What are the Symptoms of a Lack of Pantothenic Acid?

December 25, 2025 •

4 min read

Pantothenic acid deficiency is extremely rare in developed countries, typically only occurring in cases of severe malnutrition or rare genetic disorders that prevent its proper use. Despite its rarity, understanding the symptoms is important, as it helps identify and address the underlying causes of this condition.

Quick Summary

A deficiency in pantothenic acid (Vitamin B5) can cause a variety of symptoms, including systemic fatigue, neurological issues like paresthesia, mood disturbances, and gastrointestinal distress.

Key Points

Deficiency Is Rare: Pantothenic acid deficiency is uncommon in developed countries, typically linked to severe malnutrition or genetic issues.
Widespread Symptoms: Symptoms can be systemic (fatigue), neurological (numbness, tingling), digestive (nausea, pain), and psychological (irritability, insomnia).
Burning Feet Syndrome: A classic but rare symptom involves a painful burning and tingling sensation in the feet and hands (paresthesia), known as 'burning feet syndrome'.
Role in Energy: Since pantothenic acid is crucial for converting food to energy, a lack of it often results in profound fatigue and weakness.
Dietary Sources Abundant: Vitamin B5 is found in many foods, including meat, whole grains, and vegetables, making it generally easy to obtain through a balanced diet.
Special Cases: Individuals with rare genetic disorders like PKAN, chronic alcoholics, or those with malabsorption issues face a higher risk.
Treatment is Straightforward: For most, increasing dietary intake is sufficient, though supplements may be necessary under medical supervision.

What is Pantothenic Acid?

Pantothenic acid, also known as vitamin B5, is an essential water-soluble vitamin that plays a vital role in numerous bodily functions. It is a precursor to coenzyme A (CoA), a crucial molecule involved in the metabolism of carbohydrates, fats, and proteins for energy production. Additionally, B5 is necessary for the synthesis of cholesterol and various hormones, and it contributes to the health of the nervous system. The name "pantothenic" comes from the Greek word "pantos," meaning "everywhere," because the vitamin is found in nearly all foods.

Systemic and Neurological Symptoms

Because of its fundamental role in energy metabolism, a shortage of pantothenic acid can significantly impact the body's energy levels and nerve function. One of the most frequently cited symptoms of a deficiency is a profound and persistent fatigue. This can manifest as general weakness, lethargy, and a feeling of malaise.

Neurological symptoms are also a hallmark of severe deficiency. A condition known as “burning feet syndrome,” or nutritional melalgia, is a classic, though rare, indicator. This syndrome causes a burning, tingling, or prickling sensation (paresthesia) in the hands and feet, which is often more noticeable at night. Other nervous system-related issues include muscle cramps, numbness, and restlessness.

Gastrointestinal and Mood-Related Issues

Insufficient pantothenic acid can disrupt the digestive system, leading to a range of unpleasant symptoms. These include:

Nausea and vomiting
Abdominal pain or stomach cramps
Heartburn
Loss of appetite (anorexia)

In addition to physical symptoms, a lack of vitamin B5 can impact mental and emotional well-being. Individuals may experience heightened irritability, depression, headaches, and sleep disturbances like insomnia. These symptoms often reflect the vitamin's role in overall nervous system health and energy balance.

Causes of Pantothenic Acid Deficiency

Pantothenic acid deficiency is rare because the vitamin is so widely available in the food supply. However, certain populations and conditions can increase the risk of developing a deficiency:

Severe Malnutrition: People experiencing starvation or severe malnutrition are the primary group at risk.
Genetic Disorders: Rare inherited disorders, such as Pantothenate Kinase-Associated Neurodegeneration (PKAN), interfere with the body's ability to use pantothenic acid, causing deficiency regardless of dietary intake.
Alcoholism: Chronic, heavy alcohol consumption can impair nutrient absorption and increase the risk of deficiencies.
Chronic Illnesses: Conditions like inflammatory bowel disease or other malabsorption disorders can hinder the uptake of pantothenic acid.
Medication Interactions: Some medications may affect the absorption or utilization of B vitamins, though specific interactions with pantothenic acid are not widely reported.

