Niacin, & early treatment in general for SARS-CoV-2 is sensible, reduces hospitalization and mortality rate.

The longer a viral infection is allowed to progress the more cells are killed or damaged, either by the viral replication, or by the damaged cells contents harming the surrounding tissue . See for more information: Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection. (1)

*post updated 8/1/2021, & 8/24/2021, & 9/2/2021.

See my recent post for a variety of nutrients or other strategies which may help prevent or provide early treatment for a viral infection: COVID19, summary of nutrients that might help prevent, treat, recover. Or more recent: Spike Protein Risks & Aids – summary list.

The post Niacin may help prevent or treat migraines also includes a graphic by Dmitry Katz, PhD about the cofactors used in the Citric Acid Cycle by mitochondria when they are performing aerobic glycolysis – metabolizing sugar with the use of oxygen. Mitochondrial dysfunction and a shift to anaerobic metabolism of sugar or glutamate, fermentation, is associated with cancer cells and other chronic degenerative disease. The cause may be limited nutrients – the list of cofactors needed is long and includes niacin.

Cofactors needed in the Citric Acid Cycle include niacin:

  • B vitamins: B1 (Thiamin) (3) , B2 (Riboflavin) (4), B3 (Niacin) (810), B5 (Pantothenic acid) (5), B6 (Pyridoxine) (67), B7 (Biotin), B9 (Folate) (9),
  • Minerals (17): Mg++ (Magnesium) (111213), Mn++ (Manganese), K+ (Potassium) (13), Zinc (1415), Iron (16), Copper, Sulfate,
  • Amino acids: Carnitine (derived from lysine), Cysteine,
  • Antioxidants: CoQ10, Glutathione, Alpha-Lipoic Acid (ALA).

Niacin in a large dose may help with treatment of an active COVID19 illness or the symptoms of LongCovid. Specifically the niacin/nicotinic acid form, not niacinamide. The “niacin flush” that occurs is warm – and is removing inflammation along with the increased sensation of warmth on the skin. Feeling a little chilled as the niacin flush continues is also normal, internally the body is cooling somewhat as the inflammation is being removed as heat on the skin.

This article summarizes the value of a variety of B vitamins against viral infections and/or inflammation and goes into more detail about niacin use for prevention or treatment of infections and inflammation: Is Niacin a Missing Piece of the COVID Puzzle?. (2) Niacin helps our body cope with increased inflammation and without niacin the inflammation continues to become more severe. For more detail see: Sufficient niacin supply: the missing puzzle piece to COVID-19, and beyond? by Dmitry Kats, PhD (3); and Be Well: A Potential Role for Vitamin B in COVID-19, a team project including scientists from several nations. (4)

Niacin (nicotinic acid) Protocol against COVID-19,
shared with permission of the author, Dmitry Kats, PhD. *His website: niacincurescovid.com.
*The apples and antihistamines can decrease the flush effect if it seems like too much and should be fine at other times of the day, than taken with or shortly after the niacin dose.

Adequate niacin may also help the body have a stable thyroid hormone level. (5)

Low levels of niacin and a metabolite NAD+ may be involved in mitochondrial myopathy which leads to tiredness and weak muscles. Providing 500-1000 milligrams of niacin per day was found to improve muscle strength, increase NAD+ levels to the level seen in the healthy control group, and liver fat decreased by 50% in the experimental group. (6)

Potential short term symptoms – may include serotonin increase.

People who were previously low in serotonin, a neurotransmitter that affects mood and intestinal health, may experience temporary symptoms from an increase in the messenger chemical. Once the body adjusts to the new level of serotonin the symptoms should no longer occur. Symptoms of a sudden increase, or excess of serotonin may include: Agitation or restlessness, Confusion, Rapid heart rate and high blood pressure, Dilated pupils, Loss of muscle coordination or twitching muscles, Muscle rigidity, Heavy sweating, Diarrhea, Headache, Shivering, Goose bumps. (13) People experiencing Serotonin Syndrome for other reasons would likely have more severe symptoms than the short term change due to the increase in niacin. Tryptophan is an amino acid precursor for serotonin and it is depleted when there is inadequate niacin available to make NAD+.

