I've been arguing with myself for a few days now on whether or not to post this, but reading a post of MrsD's in the PN forum this morning pushed me over the edge....
http://neurotalk.psychcentral.com/post853029-40.html

Several months ago I began to notice a common thread popping up in researching several of my own medical issues (PN, chronic pain, arthritis, adrenal hormones, cystic acne, and others that escape me at the moment) - Pantothenic Acid (Vitamin B5).

Now... a couple of things about this B vitamin:

First, the RDA is very small - only about 5 mg per day. But we're learning that many of these RDAs were established many years ago, and really only constitute the amount necessary to avoid serious deficiency symptoms. And as in the case of B12, some people may actually need much more than the RDA. (e.g. The RDA for B12 is 2-3 mcg/day, while many PN sufferers take 1000 times that amount.) And in the case of vitamin D2 vs D3, there's also some old or bad information out there.

Second, admittedly, not much accepted research has been done on it. This doesn't surprise me; there's no money in it, and in todays world, research is driven for the most part by the prospect of lucrative patents and profits reaped from them. Of the research that has been done, much has been dismissed ("conflicting evidence", "insufficient evidence", "inconclusive evidence"....) but there seem to be mountains of anecdotal evidence. Again, admittedly, not the best kind; I'm generally a huge skeptic of anecdotal evidence. Give me solid science every time. So I'll even admit/confess to "situational hypocrisy" on this one.

But in this case, some extenuating circumstances have come into play:

1. My own professed philosophy, "If it can't hurt to try it, then it can't hurt to try it," and pantothenic acid has shown to be a very safe supplement, even in fairly large doses (like vitamins C & B12, the main danger/symptom of overdose seems to be diarrhea).
2. You can't argue with facts (and I'll get to that below).

3. There's no fanatic like a convert. (In this case, that would be me )

The reasons I began taking supplemental B5 daily were twofold (and for which the science was, IMO, solid):

1. Following the work of Dr. Forest Tennant, I had begun supplementing my severely low adrenal hormones, and B5 is known to support adrenal function; it is used in the synthesis of coenzyme A (CoA), and is the fuel for converting various adrenal hormones into other adrenal hormones. [citation misplaced ]

2. A study done in Germany reported 28 out of 33 PN patients experienced further improvement in their symptoms after adding taking B5 along with ALA.
http://www.diabeteslibrary.org/View....ntothenic_acid

I pretty much ignored/dismissed all the other claims for pantothenic acid - there weren't any credible studies!

I assume the B5 did what it was supposed to do with the hormones; I've felt better in general, and pain has decreased by almost 1/2.
http://neurotalk.psychcentral.com/thread156416.html

I know it improved my PN symptoms over just taking RLA (and I'm getting to that).

A little over a month ago, I ran out of B5 due to a foul-up in reordering (my fault). During that time, I noticed my pain levels increasing, my PN seemed to be flaring, as was my arthritis, and cystic acne. I didn't make the connection at first.

I got, and started, taking the B5 again about a week ago. My overall pain is back down to where it was, the PN flare stopped, and so did the arthritis and acne flares.... So I checked my pain journal, and went back further. I found (which I hadn't noticed or made the connection before because I wasn't looking for it or expecting it) that my arthritis and acne had improved significantly since taking the B5!

Apparently, I'm not the only one that's seen an improvement in arthritis and acne with B5; google: pantothenic arthritis or acne and check out the feedback.

Doc

To be fair I tried this when you brought it to the PN forum.

I started it in Sept...after my vacation. I took 1000mg a day,
for a month and saw no effect for me.

What that tells me is that perhaps some people, those with
reduced adrenal function, may benefit. But I am obviously not
in that group.

What really seems to do it for ME is ribose. I've just gone back on that after almost a year, with a hiatus, and it is just terrific
for me. I am also using l-tryptophan with good results too...but then
I am not using any antidepressants. Amitriptyline was a terrible failure for me after only one week....it raised my blood sugars! So I stopped it two months ago.

I don't take opiates for chronic pain, or other drugs in that class.
I have tramadol for severe night pain, but rarely use it.

So my experience is different from others who come here, especially those using RX drugs. Adrenal issues may exist, for some of those who read and post here, but not for me yet.

My PN pain is pretty good these days. But my arthritis is not terrific... we all have different problems.

"Too be fair"?

I don't see how that conclusion can be drawn at all(?)
What it tells me is that not everything works for everyone and maybe you don't need as much as some other people, just as some people don't need as much B12, or C, or whatever. Maybe it's an absorption/assimilation thing - don't know for sure. Lots of possibilities, but I don't see how it can be tied to adrenal function only.

