Pantethine and Arterial Plaque Removal

What is Pantethine?

Pantethine is the active form of pantothenic acid (better known as vitamin B5). In the body, pantothenic acid is converted to pantethine.  Pantethine supplements (not pantothenic acid) have been shown to significantly reduce:

• Serum triglycerides,
• Total cholesterol, and
• LDL-cholesterol (the so-called “bad cholesterol”) levels
• Increasing HDL (“good cholesterol”) levels in several clinical trials.

Most studies have been smaller but the accumulated number of them becomes impressive.  In a 16-week study of 24 menopausal women with high cholesterol, pantethine yielded significant reductions of total cholesterol, LDL, and LDL/HDL ratio.  Another study of pantethine in 7 children and 65 adults with high cholesterol and/or high triglycerides showed a significant reduction in total cholesterol, LDL, and triglycerides- as well as a substantial increase in HDL.

In another illustrative clinical trial, researchers examined the effect of oral treatment with pantethine on 20 patients with elevated cholesterol and triglycerides.  They found significant decreases of total cholesterol, LDL, and triglycerides, with increased levels of HDL.

Pantethine also has the advantage of being an effective treatment for high cholesterol while avoiding the undesirable side effects of synthetic lipid-lowering drugs.  In fact, there appears to be no toxicity or side effects from pantethine, making it an attractive and natural treatment alternative.  Pantethine has been used for the past 30 years in Japan, where it is approved as a pharmaceutical agent for the purpose of increasing HDL-C, the “good cholesterol” needed by the body to maintain a healthy heart.

Although Pantethine is derived from pantothenic acid, pantethine is not the same as pantothenic acid.  It is important to remember that the two substances are not interchangeable.  Pantothenic acid has its own benefits – but it is pantethine that lowers cholesterol and other lipid levels!   Research indicates that pantethine supplements are helpful in reducing total cholesterol, LDL cholesterol, and triglyceride levels.  At the same time, it raises the good HDL cholesterol in the body.

Pantethine works by inhibiting cholesterol manufacture and accelerating the utilization of fat as an energy source. As the biologically active form of pantothenic acid and direct precursor to Coenzyme A (CoA), pantethine plays a role in:

• the synthesis of fatty acids,
• the degradation of fatty acids,
• the Krebs cycle in which most of the body’s energy is produced,
• the acetylation of choline-the major neurotransmitter of the body,
• the synthesis of antibodies,
• the utilization of nutrients-including fats, proteins, and carbohydrates,
• the maintenance of blood sugar levels,
• the synthesis of porphyrin-a heme precursor of importance in hemoglobin synthesis,
• the metabolism of some minerals and trace elements,
• the synthesis of steroid hormones, and
• the detoxification of drugs, including sulphonamides.

This makes pantethine good for several related benefits.  You may have noticed the several highlighted “increases HDL” references.  We are very interested in that because HDL help grab and carry the arterial plaque that we are loosening up to the liver.  This and other aspects apply to both Artery Clear as well as Cholesterol Balance.

Diabetes

Pantethine may be a good cholesterol-lowering alternative for people with diabetes, who cannot take niacin due to the potential side effects on blood sugar regulation.  The FDA estimates that 90 million American adults, roughly half the adult population, have elevated cholesterol levels.  Doctors who conducted another study in Italy tested the effectiveness of pantethine in treating high cholesterol in women.  After 16 weeks of treatment, significant reductions of total cholesterol, LDL-cholesterol and LDL-C/HDL-C ratio could be observed.  The authors of the study recommended that pantethine should be considered in the long-term treatment of high cholesterol occurring in the perimenopausal age. These and several open studies have specifically studied the use of pantethine to improve cholesterol and triglyceride levels in people with diabetes and found it effective- without causing harmful effects.

However, there is some concern that very high doses can cause side effects.  For these reasons, and being in combination with several other nutrients, we have opted to keep it at sufficient levels to experience benefits without side effects.

Triglycerides and Fatty Liver

In addition to the HDL production we are interested in, pantethine also lowers triglyceride levels. Studies in the effect of pantethine on triglycerides indicate that a daily dose of pantethine is effective in lowering triglyceride levels. Triglycerides are one of the forms of fat stored by the body and used for energy and new cell formation.  In fatty liver, large droplets of fat, containing mostly triglycerides, collect within cells of the liver.