Addition 8/1/21: St. John’s Wort herbal supplements, 5-HTP, and other medications including SSRI antidepressants may increase risk of serotonin toxicity. The problem usually is seen with SSRI use, and treatment generally is to wean off the amount of whatever is being taken, without a sudden stop in case of adverse reaction to that, and the symptoms should lessen. See: St. John’s Wort Drug Interactions with Antidepressants (17)

During acute infection the risk of serotonin toxicity becoming severe is more of a concern to medical professionals I’ve been in communication with. The gradual increase over time may help when it is being used preventatively. Caution is advised with high dose niacin use. Serotonin inhibitor treatment would be needed if the problem of serotonin excess was severe.

Addition 8/24/2021: The FLCCC protocol for CoV may include SSRI medications and trying the niacin protocol and the I-MASK+ FLCCC protocol in combination may increase risk of the serotonin excess. Sudden increase of the niacin dosing to the 1000 mg amounts may also increase the risk of the adverse symptoms of serotonin excess. Try to remain calm, it is temporary though can be dangerous. Seek medical help and cut back on the niacin or SSRIs but suddenly stopping may also be risky. The FLCCC protocol uses fluvoxamine an SSRI.

Saffron taken as a medicinal herbal supplement (88 mg day per Dr. Grouf) may also help by preventing a serotonin excess which may also be a risk of a severe infection condition. “Saffron will restore breathing, heart rate and clear the lungs, it will also prevent serotonin induced injury to brain, lungs and heart and fix co–d diarrhoea” (@DGrouf)

Saffron extract may inhibit serotonin reuptake in synapses (Sophia Esalatmanesh et al., 2017). Serotonergic mechanisms have been influenced by crocin by showing antagonistic action at the 5-HT2c receptor site (Lopresti et al., 2014).
Saffron: The Age-Old Panacea in a New Light, by Maryam Sarwat · 2020, page 125, Chapter 10: Saffron in Brain Diseases, (Google Books) via (@DGrouf)

Another caution against taking saffron at the same time as curcumin/turmeric, as the phytonutrients have opposing mechanisms of action. https://twitter.com/MirrorManDan/status/1430203127257608192?s=19

Dizziness – niacin, nicotinamide and nicotine in combination, can have an adverse effect.

Dizziness may result from a combination of niacin, nicotinamide, and use of a nicotine patch. Niacin/(rxlist.18) Solution – stop taking the niacinamide.

Niacin is converted into niacinamide during metabolic use of the nutrient, so taking both is not really necessary.

Chemically, niacin is one of the simplest vitamins, having the empirical formula C6H3O2N (Illus. 13-1). Nicotinic acid and nicotinamide correspond to 3-pyridine carboxylic acid and its amide, respectively.” […] “Nicotinic acid is converted to the amide form in the tissues, and Erickson et al. (1991) suggests this occurs in the rumen. [article about supplements for lactating cows > is helpful] Nicotinamide functions as a component of two coenzymes: nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP).” […] (16)

Although niacin coenzymes are widely distributed in the body, no true storage occurs. The liver is the site of greatest niacin concentration in the body, but the amount stored is minimal.” […] (16)

Niacin can be made from tryptophan, an amino acid, as long as there is also adequate protein, energy, vitamin B6, riboflavin and necessary hormones available. Iron is also needed. Synthesis may take place in the gut as well as throughout the body. See longer excerpt in the Reference List. (16)

Glyphosate may be reducing average tryptophan levels in our diet, and in our bodies.

Glyphosate residue in our food supply may be reducing our levels of tryptophan and other amino acids (14) and trace minerals such as manganese. (15) Glyphosate is a mineral chelator and antibiotic affecting a chemical pathway that affects tryptophan. That may disrupt bacterial health, and was thought to not risk human health too, however it may affect us due to our need for the amino acids., in addition to other effects that have been less studied then the shikimate pathway mechanism of action.

The herbicide glyphosate inhibits the shikimate pathway of the synthesis of amino acids such as phenylalanine, tyrosine, and tryptophan.” (Vivankos et al., 2011) (14)

Potential long term risks – may affect liver health and gout – uric acid; quercetin may help reduce risk of uric acid build up.