The people who are taking B5 for acne, or arthritis, or other conditions, and seeing results don't all have reduced adrenal function either.

Adrenal fatigue (or insufficiency) can be caused by chronic pain, stress, infection/inflammation, environmental toxins, diet (caffeine, carbohydrates) and other factors - not just opioids. It's often found in people with diabetes and thyroid problems.
Google: adrenal fatigue causes
Google: adrenal fatigue diabetes

Sure, we're all different. I referenced your ribose post (which seems odd since several sites advise against it for diabetics) because you mentioned it was something you stopped, noticed a difference, and resumed. Stopping & starting (and checking my journal) was how I found some of these other effects the B5 was having for me - I wasn't looking for them.

If it had no other effect than stopping the cystic acne I and countless others have suffered our whole lives with, it'd be worth taking just for that.

I'm just beginning to wonder what else it may help that there are just no studies for yet.

Doc

There is a link on that thread, testing diabetics with various levels of ribose. Blood sugar testing etc, revealed no issues, in the range of up to 10 grams. This range is plenty IMO for
PNers, below 10 grams.
In fact ribose can lower elevated blood sugar which is a goal for many PNers. So yes, for me it is very useful!

https://docs.google.com/viewer?a=v&q...rQfgeRylUZNjTA

Ribose in HUGE doses is used by the body building community who are interested in large muscle mass and more
efficient energy production from that muscle during serious
weight lifting and resistance. I don't recommend this extreme use on these boards. Many supplements we see on the net come from the body building community and it is important to understand that the dose sizes are very different there.

Adrenal suppression may be part of the opiate effects on the pituitary/hypothalamic axis. It may not be just testosterone/androgen levels affected by opiates, it may be the ACTH also.

Pituitary adenomas are fairly common, and many people can have these without knowing.
It is estimated that 10% of people may have these, based on autopsies done during studies on people who have died from other reasons. Some drugs may cause them too (Risperdal is one). When a person has this, some hormones may be in excess and others suppressed. It can be very variable depending on which cells are damaged or increased.

So the adrenal cortex secretes:
1) androgens
2) glucocorticoids
3) mineralocorticoids

If you read the TBI (traumatic brain injury) forum here, you will
see some mention of pituitary function changes from head injuries also.

I am just saying that the usefulness of B5 for EVERYone, in high dose, is not probably necessary, unless there is some reason
like the adrenal cortex failure.

Acne in adults, can occur in later life... it is called "senile" acne.
Not a great name, I agree. Medically that word "senile" is also applied to OB situations, where women have children past age of 35...it is an "old" term.

But older people with severe acne in later life, often means, too MUCH hormone production. It occurs in Cushing's syndrome in both males and females. It can come back for women, around menopause as the estrogen falls, and their endogenous androgens take over. Women with higher androgen levels may display more acne than others with lower androgens.

Acne can occur with poor EFA status, low zinc intake, low folate, and low niacinamide levels, as well. There used to be a Derm product that had zinc, nicotinamide and folic acid in it:
Nicomide..now it is available generically.
from http://www.skinandaging.com/article/6571
I used to see many people respond to this mixture, esp those adults with rosacea had very good response to this product.

Keep in mind that taking a really high dose of a specific vitamin for a long time may result in a vitamin dependency. This has been seen with high dose Vit C intakes, but may occur with other
high dose use of others. Some people are born with an error of some enzyme of metabolism that requires a high dose supplement. This is also called a dependency. Infantile spasms is one example of children born with a high need for B6 (pridoxine).
Whether the dependency is inherited or generated by long term high dose use, it can occur when you suddenly withdraw the high dose substance and signs of "deficiency" then occur. This is a relatively new medical concept, but something to consider when taking really high doses of something.

So B5 works for you,and I appreciate your information posted here. It, however, did not do anything for me. And I think deficiency of B5 is quite rare. It may reside in some genetic fault, of processing the vitamin, or very poor diet.

I notice in the Wiki comments on the studies, one of them used 10-20 GRAMS to get benefits for acne in Asia.
http://en.wikipedia.org/wiki/Pantothenic_acid

And I would like to add that you should never worry about posting
something here on NT (as long as you remain within our guidelines). These forums are for discussion and opinions about things.

If that was inferred, there was miscommunication.

I am just saying that, the more I read about it, the more I believe that there may be untapped potential there, and IMO it is a vitamin worthy of much more investigation/study than it's received.

There are some things (many things I never knew about) that folks may find it helpful for that they might never have known/suspected, and while I agree it's probably not necessary, the only way to know is to try it and see.

If someone were curious in pursuing this, I'd suggest googling: pantothenic acid condition
(substituting whatever condition they're wondering about for the word "condition")

Doc