The Risks of Niacin Supplementation

This is part 2 of the pantothenic acid Mastering Nutrition podcast. Pantothenate is also known as vitamin B5! It supports your mood, mental health, skin clarity, energy, sleep, and comfort.

Alex Leaf and I team up again, this time to how to get B5 from foods and supplements, and how to know when you’re getting enough.

When you aren’t getting enough, you may suffer from fatigue, apathy, discomfort, uneasiness, or pain. You may get numbness and tingling in the hands and feet. You may get depressed, quarrelsome, childish, or want to spend all day in bed. Your pulse may get higher than you’d expect after minor exertion. Your sleep gets trashed. You get muscle cramps and abdominal cramps, you fart more, and when things get real bad you might throw up.

The best test for measuring B5 status is urinary pantothenic acid. Currently, the only place I know where to get this is the Great Plains OAT test. Hopefully someone will offer it as a standalone. Blood tests are not very useful. 😔

Official recommendations suggest we only need about 5 milligrams per day. In the podcast we discuss why some people might need GRAMS per day. 

❗❗❗There aren’t ANY supplements on the market that have the major forms of B5 found in food. There is good reason to think that food B5 is superior to supplements such as pantothenic acid and pantethine.❗❗❗

I recommend shooting for 10 milligrams per day from food, and then supplementing more when necessary:

•  2 heaping tablespoons of unfortified nutritional yeast gives you 10 mg.
•  2 100-gram servings of roasted sunflower seeds or the livers of chicken, beef, lamb, or veal will give you this, but I recommend limiting liver to two servings per week.
• 3 100-gram servings of gjetost cheese, black and red caviar, kidney from lamb imported from New Zealand, pork liver (and most products made from it), shiitake mushrooms, or canned grape leaves will do the trick.
• Most fresh cuts of muscle meat give you enough in somewhere between 3-5 100-gram servings, though some require up to four pounds and the data is pretty messy.
• Five 100-gram servings of any of the following will work: eggs, duck, goose, emu, fresh salmon or trout, raw avocado, canned chilli, peanuts, peanut butter, cashews, white or portabella mushrooms, liver pate (limit to 5 servings per week), giiblets or heart from chicken or turkey, beef thymus or heart, pork kidney or brain, or lamb brain.
• The following can give you enough if you eat four pounds of them: whole grains, most natural dairy products besides butter, most seafood that isn’t canned, most beans that aren’t canned, raw coconut, most nuts and seeds, and most processed meats.

Here are a few reasons to supplement:

• One gram of pantothenic acid from sodium or calcium pantothenate has been used for rheumatoid arthritis, and 2-10 grams per day have been used for acne. In acne, a topical cream containing dexpanthenol (a cream-soluble form of B5, the cream usually marketed as wound-healing cream) is combined with the oral dose.
• 300 mg pantethine 3 times per day lowers cholesterol.

These doses appear extremely safe, with only a very small proportion of people experiencing minor side effects even at these very high doses.

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More details in this huge podcast! Listen in below!

In this episode, you will find all of the following and more:

01:14 Recap of Part 1

06:39 Cliff Notes

14:51 The case for why urinary pantothenic acid is the only legitimate marker of nutritional status and why blood concentration is not a useful marker

28:23 How the Adequate Intake for pantothenic acid was established

29:42 The idea of pantothenic acid balance and comparing it to nitrogen balance

41:38 What I think the recommended pantothenic acid intake should be

45:06 The effect of different forms of food processing on loss of B5 from foods

50:21 Dietary sources of B5, divided into five tiers

54:11 The contribution of the gastrointestinal microbiome to B5 status

01:06:12 Causes of suboptimal status or deficiency of pantothenic acid

01:11:59 Prevalence of suboptimal pantothenic acid status

01:12:32 When I think supplementation with high doses is warranted

01:13:10 What are some of the benefits, besides fixing deficiency, that we might get from supplementing with pantothenic acid or its derivatives?

01:13:26 The use of pantethine as a therapeutic for dyslipidemia

01:23:01 Comparison of pantethine supplementation to high-dose niacin for lowering blood lipids

01:25:33 Topical dexpanthenol for skin health and wound healing

01:29:13 The effect of pantothenic acid supplementation on acne

01:32:42 The effect of pantothenic acid supplementation on sports performance

01:40:58 The effect of pantothenic acid supplementation on hair health

01:42:34 The effect of pantothenic acid supplementation on arthritis

01:48:31 Summary of pantothenic acid supplementation

01:52:28 Is there any reason to use pantothenic acid specifically versus other forms such as pantethine?

01:54:49 Does it matter if you take pantothenic acid in divided doses or all at once?

01:57:08 Does it matter if you take pantothenic acid with food?

01:58:51 Two insightful quotes from papers on pantothenic acid

02:04:08 Pantothenate should be known as the B vitamin that we know the least about, not the B vitamin that we are least likely to become deficient in.

Access the show notes, transcript, and comments here:

https://chrismasterjohnphd.substack.com/p/066-pantothenic-acid-part-2-foods