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Traditionally, this is a dermatological problem treated with various topical cleansers, antibiotics and drugs such as accutane. Acne can be a frustrating problem. Many acne sufferers have been to many doctors over years and have tried many treatments with little help. Left Image: Mona Lisa with acne on forehead (red arrow) courtesy of Wikimedia Commons. For women especially concerned about their complexion and a beautiful appearance of the skin, even a small amount of acne is a serious and intolerable situation.  Left Image: diagram of hair follicle with sebaceous glands and sebum (pink). Courtesy of Wikimedia Commons Co-Enzyme A and Pantothenic Acid for Acne  I first became aware of the use of Vitamin B5 (also called pantothenic acid) as a treatment for acne from an article in the Journal of Orthomolecular Medicine by Lit-Hung Leung from 1997. In this article, Acne is caused by slow lipid metabolism which can be corrected by adding Acetyl-CoA to speed up fat metabolism. Image left: Co Enzyme A and location of Pantothenic Acid in the CoEnzyme A molecule at the left side. Pantethine is made of two Vitamin B5 molecules linked together with two sulfurs (see below diagram), and CoEnzyme A is actually a Pantothinic Acid molecule attached to an ADP molecule. ADP is widely available throughout cellular biochemistry as the currency of energy in the cell.  Left Image: Pantethine Courtesy of Wikimedia Commons Note two B5, Pantothenic Acid Molecules attached with the two suflur molecules (S) in the center.It is well known that the Beta Oxidation of Fatty Acids depends on CoA. Acetyl CoA deficiency allows the buildup of oil in the skin causing the acne. Increasing the amount of Acetyl CoA available in the body speeds up metabolism of fatty acids and the oils are used for energy production. Taking the vitamin, pantothenic acid is the easiest way to increase acetyl Co A. Dr. Leung gave his acne patients rather large doses of 5-10 grams of Pantothenic Acid a day with considerable improvement in their acne. He reported success with this regimen. Message Board Discuss Pantethine and B5 for Acne I then looked for additional information on the use of B5 for Acne and found a large body of anecdotal information from many acne sufferers on message boards who relate their experience with various treatments including pantothenic acid. I found that many of these acne sufferers found that the vitamin B5, Pantethine, did work for them. However, a common complaint was that the large amount of pantethine (10 grams) was hard to take. L-Carnitine Used as Booster After reviewing the biochemical pathways involved, I realized that smaller amounts of pantothenic acid could be used if a booster agent was given along with it. This booster agent is L-carnitine, another vitamin which is well known as a fatty acid transporter across the mitochondrial membrane.  Reducing or Eliminating Acne with Pantethine and L CarnitineWe started using this protocol of Pantethine 750 mg with 250 mg of L Carnitine three times a day, and have had excellent success rates in reducing or eliminating acne with this regimen. An added advantage of this regimen is a good cosmetic result with smaller pore size and smoother skin. The vitamins are safe with no adverse side effects. Left Image: advanced disfiguring acne vulgaris courtesy of Wikimedia commons A college student under my care was making preparations for her wedding when she noticed some new acne lesions on her face. We immediately began the Pantethine and L-Carnitine. Her acne cleared up immediately, and she was quite pleased. By now, we have a number of satisfied patients who have used this program to clear up acne. I myself have used the program and can report that it works quite well. Also Used for Weight Loss Since this anti-acne regimen is essentially a fat burning protocol, it is also useful for weight loss as noted in this article. No Adverse Side Effects The vitamins have no adverse side effects. Acetyl CoA Important for Cholesterol and Steroid Biosynthesis Acetyl CoA is the first step in the body's synthesis of Cholesterol. Cholesterol is then used to make all steroidal hormones. Many of the steroidal hormones are made by the adrenal gland, so it is very logical that B5 deficiency can result in a syndromes called adrenal failure, or the inability to synthesis steroidal hormones such as Cortisol. See my previous article on Adrenal Fatigue for more information about this syndrome. Systemic Lupus and Acetyl CoA Deficiency  Systemic Lupus is an autoimmune disease with no known cause first described in 1851. A blood test for anti-nuclear