzyme A capsules, 8 weeks; no placebo arm Triglycerides −16.5% on pantethine, −33.3% on coenzyme A

Results vary widely. ODS reports the 2005 pooled figures as average changes with treatment, not differences from placebo. The largest placebo-controlled trial found only 4–6 mg/dL compared with placebo, and the larger LDL change in Evans et al. came from just 32 people. Going from 600 to 900 mg/day did not add to the effect, and the 2 North American trials came from one research group, with co-authors listing Daiichi Fine Chemical and Kyowa Hakko USA affiliations (NIH ODS; Evans et al. 2014).

We found no pantethine trial reporting heart attacks, strokes or deaths, so any heart benefit is unproven. ODS concludes that more studies are needed. For a different B vitamin with both lipid and outcome-trial data, see niacin.

Exercise performance

CoA is central to energy metabolism, and pantothenic acid is added to some energy drinks (NIH ODS). Controlled human data on performance are nearly absent:

  • Webster 1998. Six highly trained cyclists took placebo or 1 g of allithiamin plus 1.8 g of a pantethine and pantothenic acid compound for 7 days, in a randomized, double-blind crossover. There were no significant differences in metabolism or heart rate, or in 2,000 m time trial time (178.2 vs 170.7 s; P = 0.58) (Webster, Eur J Appl Physiol 1998).
  • Nice et al. 1984. This paper studied pantothenic acid and exercise capacity, but it has no indexed abstract and we could not access the full text, so we do not report its results (Nice et al., J Sports Med Phys Fitness 1984).

We found no trial of pantothenic acid for strength, muscle gain or recovery from resistance training.

Wound healing and skin

Oral evidence is limited. In patients having tattoos surgically removed in stages, ascorbic acid (1 or 3 g/day) plus pantothenic acid (0.2 or 0.9 g/day) was linked to higher scar breaking energy in the higher-dose group (Vaxman et al., Eur Surg Res 1996). Pantothenic acid was not tested alone. A 2009 review called randomized data on surgical wounds scarce (Ellinger & Stehle 2009), and European assessors described the same study as reporting neither adverse nor beneficial effects (SCF 2002).

Topical dexpanthenol has more data, mostly for superficial wounds and skin barrier repair:

Study Who Comparison Result
Girard et al., summarized in Gorski et al. 2020 35 burn patients, skin graft donor sites; double-blind, within-patient 5% dexpanthenol ointment vs vehicle, 14 days Tended to heal faster; better hydration in week 2 (P = 0.05); itch resolved sooner (P = 0.06)
Heise et al., Cutan Ocul Toxicol 2019 38 patients after CO₂ laser resurfacing; split wound Dexpanthenol ointment vs petroleum jelly, 7 days Smaller lesions on days 1–2; better re-epithelialization on days 1, 2 and 5. All healed by day 14
Løkkevik et al., Acta Oncol 1996 79 analyzed radiotherapy patients; within-patient, blinded scoring Dexpanthenol cream vs no cream No clinically important benefit for radiation skin reactions
Abd Elazim et al., Dermatitis 2023 50 patients in breast cancer radiotherapy; double-blind 5% dexpanthenol vs 7% ectoin cream Ectoin scored better on radiodermatitis grade (week 2, P = 0.008), pain and itch

Reviews describe dexpanthenol as a moisturizer that reduces water loss through the skin and supports re-epithelialization (Ebner et al., Am J Clin Dermatol 2002; Proksch et al., J Dermatolog Treat 2017). Much of this literature is tied to industry. The 2020 and 2017 reviews include Bayer employees as authors, and Bayer also makes dexpanthenol products (Samadi et al. 2022). The clearest benefit is early healing speed in small within-patient studies, and it should not be assumed for deep wounds or for oral B5.

Hair

In 50 people with diffuse hair loss, 6 weekly intramuscular injections of dexpanthenol 250 mg and biotin 5 mg improved hair fall and density from baseline, but the trial compared two brands with no placebo arm (Samadi et al., Dermatol Ther 2022). It cannot show that either vitamin works.

Side effects and risks

High oral doses

Toxicity appears low. No upper limit exists because systematic dose-response data are lacking, not because high doses have been proven safe:

  • US. The National Academies found no adverse-effect data from which to derive an upper limit (IOM 1998).
  • EU. The Scientific Committee on Food also could not derive a number. It noted occasional diarrhea and water retention at 10–20 g/day, and no side effects in a placebo-controlled arthritis trial that raised calcium pantothenate to 2 g/day for 8 weeks (SCF 2002).
  • Acne trial. At 2.2 g/day for 12 weeks, blood counts and liver function did not change, but with about 20 people on treatment this cannot rule out uncommon harms (Yang et al. 2014).

Liver enzymes with a megavitamin mix

In 41 children with attention deficit disorders given daily maximums of 1.2 g calcium pantothenate, 3 g niacinamide, 3 g ascorbic acid and 0.6 g pyridoxine, 42% exceeded the upper limit for serum transaminases while on vitamins. The regimen also failed to improve behavior (Haslam et al., Pediatrics 1984). Both IOM and SCF concluded that this result cannot be attributed to pantothenic acid specifically.

Eosinophilic pleuropericarditis

We verified one published case. A 76-year-old woman with no allergy history developed pleurisy and pericardial tamponade (fluid compressing the heart), with blood eosinophils of 1,200–1,500 cells/mm³, after taking vitamins B5 and H (biotin) for 2 months. Infection, autoimmune and cancer screens were negative, and she recovered after the vitamins were stopped (Debourdeau et al., Ann Pharmacother 2001).

A single case involving two vitamins cannot establish cause or show which vitamin was responsible, and the abstract does not give the doses. The authors did consider the link plausible and urged awareness. The ODS fact sheet does not mention it, and the IOM report predates it.

Skin allergy to topical products

Dexpanthenol is usually well tolerated, with a low risk of irritation or sensitization (Ebner et al. 2002). Allergy still occurs and is being found more often. A 2025 review reports rising rates of positive patch tests, from 0.2%–0.7% to 1.2%, including from products marketed as hypoallergenic (Weber & Hylwa, Dermatitis 2025).

Interactions

Pantothenic acid has no known clinically relevant interactions with medications (NIH ODS).

In the US, pantothenic acid, calcium pantothenate and pantethine are sold in dietary supplements (NIH ODS). Dexpanthenol is also an ingredient in FDA-approved multivitamin injections, such as one that supplies 15 mg per 5 mL vial and is indicated for preventing vitamin deficiency in people on parenteral nutrition (DailyMed).

Pantothenic acid and its derivatives are not named on the WADA 2026 Prohibited List.

Key takeaways

  • Essential, and rarely lacking. The adult Adequate Intake is 5 mg/day, typical diets supply about that much, and documented deficiency is confined to extreme circumstances.
  • The form matters. Calcium pantothenate, pantethine and topical dexpanthenol have separate evidence, and results for one should not be applied to another.
  • Acne evidence is weak. It rests on one small, sponsored trial of 2.2 g/day with unbalanced groups, unreplicated and absent from the recommendations in the AAD guideline abstract.
  • Pantethine lowers lipids modestly. Placebo-controlled effects were small in the largest trial (LDL about −4 mg/dL), and no trial we found reports cardiovascular events.
  • No performance benefit shown. The one human trial we could read, in six cyclists, found none, and no resistance training trials were found.
  • Low toxicity, thin data. No upper limit exists because dose-response data are lacking. Diarrhea is reported at 10–20 g/day, one case report links B5 and biotin to life-threatening eosinophilic pleuropericarditis, and competition with biotin is shown only in cell culture.

Sources

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