Vitamin B5 for Ankylosing Spondylitis and Iritis

B-vitamin-sm
Image adapted from E-codices on Flickr

Based on about 20 years of experience with self-treatment, I firmly believe that daily therapeutic doses (500mg/day) of Vitamin B5 (Pantothenic Acid, Calcium Pantothenate) have an overall protective/preventive effect on my Ankylosing Spondylitis and Iritis (acute anterior uveitis), and that its effects are felt over time, not immediately.

Below I describe my personal experimentation.

I conclude this post with information from research articles.

Personal experimentation

I have had Ankylosing Spondylitis and its related condition, Iritis (Acute Anterior Uveitis) since 1987. It was not officially diagnosed until I had enough damage to my sacroiliac joint to show up on an xray in 1999.

One day in the 1990s, I was in a London Drugs store (a Canadian drug store chain) waiting to pick up a prescription, and I happened to take a book off the shelf. It was written by a woman with many of my arthritis symptoms. She said that she tried taking Vitamin B5 (Pantothenic Acid) in large doses (like 500 mg/day) and that it alleviated her symptoms. I wish I had bought the book or remembered its title!  (Does anyone out there know which book this was?)

I started experimenting with taking 500mg Vitamin B5 in the mid-1990s. Apparently there is no known toxicity, so you can take larger doses.

  • At first, it didn’t seem to do much, though I wasn’t taking it every day.  I gave up on it around 1997. Then a year later, I had the worst joint flare ups I had ever experienced, in the years 1998-2001. I was in my late 20s but felt and looked like I was an old grandma crossing the street slowly, limping along. My hip joint felt like it was grating bone against bone. I’d wake up in pain. Activity made it worse, not better.
  • Out of frustration I returned to taking B5 again. I figured it would not hurt to try, rather than be on steroid drugs all the time.  Over time, the arthritis symptoms subsided considerably, and I had fewer flare-ups per year.  I decided that it did make a difference, after all.
  • Since 2001, I have often noticed hints of an iritis or arthritis flare-up within a week after I missed two or more daily B5 doses. It has happened so many times that it cannot be a mere coincidence.
  • When I do get a flare-up of iritis (uveitis), I double my daily dose.  It speeds up the healing process considerably. A 6-week flare up (including the weeks of slowly tapering off the predisnolone eye drops from 1x/hour to 1x/day) usually became a 3- or 4-week flare up.  My eye doctor and I both noticed the difference!

On the other hand, my family members have not seen any benefit to using B5 for Rheumatoid Arthritis or occasional Bursitis.

Vitamin B5 is not that easy to find: it is not sold in most Canadian chain grocery stores or drug stores. You have to go to a natural food store or nutrition supplement store.  It is fairly cheap as vitamins go.

I take my B5 along with a B-complex vitamin since the B-vitamins work together, and I take it with food, since it is acidic.

Research on Vitamin B5 that may be relevant to AS and Uveitis

Kelly (2011) noted that some studies showed theraputic doses of Vitamin B5 helped with Rheumatoid Arthritis:

  • “A double-blind study of persons with rheumatoid arthritis patients, who had not responded to previous drug treatment with salicylates, compared the addition of pantothenic acid (500 mg/d initially, increasing to 500 mg four times daily by the 10th day) with placebo. A significant reduction in morning stiffness, degree of disability, and severity of pain was reported for persons taking pantothenic acid. (70)” (as cited in Kelly, 2011, Osteoarthritis and Rheumatoid Arthritis section, para. 2)

Most literature on this vitamin discuss the way B5 supports the function of the adrenal glands and their secretion of steroids. This has been known since the 1940s and 50s.  A more recent 2013 study on rats showed that Pantothenic acid as “an essential factor in adrenal steroidogenesis” — the natural secretion of corticosterone and progesterone (Pan, 2001, p. 101).

As for eye health, this is not necessarily about uveitis, but

  • An old study in 1949 (on rats) showed that “a deficiency of pantothenic acid and of pyridoxine will produce corneal vascularization.” “Corneal opacities and ulcerations were also seen to occur.”  “Some of the animals were treated with pantothenic acid. Within a few days the cornea became clear and the vessels gradually became free of blood.” (Bowles & Hall, 1949, pp. 112-113).
  • It could affect the retina of the eye. An article titled “Defective pantothenate metabolism and neurodegeneration” by Hayflick (2014) states that “PKAN (pantothenate kinase-associated neurodegeneration) manifests with damage to brain, retina and testis and is caused by mutations in PANK2, the gene encoding the mitochondrial form of pantothenate kinase, a key regulatory enzyme in CoA [Coenzyme A] synthesis” (Abstract).