antibodies is diagnostic. However, a number of features of Lupus suggest a link with steroid hormone synthesis. For example, there is a well know tendency for lupus to flare up under certain conditions in which there is a greater demand for steroidal hormone biosynthesis, such as puberty, and pregnancy. Females are more affected than males by a ratio of ten to one. Lupus preferentially affects females because they have greater demands for hormone production than do males. These lupus flares seem to correlate with demand for higher levels of hormones. Production of higher hormone levels could deplete the stores of precursor molecules for production of these hormones. The first such precursor molecule is acetyl CoA, so a deficiency in acetyl CoA could be the culprit. Left Image: Young woman with malar rash (butterfly rash) suggesting lupus. Image Elizabeth Hammond, MD, University of Utah. Low Hormone Levels in Lupus Another feature of female lupus patients is that when hormone levels are measured, they tend to run low. Irregular menstrual cycles and absent menses is common among lupus patients. Giving hormones to raise levels seems to help. DHEA for Lupus For example, Quality of Life for Lupus patients seems to be ameliorated by DHEA administration, an adrenal hormone precursor. DHEA adninistration can even reduce the number of Lupus Flares. After menopause when hormone production declines dramatically, there is a reduction in Lupus flares and the disease becomes quiescent. Acne tends to be a common issue for lupus patients given DHEA, and this would be expected assuming there is an underlying B5/Acetyl CoA deficiency. Administration of B5 along with the DHEA usually resolves the acne. Low Adrenal Cortisol in Lupus Cortisol production is also decreased in lupus patients, explaining why they do better when treated with steroids. Drug Induced Lupus Another interesting feature of Lupus is that the disease can be caused by 70 various drugs. The three most common are procainamide, hydralazine and isoniazid. These drugs have nothing in common except they are metabolized by the acetylation pathway, a connection to Acetyl CoA. Could Lupus be Caused by a Combined Deficiency ? The first manifestations of Deficiency States are in the skin, joint and connective tissue with various lesions. The vital organs are only involved much later on. For example, deficiency states such as beri beri and scurvy initially spare the vital organs, and involve the skin and musculoskeltal system. Lupus follows this pattern as well. In his article, Dr. Leung noted a connection between Systemic Lupus (SLE) and Acetyl CoA deficiency, however he was not the first to suggest giving Pantethine (Vitamin B5) to Lupus patients. There were a number of reports on this in the 1950's. However, early studies seemed to discredit the whole idea of B5 deficiency or acetyl CoA deficiency or a genetic acetylation defect in Lupus. Nonetheless, Leung reported improvement in his lupus patient who supplemented with pantothenic acid. Late stages of Lupus are characterized by specific anti nuclear antibodies (ANA test) which obviously will not be affected by giving pantothenic acid. However, much can be done to improve quality of life of the lupus patient. Perhaps a combined approach supplementing with bioidentical hormones such as estradiol, progesterone, DHEA, Cortef, testosterone as well as vitamin mineral supplementation with pantethine, and others would be the most logical way to help lupus patients get back their health. Facial Rash of Lupus, Pregnancy and Addison's Another interesting connection is the appearance of a skin rash on the face in lupus flares with pregnancy. There can be increased facial skin pigmentation in pregnancy itself (without lupus) called Melasma, also known as chloasma or the mask of pregnancy. Also, Addisons Disease, adrenal failure, or failure to produce sufficient adrenal hormones results in hyper-pigmentation changes in the face and elsewhere. Characteristic sites are skin creases in the hands, and the inside of the cheek (buccal mucosa), also old scars may darken. All three, Lupus, Prognancy and Addisons, share the same mechanism, the need to stimulate more adrenal steroidal hormone synthesis by increasing ACTH levels (ACTH = adreno cortico stimulating hormone). ACTH is secreted by the pituitary to stimulate more adrenal hormone synthesis. Increased ACTH also causes an increase in melanocyte-stimulating hormone (MSH). The melanocytes cause the pigmentation. A Lupus Patient Tells Her Story A 45 year old lupus patient came to see me in the office. She had been to many rheumatologists and specialists over the