People with liver damage or gout may need to avoid taking large doses of niacin long term (more than 2000-6000 mg/day). Taking it along with alcohol use may increase the risk of liver damage and worsen the symptoms of the niacin flush with itching. Long term use of large doses may lead to gout, excess uric acid. (7) Symptoms of gout can occur abruptly even waking up at night with severe joint pain, most frequently occurring in the joint at the base of the large toes. Other joint tissue can also be affected. Pain, swelling and redness in the affected toe or other joints are typical symptoms. (8)

Use of large doses of niacin/nicotinic acid for treatment of patients with symptoms of schizophrenia were studied extensively in the 1950s-70s. Use of nicotinamide was not found to help similarly and the treatment was most immediately beneficial for patients with acute onset of the schizophrenia symptoms. People with chronic schizophrenia took longer to respond to use of niacin and needed larger doses to achieve symptom relief. Regarding risk of toxicity, liver concerns, gout, and increases in blood uric acid were observed but were not too severe of a problem, compared to the adverse side effects seen with standard psychiatric medications, and some patients could use a different form or a smaller dose. “The vitamin has been given to patients suffering from gout whose symptoms were not aggravated and it did not interfere with their specific treatment for gout.” (9)

Uric acid/urate levels in gout can be reduces with use of xanthine oxidase inhibitors (10) which include the phytonutrient quercetin. (11) For more information about quercetin’s other benefits as a zinc ionophore and bioflavonoid see the recent post: COVID19, summary of nutrients that might help prevent, treat, recover.

Quercetin is found in many plant foods in small amounts, and rich in some foods like capers (Alcaparras) and cilantro. It is also found in citrus and pomegranate peel. “The researchers note that pickling promotes conversion of rutin (flavonoid compound also called rutoside in capers) to quercetin, the ingredient that they found to be an efficacious KCNQ channel activator. This makes pickled capers as the richest known “natural” source of quercetin, with a maximum reported concentration of 520 mg/100 g for canned capers, compared to a maximum of 323 mg/100 g quercetin for raw capers.” (12) People with Mast Cell overactivity (seasonal allergy & other symptoms might be present) may need to avoid pickled or other fermented foods as that can worsen mast cell symptoms, for more information see: MCAS/Histamine.

Other nutrients that may help as cofactors recommended by Dimitry Kat’s, Ph.D. include vitamin C, a B complex, vitamin D3, zinc, magnesium, and Black seed oil, quercetin, and N-acetyl cysteine could provide additional antioxidant support.

Dr. Kats’ All Natural Daily Protocol for COVID19 (*may help preventively, during viral or other infections, and during recovery. The nutrients help the body remove inflammation as heat loss, the skin reddening ‘niacin flush’. The nutrients also are used by mitochondria to provide us energy and reduce risk of cancer. Niacin and magnesium help cells engulf damaged cells, pathogens, and chemical debris, or tangled proteins for reuse as nutrients. )

Dr. Kats’ Niatonin Protocol (update 9/2/21)

Melatonin and niacin are recommended in the most recent version of the Kats’ protocol, available in this post: Spike summary spreadsheet; telomerase, Circadian cycle & Nrf2, Aug. 22, 2021. Caution: Melatonin is a hormone normally present and active in very tiny amounts, not a milligram, micrograms, and too much may disrupt sleep cycle. Too much regularly, may suppress our own production of melatonin.

Simply focusing on improving sleep habits and getting full spectrum light during the day can help all of the genes and hormones effected by our circadian cycle. Hundreds of genes are activated or de-activated during the day/night transitions – during normal health. Modern life tends to keep us in the inflammatory day time mode – all of the time. That is really what Metabolic Syndrome is – constant low level inflammation instead of cycling between anti-inflammatory night-time growth and repair mode, and the active get busy and do stuff, inflammatory day-time mode.

Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

  1. Peter A. McCullough, MD, MPH. et al., Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection. August 06, 2020 American Journal of Medicine, VOL 134, ISSUE 1, P16-22, JANUARY 01, 2021 DOI:https://doi.org/10.1016/j.amjmed.2020.07.003 https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltext
  2. Mercol J, Is Niacin a Missing Piece of the COVID Puzzle?, Jan 20, 2021, mercola.com, https://articles.mercola.com/sites/articles/archive/2021/01/20/what-are-the-benefits-of-niacin.aspx
  3. Kats D, Sufficient niacin supply: the missing puzzle piece to COVID-19, and beyond?, preprint, https://osf.io/uec3r/
  4. Be Well: A Potential Role for Vitamin B in COVID-19, Maturitas, Shakoor H, Feehan J, Mikkelsen K, et al. Be well: A potential role for vitamin B in COVID-19. Maturitas. 2021;144:108-111. doi:10.1016/j.maturitas.2020.08.007 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428453/
  5. Shakir KM, Kroll S, Aprill BS, Drake AJ 3rd, Eisold JF. Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state. Mayo Clin Proc. 1995 Jun;70(6):556-8. doi: 10.4065/70.6.556. PMID: 7776715. https://pubmed.ncbi.nlm.nih.gov/7776715/
  6. Pirinen E, Auranen M, Khan NA, Brilhante V, Urho N, Pessia A, Hakkarainen A, Kuula J, Heinonen U, Schmidt MS, Haimilahti K, Piirilä P, Lundbom N, Taskinen MR, Brenner C, Velagapudi V, Pietiläinen KH, Suomalainen A. Niacin Cures Systemic NAD+ Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy. Cell Metab. 2020 Jun 2;31(6):1078-1090.e5. doi: 10.1016/j.cmet.2020.04.008. Epub 2020 May 7. Erratum in: Cell Metab. 2020 Jul 7;32(1):144. PMID: 32386566. https://pubmed.ncbi.nlm.nih.gov/32386566/
  7. Niacin, mayoclinic.org, https://www.mayoclinic.org/drugs-supplements-niacin/art-20364984
  8. Gout – Symptoms & Causes, mayoclinic.org, https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897
  9. Hoffer A, Megavitamin B-3 Therapy for Schizophrenia, Canad. Psychiat. Ass. J. Vol. 16 (1971) https://journals.sagepub.com/doi/pdf/10.1177/070674377101600605
  10. White WB, Gout, Xanthine Oxidase Inhibition, and Cardiovascular Outcomes. Circulation. 2018;138:1127–1129 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.036148
  11. Zhang C, Wang R, Zhang G, Gong D. Mechanistic insights into the inhibition of quercetin on xanthine oxidase. Int J Biol Macromol. 2018 Jun;112:405-412. doi: 10.1016/j.ijbiomac.2018.01.190. Epub 2018 Jan 31. PMID: 29410028. https://pubmed.ncbi.nlm.nih.gov/29410028/
  12. Kim Stewart, Discovery: Caper Berry’s Quercetin Activates KCNQ Potassium Channel. July 16, 2020, todayspractitioner.com https://todayspractitioner.com/botanical-medicine/discovery-caper-berrys-quercetin-activates-kcnq-potassium-channel/
  13. Serotonin Syndrome: Symptoms & Causes, mayoclinic.org https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
  14. Vivancos PD, Driscoll SP, Bulman CA, et al. Perturbations of amino acid metabolism associated with glyphosate-dependent inhibition of shikimic acid metabolism affect cellular redox homeostasis and alter the abundance of proteins involved in photosynthesis and photorespiration. Plant Physiol. 2011;157(1):256-268. doi:10.1104/pp.111.181024 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165874/
  15. Samsel A, Seneff S. Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies. Surg Neurol Int. 2015;6:45. Published 2015 Mar 24. doi:10.4103/2152-7806.153876 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392553/
  16. Niacin, DSM.com, https://www.dsm.com/anh/en_US/products/vitamins/vitamin-nutrition-compendium/companion-animals/niacin.htmlThe amino acid tryptophan is a precursor for the synthesis of niacin in the body. There is considerable evidence that synthesis can occur in the intestine. There is also evidence that synthesis can take place elsewhere within the body. The extent to which the metabolic requirement for niacin can be met from tryptophan will depend first on the amount of tryptophan in the diet and second on the efficiency of conversion of tryptophan to niacin. The pathway of tryptophan conversion to nicotinic acid mononucleotide in the body is shown in Figure 13-1. Protein, energy, vitamin B6 and riboflavin nutritional status as well as hormones, affect one or more steps in the conversion sequence shown in Figure 13-1. Therefore, they can influence the yield of niacin from tryptophan. Iron is required by two enzymes for the conversion of tryptophan to niacin with a deficiency reducing tryptophan utilization.” (16)
  17. St. John’s Wort Drug Interactions with Antidepressants, verywellmind.com, https://www.verywellmind.com/st-johns-wort-drug-interactions-with-antidepressants-1066686
  18. Niacin, RxList.com https://www.rxlist.com/niacin/supplements.htm

