Vitamin B5 (Pantothenic acid) for Cholesterol
Plain vitamin B5 (pantothenic acid) is not shown to lower cholesterol; the limited evidence applies only to pantethine, a high-dose B5 derivative, and even that is weak. If your goal is lower cholesterol, B5 supplements are not a substitute for diet, lifestyle, or statins.
Why this grade7-layer evidence engine
The grade is Weak (Tier C) because nearly all the supportive data concern pantethine, a disulfide derivative of B5 taken at pharmacological doses (600-900 mg/day), not the ordinary pantothenic acid sold as vitamin B5. Two small industry-funded double-blind RCTs found modest benefits: Evans 2014 (PMID 24600231) lowered LDL-C about 11% versus placebo over 16 weeks (n=24 completers, triglycerides unchanged), and Rumberger 2011 (PMID 21925346, n=120) added roughly a 4 mg/dL LDL-C reduction on top of diet.
An older systematic review by McRae 2005 (28 mostly open-label, uncontrolled trials, n=646) reported larger drops (LDL-C around 20%, triglycerides around 33%), but those legacy studies are low quality and likely overstate the effect. The fact that both modern, better-controlled trials were funded by the manufacturer of the pantethine product, while the bigger numbers come from weaker old studies, is exactly why this stays at Weak rather than higher.
Regulators and clinics echo the caution. Mayo Clinic says there is not enough reliable evidence that pantothenic acid itself helps high cholesterol; Harvard Health calls any blood-lipid benefit unclear; the National Lipid Association notes the pantethine trials are small and of limited quality; and NIH ODS does not list cholesterol as a use. There is no independent high-quality meta-analysis and no guideline body recommends it first-line.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.464
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 無高階證據可裁決
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 1 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status