How to Ensure Adequate Intake

For most people, maintaining a balanced, varied diet is enough to prevent pantothenic acid deficiency. However, those with risk factors may need to be more mindful of their intake. Incorporating a variety of the following foods is recommended:

Animal Sources: Beef, poultry, salmon, and organ meats like liver and kidney.
Plant Sources: Avocado, mushrooms (especially shiitake), broccoli, potatoes, whole grains, nuts, and seeds.
Dairy and Eggs: Milk, yogurt, and eggs are good sources of pantothenic acid.

It is worth noting that pantothenic acid is sensitive to heat, and boiling and processing can significantly reduce its content in foods. Cooking methods that use less heat or water, like steaming or baking, can help preserve the vitamin.

Comparison of Pantothenic Acid Deficiency vs. PKAN


Symptom	General Deficiency (Rare)	PKAN (Rare Genetic Disorder)
Fatigue	Common	Common
Neurological Issues	Paresthesia (numbness/tingling), burning feet, muscle cramps	Progressive involuntary movements, spasticity, dystonia, and nerve degeneration
Digestive Issues	Nausea, vomiting, abdominal pain, loss of appetite	Less prominent, but can occur alongside general deficiency symptoms
Mental Health	Irritability, depression, restlessness, sleep disturbances	Significant cognitive and behavioral changes associated with neurological damage
Underlying Cause	Severe malnutrition, alcoholism, or malabsorption	Mutation in the PANK2 gene disrupting B5 metabolism
Prognosis	Reversible with increased intake through diet and/or supplements	Progressive and can lead to significant disability, managed primarily by symptom relief

Conclusion

While a deficiency in pantothenic acid is uncommon in the general population, its symptoms can be debilitating when they do occur. Symptoms often present as a cluster of issues, including fatigue, various neurological problems like 'burning feet syndrome' or paresthesia, and gastrointestinal distress. In extremely rare cases, a genetic disorder, PKAN, can also lead to symptoms by interfering with the body's use of B5. For most people, a balanced diet rich in a variety of foods such as meat, whole grains, and vegetables is sufficient to maintain healthy levels. For those at higher risk, a healthcare provider can help determine the best course of action, which may include dietary adjustments or supplementation. Given that symptoms can overlap with other conditions, it is crucial to consult a medical professional for an accurate diagnosis and treatment plan. To explore high-B5 foods further, a detailed list is available on the NIH Office of Dietary Supplements website.

Frequently Asked Questions

No, it is extremely rare in developed nations because the vitamin is present in a wide variety of foods. It typically occurs in cases of severe malnutrition or specific metabolic disorders.

Psychological symptoms can include irritability, depression, restlessness, sleep disturbances like insomnia, and mood changes.

'Burning feet syndrome' is a rare condition associated with severe vitamin B5 deficiency, causing a painful burning and tingling sensation (paresthesia) in the feet, sometimes extending to the hands.

Excellent sources include meat, fish, eggs, milk, organ meats, whole grains, legumes, and certain vegetables like avocado, mushrooms, and broccoli.

Yes, pantothenic acid is water-soluble and sensitive to heat, meaning a significant amount can be lost during cooking, especially boiling. Light cooking methods are preferable to preserve the vitamin.

Individuals with severe malnutrition, alcoholism, certain gastrointestinal diseases, or a rare genetic disorder called Pantothenate Kinase-Associated Neurodegeneration (PKAN) are at higher risk.

Treatment typically involves increasing dietary intake of B5-rich foods and, if needed, taking supplements under the supervision of a healthcare professional. Addressing any underlying causes is also crucial.

As a component of coenzyme A, pantothenic acid is crucial for converting food into energy, synthesizing fats, hormones, and cholesterol, and supporting nervous system function.