Fonia- sustainable grain

Our changing world and growing population can benefit from changing what we put on our menu plans – change what we eat often. Fonia is a drought tolerant grain in the millet family which can be harvested in just six to eight weeks from planting and it tolerates poor soil conditions.

Fonia is native to West African countries and may also have been used by ancient Egyptian cultures as the grain has been found in archeological sites.

Fonia is cooked similarly to rice but is a smaller grain. It would be good as a hot breakfast porridge or used like rice in salads or side dishes. It is gluten free, rich in fiber, protein, magnesium, zinc, and B vitamins. For more information and a couple recipes see: “Whole Grains- Fonio,” By Jessica Levinson, Today’s Dietitian, https://www.todaysdietitian.com/newarchives/0918p12.shtml

Disclaimer: Information provided for educational purposes within the guidelines of fair use, not intended for individual health care guidance.

Choline and betaine – water soluble nutrients

Choline is a newer discovery in the nutrient world. It is considered to be a member of the water soluble B vitamins group which are nutrients involved in metabolism – the use of energy within the body. We can produce small amounts of choline so it isn’t considered a vitamin but as we can not produce enough for health it is considered an essential nutrient. (1) Betaine is a slightly different form of choline. Choline is found throughout the body but is particularly important within the brain and is needed for the neurotransmitter acetylcholine. Betaine is a metabolite of choline.

Choline, a water soluble nutrient. Foods Sources and symptoms of deficiency.

Choline is most typically found within phospholipids (such as phosphatidylcholine) which are important in membranes and as messenger chemicals within the brain and in the immune system. It may play a role in prenatal brain development but research on supplementation within pregnancy r to protect cognitive skills in the elderly is still in early stages. (1)

Choline is a  methyl donor (1) which means it can share a methyl group – essentially one carbon atom with three hydrogen atoms with an overall neutral charge.

An important role of methyl groups is in the release of energy from sugar within mitochondria. The methyl group is passed back and forth between nutrients and enzymes that are involved in breaking down a molecule of fat or sugar for use of the stored energy that is released when a double bond is broken. The methyl group is combined with an acetyl group when it is removed from the area on the chain of carbon molecules when a double bond is broken. An acetyl group is an atom of carbon combined with one atom of hydrogen and the group has a negative charge. The process for breaking down the glucose sugar molecule is called the Krebs cycle and most beginning level organic chemistry or nutrition students will remember having to memorize all of the steps involved. My summary may be inaccurate – college was a long time ago – the important point is that B vitamins and methyl donors are needed for mitochondria to be able to release energy from glucose/sugar molecules).

  • (The Krebs cycle is also known as the “citric acid cycle or the tricarboxylic acid (TCAcycle.” More info: Krebs cycle.)

Methyl groups are also important in controlling gene activity. They act like an on/off switch for genes. A gene that is fully methylated – all the available double bonds between carbon atoms are broken into single bonds with a methyl group added instead – is in the off position, the protein that the gene would encode is not being made. Genes that are unmethylated have double bonds and are in the on position, the pattern for assembling amino acids into a protein can be read by a matching strand of RNA and the protein can be formed (generally in the endoplasmic reticulum or Golgi apparatus areas of a cell).

Betaine and the more familiar B vitamins folate (B9 if anyone is counting), B6 and B12 are also methyl donors. Folate deficiency has been associated with less gene methylation (a histone is part of a gene). (2) More about methyl donors as a group is available here:  Methyl Donors and BPA.

  • The number system for naming B vitamins was derived at an earlier stage of research and some of the chemicals that were given numbers at the time were discovered to not be essential nutrients – meaning the body was able to form them within the normal health and didn’t essentially need to have them included in the diet (so that is why we don’t hear about a B4, B8, B10 or B11).

