Pantethine

Pantethine (bis-pantethine or co-enzyme pantethine) is a dimeric form of pantetheine, which is produced from pantothenic acid (vitamin B5) by the addition of cysteamine. Pantethine is composed of two molecules of pantetheine linked by a bridging disulfide. Pantetheine is an intermediate in the production of coenzyme A by the body. Most vitamin B5 supplements are in the form of calcium pantothenate, a salt of pantothenic acid, with doses in the range of 5 to 10 mg/day. In contrast, pantethine is sold as a dietary supplement for lowering blood cholesterol and triglycerides at doses of 500 to 1200 mg/day. Pantethine (bis-pantethine or co-enzyme pantethine) is a dimeric form of pantetheine, which is produced from pantothenic acid (vitamin B5) by the addition of cysteamine. Pantethine is composed of two molecules of pantetheine linked by a bridging disulfide. Pantetheine is an intermediate in the production of coenzyme A by the body. Most vitamin B5 supplements are in the form of calcium pantothenate, a salt of pantothenic acid, with doses in the range of 5 to 10 mg/day. In contrast, pantethine is sold as a dietary supplement for lowering blood cholesterol and triglycerides at doses of 500 to 1200 mg/day. Pantethine is available in the United States as a dietary supplement because of evidence of its health benefits for lowering elevated LDL-cholesterol and triglycerides, and raising HDL-cholesterol (the 'good' cholesterol). In multiple clinical trials of patients with elevated cholesterol and triglycerides, total and LDL cholesterol were decreased by an average of 12%, triglycerides decreased by 19%, and HDL cholesterol was increased by 9%. These clinical trials were conducted with daily intakes ranging from 600 to 1200 mg/day. Within this dose range there is no evidence of a dose-effect relationship, i.e. changes in lipid concentrations overlapped across the range of doses. Direct dose-response evidence is not available because no trial tested more than one dose. A few trials conducted in Japan tested 300 mg/day and reported decreases in total cholesterol of about 4%, increases in HDL-cholesterol of 5% and inconsistent results for triglycerides. Most of the literature on pantethine and lipids is 20–30 years old, but recent carefully controlled trials of 600 and 900 mg/d doses have shown similar statistically significant lowering of LDL cholesterol in individuals with greatly or moderately elevated levels of blood lipids.