years with a confirmed diagnosis of lupus. She appeared under weight and chronically ill, and had absent menses for the last 7 years. Her main complaint was severe chronic fatigue and inability to gain weight. In the past she had been on many of the usual drug treatments for lupus with many adverse effects and no real improvement in quality of life. Initial testing showed low salivary cortisol, and low serum levels for the other hormones, DHEA, estradiol, progesteron and testosterone. She also had low B12 and Vitamin D levels. She was started on bio-identical hormones, Pantethine (B5), B12 and Vitamin D. About three months after starting treatment, she calls me and states she is feeling much better with improved energy levels, and she just had a normal period, the first one after seven years of absent menses. Previous Articles on Adrenal and B5: For more information on the use of B5, Pantothenic Acid and Adrenal Fatigue, see my previous article: Adrenal Fatigue by Jeffrey Dach MD Jeffrey Dach MD 4700 Sheridan Suite T Hollywood Fl 33021 954-983-1443 www.jeffreydach.com www.drdach.com www.naturalmedicine101.com www.truemedmd.com Links and References http://www.b5acnetreatment.com/2007_03_01_archive.html http://www.acnetohealth.com/vitamin-b-5-acne.html http://forum.lef.org//default.aspx?f=35&m=22990 http://deficiencydiseases.com/ http://www.coenzyme-a.com/acne_vulgaris.html The Effect of Pantothenic Acid on Acne Vulgaris http://www.coenzyme-a.com/research.html http://www.coenzyme-a.com/research.html http://www.coenzyme-a.com/research.html http://www.acne.org/messageboard/index.php?showtopic=15341 http://www.ironmagazineforums.com/history/topic/23051-1.html http://www.clearskin.net/viewtopic.php?t=1907 Here is a brief summary of my own B5 use: by William G. Gray • Started November 10th at 5 grams per day • After noticeable acne clearing, increased dosage after 1 week to 10 grams per day • After another 2 weeks of more dramatic improvements, increased dosage to 15 grams per day, and maintained daily dosage to present I spread my B5 intake over the day, divided into 6 x 2.5 gram doses. I've found the B5 seems more effective if I don't take it with food, but rather take it at least 10-15 minutes before a meal or at least an hour afterward. I currently use TwinLab brand, 500mg B5 capsules. My improvements have been that I now get virtually no acne…except if I eat a lot of sugary and/or oily food, in which case the few acne bumps I do get are extremely minor and disappear quickly, never getting infected. My skin is still slightly oily from the seborrheic dermatitis, but it is no longer as red and irritated as it used to be, and the dermatitis seems to be gradually fading. The only negative side effects I noticed were minor diarrhea at first, accompanied by hunger cravings, both of which disappeared after a few days (the diarrhea after about 2). I did notice the diarrhea effect again when I increased my dosages, but it again disappeared after a couple of days. I have noticed at least two positive side effects: increased energy throughout the day, and what seems to be a boost to my immune system; I have been exposed to all manner of colds, flu, and illness this winter and have not gotten sick, whereas normally I would have gotten at least a couple of colds. Sincerely, William G. Gray http://b5foracne.vze.com/ http://b5foracne.vze.com/ http://www.vitaminb5acne.com/faq.html http://orthomolecular.org/library/jom/1997/articles/1997-v12n02-p099.shtml http://deficiencydiseases.com/ http://orthomolecular.org/library/jom/1997/pdf/1997-v12n02-p099.pdf It has been hypothesized that acne vulgaris is linked to Coenzyme-A due to its activity in fatty acid metabolism and sex hormone synthesis (Lit-Hung Leung, M.D., Pantothenic Acid in the Treatment of Acne Vulgaris, “A Medical Hypothesis” , Journal of Orthromolecular Medicine Vol. 12, No. 2, (1997)). Coenzyme-A is formed from adenosine triphosphate, cysteine and Pantothenic Acid. A deficiency in Pantothenic Acid potentially inhibits or reduces the activity of Coenzyme-A in its fatty acid metabolism and sex hormone synthesis. If the fatty acid metabolism activity is diminished, lipids, which are a combination of fatty acids, begin to accumulate in the sebaceous glands thereby increasing the sebum excretion and in turn, the production of acne vulgaris. Pantothenic Acid is essential for the proper functioning of Coenzyme-A and its related activity; if a deficiency in Pantothenic Acid exists, an increase of sebum production occurs due to the accumulation of lipids in the sebaceous glands. Pantothenic Acid in the present invention therefore reduces sebum production.