Excessive intake of choline above 7500 milligrams may cause a drop in blood pressure, sweating, vomiting and digestive upset, and change in body odor. The recommended Upper Limit is 3,500 mg/day. It would be difficult to reach that amount with food sources. (Safety information, lpi.oregonstate.edu)

Food Sources of Choline:

Good sources of choline include meats, fish & shellfish, eggs/egg yolks, cheese, milk, yogurt, broccoli, cauliflower, cabbage, kale, kohlrabi and other cruciferous vegetables, green leafy vegetables, pomegranate seeds, sesame seeds, tahini, peanuts,  soybeans, beans, brown rice, whole grains.

Food Sources of Betaine:

Sweet potatoes, meats, cheese, beets, basil, spinach, green leafy vegetables, brown rice, whole grains.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

References:

  1. Choline, Linus Pauling Institute, Oregon State University, http://lpi.oregonstate.edu/mic/other-nutrients/choline
  2. Benjamin A. Garcia, Zigmund Luka, Lioudmila V. Loukachevitch, Natarajan V. Bhanu, Conrad Wagner, Folate deficiency affects histone methylation,

    Medical Hypotheses, Volume 88, March 2016, Pages 63-67, ScienceDirect, https://www.sciencedirect.com/science/article/pii/S0306987716000116

  3. Foods used in the 30% Calories from Carbohydrates Menu Plans, https://effectiveselfcare.info/2018/05/19/healthy-hair-is-the-proof-of-a-healing-diet/

Pantothenic Acid – vitamin B5

Vitamin B5 is typically referred to by its chemical name Pantothenic Acid. Why some of the B Vitamins are called a name and some by the number may have to do with the variety of the forms commonly found in the body or in the food supply. Vitamin B6 has several important chemical forms as do vitamin D and vitamin E. Getting a variety of foods within the diet on a regular, daily, weekly or even monthly basis can help to provide some of the various forms. Vitamin E in a supplement might only provide one of the bioactive forms of the group of nutrients while eating nuts and seeds would be providing some of all of the group in addition to B vitamins and other minerals.

Pantothenic Acid – vitamin B5. Food Sources and Symptoms of Deficiency.

Pantothenic Acid is a water soluble B vitamin that is essential in metabolic pathways in all forms of life, plants, animals and microbes. It is a precursor chemical for coenzyme A which is involved in many reactions that help sustain life and is needed for other proteins that are needed for making fatty acids – fats of different lengths and types. It does have other active chemical forms but is not typically referred to by their names, pantothenol – may help with healing skin wounds, research is in early stages; and pantethine – may help lower cholesterol and lipid (fat) levels in the blood. (1)

Dietary deficiency of Pantothenic Acid is very rare as the vitamin is found in most animal and plant food products. There have been no known cases of overdose/toxicity so no Upper Limit for safety has been set. Deficiency is so rare it has only been documented in prisoners of war (POWs) and the symptoms relieved by supplementation of Pantothenic Acid were reported by the POWs to be “numbness and painful burning and tingling in their feet.” (1)

Pantothenic Acid is involved in converting the B vitamin folate into an active form so a deficiency in Pantothenic Acid might result in folate deficiency symptoms, (1) (megaloblastic anemia with fatigue and normal levels of iron but with fewer red blood cells that are immature, too large (macrocytic) and nonfunctional (2). Vitamin B12 deficiency can also be a cause with similar lab values but supplements or injections of that B vitamin wouldn’t help if deficiency of the active form of folate was the cause. Supplements of folic acid, the inactive form most commonly used in multi-vitamins or fortified foods, wouldn’t help either. Beans, peas and asparagus are good food sources of folate, more information about that B vitamin is available here: (Folate is essential and Folic Acid is commonly available)

Genetic differences may affect some individual’s ability to phosphorylate (add atoms of the mineral Phosphorus) to the molecule of Pantothenic Acid for the transformation of the vitamin precursor into the bioactive coenzyme A. The enzyme is needed for transporting fatty acids (lipids/fats) into the mitochondria for use for energy production. Someone with a genetic difference might not be able to use fats for energy as well as someone with typical ability to phosphorylate the Pantothenic Acid molecules in the production of Coenzyme A. One known gene that could inhibit the production of Coenzyme A is Pantothenic acid kinase II (PANK2) . Symptoms of people with a double gene difference in PANK2 may include changes in movement control (dystonia), and impaired vision, intelligence, speech, and behavior, and personality disorders (15). (1)

Symptoms of deficiency of Coenzyme A might include gaining weight more easily than average and more readily getting tired when exercising for longer amounts of time. That is my interpretation though.