Coenzyme A (CoA) is involved in more than 70 enzymatic reactions.  Pantethine is a precursor of CoA- and CoA is a co-factor in fatty acid oxidation and carbohydrate metabolism.  Some people have only modestly elevated cholesterol but very high triglycerides, so pantethine may be especially useful for them.

As a pleasant byproduct, pantethine appears to improve symptoms associated with having a fatty liver.  Since the liver filters out our loosened plaque – as well as many other things – we want a healthy and unplugged liver.  (The milk thistle in our Foundation multivitamin also helps here.)

The liver is also the organ responsible for changing fats eaten in the diet to types of fat that can be stored and used by the body. In a study conducted in Japan, 600 mg/day of pantethine was administered to 16 outpatients with fatty liver and hypertriglyceridemia.  This was to see whether pantethine improved fatty liver using abdominal plain computed tomography.  Nine of the 16-pantethine patients were no longer diagnosed as having fatty liver after the study period.

All-in-all, we are pleased to include pantethine in our Artery Clear.

   (Abstract):

As a precursor to Coenzyme A, a necessary component of the lipid catabolic process, pantethine would be a logical addition to lipid lowering regimens.  Interestingly, pantethine has been shown to lower triglycerides and LDL while increasing HDL by a mechanism other than the coenzyme A portion of the molecule.  Pantethine is thought to inhibit cholesterol synthesis as well as accelerate fatty acid break down in the mitochondria.  Sub-therapeutic doses can work synergistically with other ingredients to reduce cholesterol and triglyceride levels.

Wittwer C. Et. al. Pantethine lipomodulation: evidence for cysteamine mediation in vitro and in vivo. Atherosclerosis. 1987; 68(1-2):41-49
Cighetti G. Et al. Modulation of HMG-CoA reductase activity by pantetheine/pantethine. Biocheim Biophys Acta. 1988; 963(2):389-393

Pantethine References:

Arsenio L, Bodria P, Magnati G, Strata A, Trovato R. “Effectiveness of long-term treatment with pantethine in patients with dyslipidemia.” Clin Ther 1986;8(5):537-45

Angelico M, Pinto G, Ciaccheri C, et al. Improvement in serum lipid profile in hyperlipoproteinaemic patients after treatment with pantethine: a crossover, double-blind trial versus placebo. Curr Ther Res. 1983;33:1091-1097.

Avogaro P, Bon GB, Fusello M. “Effect of pantethine on lipids, lipoproteins and apolipoproteins in man.” Curr Ther Res 1983;33:488-93.

Bertolini S, Donati C, Elicio N, et al. Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children. Int J Clin Pharmacol Ther Toxicol. 1986;24:630-637.

Binaghi P, Cellina G, Lo Cicero G, Bruschi F, Porcaro E, Penotti M. Evaluation of the cholesterol-lowering effectiveness of pantethine in women in perimenopausal age. Minerva Med. 1990;81:475-9.

Bertolini S, Donati C, Elicio N, et al. Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children. Int J Clin Pharmacol Ther Toxicol. 1986;24:630-7.

Carrara P, Matturri L, Galbussera M, et al. Pantethine reduces plasma cholesterol and the severity of arterial lesions in experimental hypercholesterolemic rabbits. Atherosclerosis. 1984;53:255-264.

Da Col PG, Cattin L, Fonda M, et al. Pantethine in the treatment of hypercholesterolemia: a randomized double-blind trial versus tiadenol. Curr Ther Res. 1984;36:314-322.

Donati C, Barbi G, Cairo G, et al. Pantethine improves the lipid abnormalities of chronic hemodialysis patients: Results of a multicenter clinical trial. Clin Nephrol. 1986;25:70-74.

Gaddi A, Descovich GC, Noseda G, et al. Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia. Atherosclerosis. 1984;50:73-83.

Maggi GC, Donati C, Criscuoli G. “Pantethine: a physiological lipomodulating agent, in the treatment of hyperlipidemias.” Curr Ther Res 1982;32:380-6.

Nagiel-Ostaszewski I, Lau-Cam CA. “Protection by pantethine, pantothenic acid and cystamine against carbon tetrachloride-induced hepatotoxicity in the rat.” Res Commun Chem Pathol Pharmacol 1990 Feb;67(2):289-92