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Acne and B5
Vitamin B5 may well be the most important vitamin in acne treatment and here is why.
Vitamin B5 or pantothenic acid is a water-soluble vitamin and a member of the B vitamins. It is an essential nutrient in humans because it is required for the production of coenzyme A and the metabolism of carbohydrates, proteins and fats.
The biologically active form of Vitamin B5 is D-pantothenic acid. The L-form can actually inhibit the activity of the active form.
A little vitamin B5 is found in almost every food but the richest sources of the vitamin are cereals, whole grains, legumes, eggs, meat, avocado and yogurt.
Although meat is the major dietary source of pantothenic acid in humans, we generally have double the store of the vitamin in our muscles than animals have in their muscles.
Also, vitamin B5 is mostly found in the outer layers of whole grain. Since these layers are removed during milling, grains may not serve as the best source of the vitamin.
The recommended daily intake of vitamin B5 for children is 2 – 4 mg/day. Adults can take 5 – 7 mg/day of the vitamin.
Pantothenic acid is bound up with carrier proteins in most dietary sources. Since the body only absorbs free pantothenic acid, these protein complexes of vitamin B5 are broken down in the lumen of the intestine to release the free vitamin.
Given the wide availability of pantothenic acid in foods, vitamin B5 deficiency is very rare. In the few cases of such, supplementation with vitamin B5 was enough to reverse the symptoms of the deficiency.
Symptoms of vitamin B5 deficiency includes numbness, muscle cramps, hypoglycemia, fatigue, irritability, sleep disturbance and skin lesions such as acne-like eruptions.
Since vitamin B5 is a water-soluble vitamin, it produces no toxicity even in high doses. Large doses which are up to 1000 times the recommended daily intake may cause diarrhea. Even topical administration of the vitamin causes no adverse effects.
The two most common vitamin B5 supplements are pantothenol and calcium pantothenate. Compared to pantothenic acid, these are more stable forms of the vitamin.
High doses of vitamin B5 (about 2 g/day) can be used to relieve pain in people suffering from rheumatoid arthritis as well as relieve morning stiffness and walking difficulties.
Studies into the roles of vitamin B5 in biological systems are showing that the vitamin can be useful in treating other medical conditions. These include diabetic ulceration, wound healing, peripheral neuropathy due to diabetes and obesity.
Vitamin B5 has also proven useful for reducing the serum levels of cholesterol and LDL (low density lipoproteins); it is also used in hair care products and in the treatment of acne.
The three defining studies that established the importance of vitamin B5 in acne treatment were done by Dr. Lit-Hung Leung. The first two studies were published in Medical Hypotheses in 1995 and the third followed in 1997 in The Journal of Orthomolecular Medicine.
In a case of accidental discovery, the first study by Dr. Leung was investigating the role of pantothenic acid in fasting and appetite suppression to see if it can provide any benefit as a weight loss supplement.
However, the researcher noticed that vitamin B5 was also having a different but marked effect on the study participants who also had acne. The results of the study showed that vitamin B5 reduced sebum production in this group of subjects and also improved their acne breakouts.
This discovery led to the second study which focused on the link between pantothenic acid and acne. The second study investigated the role of vitamin B5 deficiency in the development of acne.
In this paper published in the same year as the first, Dr. Leung took results from his earlier research and applied the findings. The study included 55 women and 45 men who suffered from acne.
This group of study participants was given 10 – 20 g/day of vitamin B5. 80% of the dose was delivered orally while the other 20% was given through topical creams containing pantothenic acid. The results showed that there were marked improvements in acne symptoms in all participants between 1 week and 1 month after the treatment began.
With this result, the researcher argued that vitamin B5 deficiency is a more important cause of acne than even hormonal imbalance. He also recommended that high doses of this vitamin can be effective in acne treatment.
Two years later, Dr. Leung tied the two earlier studies together to show that vitamin B5 supplement can provide relief for acne and obesity.
In the paper, the researcher noted that high doses of vitamin B5 is needed to access the fat stores around the body. Therefore, vitamin B5 supplementation can improve acne symptoms as well as lead to significant weight loss.
By decreasing the sizes of skin pores, vitamin B5 produces an effect that is similar to the astringent remedies used in acne treatment. When the size of the skin pore is reduced, there is less chance that dirt, formed by a mixture of sebum, dead skin cells and bacteria, will clog the pores.
By extension, constricting the pores will push out the dirt filling them up. When skin pores are clogged, they reduce the ability of the skin to properly function as an excretory organ.
Therefore, the toxins that should be pushed out of the body accumulate under the skin instead. There, they promote inflammation and turn into pus. This leads to the formation of acne lesions such as pimples, whiteheads and blackheads.
The second mechanism by which vitamin B5 prevents acne breakout is through coenzyme A.
Coenzyme A is an important cofactor for a number of biochemical processes in the body. For example, it is responsible for fatty acid metabolism.
When there is insufficient vitamin B5 to stimulate the formation of coenzyme A, the metabolism of fatty acids suffers. Therefore, excess lipids accumulate in sebaceous glands. To eliminate them, the sebaceous glands increase the production of sebum.
When excess sebum is produced on the skin, it makes the skin ideal for bacterial colonization and it increases the clogging of the pores. These actions quickly lead to the appearance of acne lesions.
Therefore, to reduce acne breakouts, it is important to reduce sebum production by increasing fatty acid metabolism through increased production of coenzyme A and supplementation with high doses of vitamin B5.
Vitamin B5, through coenzyme A, also affects the production of androgens. When the level of pantothenic acid falls in the body, coenzyme A preferentially increases the production of androgens.
Androgens such as testosterone and DHT, its metabolite, are responsible for most acne cases caused by hormonal imbalance. These male sex hormones cause the enlargement of the sebaceous glands which leads to increased production of sebum.
To prevent this from happening, high doses of vitamin B5 can regulate coenzyme A activity such that it reduces the production of androgens.
Since the Leung papers got published, acne products have increasingly included vitamin B5.
Given the reports of the many acne sufferers who experienced improvements following vitamin B5 supplementation, it is right to agree with Dr. Leung’s findings even though more studies are needed.
In acne treatment, high doses of vitamin B5 are required. Dr. Leung recommends 10 g/day of the vitamin.
However, such high doses cause gastrointestinal discomfort for acne patients. Gastrointestinal side effects to expect from megadoses of vitamin B5 include diarrhea and bloating.
There are 2 ways to get around this. The first option is to employ the same modifications used in one of Dr. Leung’s studies. This involves splitting the vitamin B5 supplementation between oral and topical forms of the vitamin.
While he used 80/20 split between oral/topical doses of the vitamin, it is possible to shift to 50/50 split between the two dosage forms. This is advisable and safe because topical vitamin B5 has not been shown to produce any side effects.
The second option involves taking a much lower oral dose of vitamin B5 and then boosting its effect with another supplement.
L-carnitine qualifies as the booster. It can improve fatty acid metabolism because it is a carrier molecule for moving fatty acids across the mitochondrial membrane.
Since it quickens the effect of vitamin B5 on reducing fatty acids, it becomes helpful in relieving acne symptoms.
Therefore, 750 mg vitamin B5 and 250 mg L-carnitine are recommended to be taken three times daily to achieve the same effect produced by megadoses of pantothenic acid in acne treatment.
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