Other potential benefits of B5

  • Kelly’s 2011 summary also notes that Pantothenic Acid therapy successfully helped reduce acne.
    • See Leung, 1995.
    • This was also more recently confirmed in a 2014 study by Yang, et. al.
  • Kelly’s summary noted that it also reduced obesity & fat
    • This was later confirmed in a 2013 study by Shibata et al.
  • Sampedro, et al, 2015 summarized that “Several clinical trials have been undertaken in humans using pantothenic acid supplementation and its derivatives in various medical fields, such as hyperlipedemia, obesity, acne vulgaris, alopecia, hepatits A, lupus erythematosus, osteoarthritis, rheumatoid arthritis, and wound healing.”

Pantothenic acid deficiency

Pantothenic acid is available in many foods, and the amount needed to prevent deficiency is a mere 5mg/day for adults. The gut microbiome synthesizes many of the B vitamins we need, including Vitamin B5.

However, Kelly (2011) has noted that pantothenic acid deficiency may be found in some diets and with oral contraceptive use.  It is possible that various factors could interfere with normal rates of B5 production/absorbtion even if B5 is adequate in one’s diet. It is also possible that certain human genetic mutations may interfere with absorption and uptake of B5.

Deficiency was induced in a small human study done in the 1950s, as reported by Sampedro (2015):

“serious clinical symptoms appeared within a few weeks. The triad of fatigue (including apathy and malaise), headache, and weakness was the most consistent finding. Other symptoms included emotional lability, impaired motor coordination, paresthesias, burning sensations of the hands and feet, muscle cramps, and gastrointestinal disturbance such as nausea, vomiting and abdominal cramps. Some subjects had tachycardia, orthostatic hypotension, and fluctuations in arterial blood pressure. In some individuals, upper respiratory infections were common, while in others, they were not. One subject who had many infections had a decrease in gamma globulins, but in other subjects, they were normal. Furthermore, other lab abnormalities included a reduction in urinary 17-ketosteroids, a loss of the eosinopenic response to ACTH, abnormal glucose tolerance, and increased sensitivity to insulin (3, 19, 20). Secretion of gastric hydrochloric and pepsin was also reduced in these subjects (39).” (as summarized by Sampedro, 2015)

References

Bowles, L. L., & Hall, W. K. (1949). Corneal changes in the rat with deficiencies of pantothenic acid and of pyridoxine. The Journal of Nutrition, 37(1), 9.
Hayflick, S. J. (2014). Defective pantothenate metabolism and neurodegeneration. Biochemical Society Transactions, 42(4), 1063.

Kelly, G. S. (2011). Pantothenic Acid. Alternative Medicine Review 16(3) 263-274.

Leung, L. H. (1995). Pantothenic acid deficiency as the pathogenesis of acne vulgaris. Medical Hypotheses, 44(6), 490–492. http://doi.org/10.1016/0306-9877(95)90512-X

Pan, L., Jaroenporn, S., Yamamoto, T., & Nagaoka, K. (2012). Effects of pantothenic acid supplement on secretion of steroids by the adrenal cortex in female rats. Reproductive Medicine and Biology, 11(2), 101–104. http://doi.org/10.1007/s12522-011-0113-6

Sampedro, A., Rodriguez-Granger, J., Ceballos, J., & Aliaga, L. (2015). Pantothenic acid: An overview focused on medical aspects. European Scientific Journal, 11(21).

Shibata, K., Fukuwatari, T., Higashiyama, S., & Sugita, C. (2013). Pantothenic acid refeeding diminishes the liver, perinephrical fats, and plasma fats accumulated by pantothenic acid deficiency and/or ethanol consumption. Nutrition, 29(5), 796. http://doi.org/10.1016/j.nut.2013.01.002

Yang, M., Moclair, B., Hatcher, V., Kaminetsky, J., Mekas, M., Chapas, A., & Capodice, J. (2014). A Randomized, Double-Blind, Placebo-Controlled Study of a Novel Pantothenic Acid-Based Dietary Supplement in Subjects with Mild to Moderate Facial Acne. Dermatology and Therapy, 4(1), 93–101. http://doi.org/10.1007/s13555-014-0052-3

 

 

 

 

 

 

 

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