I have a different genetic difference that affects phosphorylation so I may also have trouble producing Coenzyme A. Betaine-homocysteine methyltransferase (BHMTis a gene involved in protein metabolism that could cause reduced Dimethylglycine and methionine.  Chronic Fatigue Syndrome has been associated with a lack of Dimethylglycine (the amino acid – glycine). The metabolic pathways are very complex chemistry and it looks like this gene is more involved in the chemistry of the B vitamins choline and betaine. The phosphorylation problem is more specifically with phospholipids and  glycerophospholipids – both essential parts of membranes and cannabinoids. (Glycerophospholipid biosynthesis) (Phospholipid metabolism)

I will discuss betaine and choline in additional posts. An overview about phospholipids and food sources is available in the post Macro & micro-nutrients, an overview & food sources.

Symptoms of Pantothenic Acid deficiency in lab animals or other groups of animals found to have deficiency of vitamin B5 in their food supply included skin irritations, graying of fur or feather abnormalities, anemia due to reduced heme production,  nerve problems involving reduced myelin sheath, low blood glucose, rapid breathing and heart rate, and damaged adrenal glands. (1)

So it is good that Pantothenic Acid is readily available in many foods because clearly it is very important to our health. However supplements of Pantothenic Acid or rubbing it directly on the scalp or gray hair did not restore hair color in humans with gray hair. (1)

Food Sources for Pantothenic Acid (vitamin B5):

Organ meats (liver and kidney), Meats, Fish and Shellfish, Salmon, Egg yolk, MIlk, Yogurt, Cheese, Avocado, Broccoli Sweet Potato, Carrot, Celery, Mushrooms, Pomegranate Seeds, Sesame Seeds/Tahini, Beans, Nuts, Seeds, Almonds, Walnuts, Whole Grains, Brown Rice, Enriched Flour Products depending on the source – Canadian guidelines require it while the U.S guidelines do not.  (4, 5) “Processing and refining grains may result in a 35 to 75% loss. Freezing and canning of foods result in similar losses (16).” (1)

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

References:

  1. Pantothenic Acid, Linus Pauling Institute, Oregon State University, http://lpi.oregonstate.edu/mic/vitamins/pantothenic-acid
  2. Anemia of Folate Deficiency, https://www.hopkinsmedicine.org/healthlibrary/conditions/hematology_and_blood_disorders/anemia_of_folate_deficiency_85,P00089
  3. Foods used in the 30% Calories from Carbohydrates Menu Plans, https://effectiveselfcare.info/2018/05/19/healthy-hair-is-the-proof-of-a-healing-diet/
  4. Institute of Medicine (US) Committee on Use of Dietary Reference Intakes in Nutrition Labeling. Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification. Washington (DC): National Academies Press (US); 2003. 3, Overview of Food Fortification in the United States and Canada. https://www.ncbi.nlm.nih.gov/books/NBK208880/
  5. Guidance Document Repository (GDR), Prohibition against the sale of unenriched white flour and products containing unenriched flour. Canadian Food Fortification Guidelines; Grain and Bakery Products,  Canadian Food Inspection Agency, http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/grain-and-bakery-products/unenriched-flour/eng/1415915977878/1415915979471

15. Kurian MA, Hayflick SJ. Pantothenate kinase-associated neurodegeneration (PKAN) and PLA2G6-associated neurodegeneration (PLAN): review of two major neurodegeneration with brain iron accumulation (NBIA) phenotypes. Int Rev Neurobiol. 2013;110:49-71.  (https://www.ncbi.nlm.nih.gov/pubmed/24209433)

16. Food and Nutrition Board, Institute of Medicine. Pantothenic acid. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, D.C.: National Academy Press; 1998:357-373. National Academy Press,  (https://www.nap.edu/read/6015/chapter/12)