What are the symptoms of B5 pantothenic acid deficiency?

December 19, 2025 •

4 min read

While exceedingly rare, severe cases of pantothenic acid (vitamin B5) deficiency have been documented, most notably causing a condition known as "burning feet syndrome" among prisoners during World War II. Understanding what are the symptoms of B5 pantothenic acid deficiency is crucial for at-risk individuals to identify potential health issues early.

Quick Summary

A B5 pantothenic acid deficiency can cause a variety of symptoms, including fatigue, irritability, insomnia, and gastrointestinal issues. Neurological problems like muscle cramps, numbness, and burning sensations in the hands and feet are also possible.

Key Points

Rare but Serious: B5 deficiency is uncommon but can cause severe symptoms if it occurs alongside malnutrition or other nutrient deficiencies.
Fatigue is a Key Symptom: The most prominent sign is severe fatigue and weakness, stemming from impaired energy production.
Neurological Issues Exist: Neurological problems include irritability, insomnia, numbness, muscle cramps, and the painful "burning feet syndrome".
Digestive Problems Occur: Gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and loss of appetite are also common.
Dietary Intake is Preventative: Since B5 is found in a wide variety of foods, a balanced diet is the most effective way to prevent a deficiency.
Professional Guidance is Needed: If a deficiency is suspected, consulting a healthcare provider is essential for accurate diagnosis and treatment.

Introduction to Pantothenic Acid

Pantothenic acid, commonly known as vitamin B5, is a water-soluble vitamin essential for numerous metabolic processes in the human body. Its name, derived from the Greek word "pantos," meaning "everywhere," reflects its widespread availability in various foods. B5 plays a critical role in converting carbohydrates, fats, and proteins into energy by synthesizing coenzyme A (CoA). It is also vital for the synthesis of fatty acids, cholesterol, steroid hormones, and certain neurotransmitters. Because it is so ubiquitous in a typical diet, an isolated B5 deficiency is extremely rare. However, when it does occur, it is often alongside other nutrient deficiencies, severe malnutrition, or in individuals with specific genetic conditions.

Common Symptoms of B5 Deficiency

When B5 deficiency does manifest, the symptoms are often non-specific, overlapping with deficiencies of other B vitamins. These can be broadly categorized into fatigue-related symptoms, mood disturbances, and gastrointestinal issues.

Fatigue and Energy Impairment

As B5 is crucial for energy production, one of the most prominent signs of a deficiency is impaired energy production.

Fatigue: A persistent, severe feeling of tiredness and a general lack of energy are common early indicators.
Weakness: Generalized muscle weakness and reduced tolerance for physical activity are often experienced.
Weakened Immunity: A compromised immune system can lead to an increased frequency of upper respiratory tract infections.

Psychological and Neurological Symptoms

Because B5 is important for the synthesis of neurotransmitters, its deficiency can lead to various psychological and neurological problems.

Irritability and Restlessness: Mood changes, including increased irritability, are frequently reported.
Insomnia: Difficulty sleeping and other sleep disturbances can occur.
Depression: Feelings of depression and apathy can accompany other symptoms.
Headaches: Chronic or recurring headaches are another potential sign.

Gastrointestinal Disturbances

Digestive issues can also signal a B5 deficiency, stemming from its role in metabolism and nutrient absorption.

Nausea and Vomiting: Sensations of nausea and bouts of vomiting are common.
Abdominal Pain: Upper stomach or abdominal cramps may occur.
Loss of Appetite: A general loss of appetite, or anorexia, can accompany other gastrointestinal symptoms.

Skin and Hair Manifestations

In some cases, B5 deficiency can impact the skin and hair, though these are less common.

Thinning Hair: Hair loss or thinning hair has been associated with B5 deficiency.
Skin Pigmentation: The appearance of pigment spots on the skin may also occur.

Serious and Rare Symptoms: Burning Feet Syndrome

In severe and prolonged cases of B5 deficiency, more distinct neurological symptoms can arise. The most famous example is Burning Feet Syndrome, or Grierson-Gopalan syndrome, a condition observed in undernourished prisoners of war during WWII. The symptoms are as follows:

Numbness and Burning: Sufferers experience numbness, tingling, and a painful, burning sensation in their hands and feet.
Shooting Pains: Sharp, shooting pains can accompany the burning feeling, particularly in the feet.
Muscle Cramps and Spasms: The deficiency can lead to muscle twitching, spasms, and cramps.
Impaired Muscle Coordination: In severe instances, impaired muscle coordination and balance can occur due to damage to the nervous system.

Comparison of Common vs. Severe B5 Deficiency Symptoms


Symptom Category	Common/Mild Deficiency	Severe/Chronic Deficiency
Energy & Fatigue	Fatigue, weakness, low stamina	Severe exhaustion, apathy, impaired energy production
Neurological	Irritability, insomnia, general restlessness	Burning feet syndrome (numbness, tingling, burning pain), muscle cramps, impaired coordination
Gastrointestinal	Stomach pain, nausea, vomiting, loss of appetite	Severe and persistent gastrointestinal distress
Mood	Irritability, depression, apathy	Pronounced depression, severe mood swings
Immunity	Increased frequency of infections	Significantly weakened immunity
Skin & Hair	Thinning hair, skin pigment changes	Potentially more pronounced dermatological issues

How to Address B5 Deficiency

Since deficiency is rare, the most effective preventative measure is maintaining a balanced and varied diet. However, for those with identified risks or symptoms, medical guidance is crucial. Good sources of B5 include organ meats, whole grains, avocados, eggs, mushrooms, and legumes. In some cases, a healthcare provider may recommend a vitamin B complex supplement or a specific pantothenic acid supplement.

Conclusion

While a severe, isolated B5 pantothenic acid deficiency is an infrequent occurrence, its potential symptoms can significantly impact quality of life. Common signs often mimic other B vitamin deficiencies, such as fatigue, mood changes, and digestive issues. In rare but severe cases, characteristic neurological symptoms can arise, including the distinctive "burning feet syndrome". Because B5 is so widely available in the food supply, maintaining a healthy, balanced diet is the best way to ensure adequate intake. If you suspect a vitamin B5 deficiency, consulting a healthcare professional is the appropriate course of action for diagnosis and treatment. For more comprehensive information on dietary recommendations, the National Institutes of Health provides a detailed fact sheet for health professionals: Pantothenic Acid - Fact Sheet for Health Professionals.

Frequently Asked Questions

Pantothenic acid's primary function is to help the body convert food into energy by assisting in the synthesis of coenzyme A (CoA), which is vital for metabolizing carbohydrates, fats, and proteins.

A deficiency in B5 pantothenic acid is very rare because the vitamin is widely available in many plant and animal-based foods. It typically only occurs in cases of severe malnutrition or with other multiple B vitamin deficiencies.

Burning feet syndrome, or Grierson-Gopalan syndrome, is a neurological condition associated with severe B5 deficiency, characterized by painful burning, numbness, and shooting pains in the feet and hands.

Yes, a deficiency can impact your mood and mental performance. Symptoms can include irritability, restlessness, insomnia, and depression, as B5 is involved in neurotransmitter synthesis.

Good food sources of pantothenic acid include organ meats, whole grains, avocados, broccoli, eggs, milk, mushrooms, and legumes.

A B5 deficiency can be diagnosed through blood or urine tests that measure vitamin B5 levels. A healthcare provider will typically perform these tests if symptoms suggest a deficiency.

Yes, supplementation can help prevent a deficiency, especially for individuals with poor diets or specific health conditions. However, it's always best to consult a healthcare provider before starting any new supplement regimen.