Leung LH. Department of General Surgery, Hong Kong Central Hospital, Hong Kong. For years, the pathogenesis of acne vulgaris has been known to be strongly influenced by hormonal factors. However, the exact role of and the interrelationship among the various hormones in question have not been well elucidated. Here, I wish to suggest a radically different theory for its pathogenesis and relate its basic pathology to a deficiency in pantothenic acid, a vitamin hitherto not known to cause any deficiency syndrome in humans. Hence, the effect of hormonal factors in this disease entity becomes secondary to that of the availability of pantothenic acid. A complete cure of this condition is effected by a very liberal replacement therapy with the vitamin. http://ezinearticles.com/?Using-Pantothenic-Acid-(Vitamin-B5)-as-an-Acne-Treatment&id=48855 http://www.ncbi.nlm.nih.gov/pubmed/3976557?dopt=Abstract http://lpi.oregonstate.edu/infocenter/vitamins/pa/ http://askwaltstollmd.com/archives/acne/71477.html#72393 Scientific evidence suggests that nutritional supplements may be useful treatments for acne, a common and embarrassing skin condition that afflicts both adults and teenagers. Increased stimulation of the skin and bacterial infections appear to play major roles in the development of acne. Conventional treatments include drying agents, topical anti-inflammatory medications, antibiotics and, in severe cases, steroids. While prescription medications may be effective, many of these substances have side effects that limit the duration of use. Some studies suggest that certain natural oral and topical treatments may work as well as prescription medications, with fewer reported side effects. Several studies have shown that taking zinc may reduce the severity of acne.1 2 Most of the studies used 50 mg of zinc three times per day. However, with the development of better absorbed forms of zinc, many doctors now recommend 30 mg two or three times per day initially, and lower amounts after the first 12 weeks. One study found that zinc may be as effective as oral antibiotic therapy.3 It is recommended to take zinc with food to avoid getting an upset stomach. Long-term use of zinc may require adding 1 to 2 mg per day of copper to prevent copper deficiency. The results of another study suggest that vitamin B5 (pantothenic acid) may also be useful in treating acne.4 However, participants in the study took 10 grams per day orally, which is an extremely large amount, and also used a 20% topical cream of vitamin B5 daily. Although no significant side effects occurred, the long-term safety of such large amounts taken orally has not been studied. Mild cases cleared in a couple of months and more severe cases took up to six months to clear. It is unknown whether lower amounts would produce the same results. In another study, high amounts of vitamin A were used to treat severe acne in teenagers.5 Girls took up to 300,000 IU per day and boys took up to 500,000 IU per day. Although the acne was lessened, the benefit seemed to diminish once the oral vitamin A therapy was discontinued. Such high intake is potentially toxic and should only be done under the supervision of a physician. Women with premenstrual acne may find benefit with vitamin B6. One small trial found 50 mg per day of vitamin B6 (pyridoxine) alleviated flare-ups of acne before the onset of their menstrual cycles.6 Using topical formulations may help with acne as well. One study showed that a 4% niacinamide gel used twice daily for two months significantly reduced acne lesions.7 Other trials have demonstrated that a 20% azelaic acid cream worked as well as benzoyl peroxide, oral tetracycline and retinoic acid.8 9 Although these topical formulas are natural substances, they are available only by prescription. For more information on herbal therapies for acne, see today’s related Newswire article. References: 1. Hillström L, Petterson L, Hellbe L, et al. Comparison of oral treatment with zinc sulfate and placebo in acne vulgaris. Br J Dermatol 1977;97:681–4. http://www.dermatologytimes.com/dermatologytimes/article/articleDetail.jsp?id=188762 • Vitamin A acetate 5000 IU Pantethine:
After reading about pantethine (the active form of B-5), i'm wondering why people aren't trying it instead of b5? From what ive read, you get a better effect with a lot less to no side effects. Because you only have to take around 900 mg or so of pantethine, there will be no adverse side effects. Has anyone tried pantethine that had no success with b5? or if you never used b5 but are having success with pantethine please share. I'm just curious as to why people are using this supplement that seems like a much healthier avenue than b5 If you want to try it, try and include a 450mg or 300mg pill and gradually diminish your B5 dosage over time. Play around with dosage and see what works best for you, that's what I did. This is so much better than trying to swallow 6-7 1G giant B5 pills. for the three of you: malia, 2SG, and dude123, I wouldn't stop taking B5 when you get your order, definitely take both for some time and diminish B5 accordingly. ============ Now that I am finished Breast feeding I started 5 grams again, but then I read about Pantethine and have been taking that for the last week. So far there has been no complications from switching from b-5 to pantethine (900mg). My face looks great. No new break outs after the initial breakout beginning the first week of taking the b-5. I can tell my skin is much dryer and my lips are a tad dryer, I've been needing to use carmex on them. My hands need lotion too. Between Pantethine and Dan's BP GEL I look and feel great!! I think this is really promising!! I'm using the NOW brand of Pantethine. It cost 22.49 (usd) at my local healthfood store. No new breakouts!! I know it's working because I've got to use Carmex on my lips and have a little bit dryer hands. I'm still not completely oil free on my face, but I can tell it's much less and my face is clear. So far so good. I'm really happy about this prospect!! (to be fair I've always been on BP, for the last 15 yrs and it's always helped my face, but I've never been clear always about 3 or more spots in one day. I don't follow Dan's routine. But I do believe in his BP Gel. I don't eat very well, I have hormonal acne and I only wash my face when I take a shower, which is every two days because the ends of my hair tend to be dry! And I switched from Neutrogena's BP to Dan's 3 days ago! I only put it on at night before I go to bed.) Pantethine is safer and works the same. It is the active ingredient in Vitamin B5. If you have -any questions, feel free to ask me and I'll respond in this thread. K so I started taking Pantethine for my acne last month with a B-complex daily, was on 1200 MG's each day spread into 3 pills, usually around 5-6 hours apart, 450/450/300. after about 3 days i noticed my skin a hella lot less oily, but then it seem'd to slowly return at around day 5, i experince a pretty lame breakout after a few days that got a little worse up untill about 2 weeks, at about 2 weeks i started to see MINOR results i might be wrong .... anyways im a little over a month now and i have barely NO acne anymore, i didn't really notice at first but now that i look its al lred spots now theres NO acne, and my skin is looking fresher then FREAKING EVER. Pantethine owned all the little zits right away and then slowly *dried up* all other larger white heads. Now when i feel my face it feels smooth and im LOVING it, only continue'ing to get better too im still getting 1 major pimple each week but thety get owned QUICK LOL so yea, IM A BELIEVER, PATETHINE = OWNAGE gonna post my next update sometime in a few more weeks I hope it keeps working gonna alsp try some acv for my red spots see how that goes ... PEOPLE USE PANTETHINE FREAK B5 http://www.coenzyme-a.com/testimonial.html Dear Coenzyme-A Technologies, http://www.ncbi.nlm.nih.gov/pubmed/13985157 51. Welsh AL. Lupus erythematosus: Treatment by combined use of massive amounts of pantothenic acid and vitamin E. Arch Dermatol Syphilol 1954;70:181–98. Some patients showed improvement of symptoms which the authors http://archive.food.gov.uk/committees/evm/papers/evm0101.pdf Fair Use Notice: |
A Flawed and Corrupted Study
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