Marginal deficiency

Pantothenic acid occurs to some extent in all foods, so that dietary deficiency of this vitamin is extremely rare. However, pantothenic acid deficiency in humans has not been well documented and probably does not occur in isolation but in conjunction with deficiencies of other B vitamins.

Frank deficiency

Clinical cases of defiencies of pantothenic acid have not been identified, although it has been implicated in the "burning feet" syndrome, a condition observed among malnourished prisoners of war in the 1940s. Deficiency symptoms have been shown experimentally by administering the antagonist omega-methyl pantothenic acid. They included fatigue, headaches, sleep disturbances, nausea, abdominal cramps, vomiting and flatulence. The subjects complained of tingling sensations in the arms and legs, muscle cramps and impaired coordination. There was cardiovascular instability and impaired responses to insulin, histamine and ACTH (a stress hormone).

When healthy young men were fed a synthetic diet virtually free of pantothenic acid for 9 weeks, the only main symptom was fatigue. Dietary deficiency of pantothenic acid in animals results in a wide variety of abnormalities, such as retarded growth, impaired fertility, gastrointestinal lesions, neuromuscular disorders, dermatological disorders, adrenal gland necrosis and sudden death.

Groups at risk of deficiency

Since alcohol interferes with the utilisation of pantothenic acid, heavy drinkers have increased needs of vitamin B5. Low concentrations of pantothenic acid in the blood have been found in women on oral contraceptives whose intake usually be just adequate. Urinary excretion of pantothenic acid is increased in diabetes and absorption may be impaired in people with disorders of the digestive tract. Many studies have shown that elderly people often have low intakes and low blood levels. From animal experiments it could be expected that pantothenic acid requirements are increased during growth, pregnancy and lactation.

It has also been noted that various post-surgical complications may be due to pantothenic acid deficiency.