Twenty-nine patients with hypertriglyceridemia (type IV hyperlipoproteinemia) or elevations of both LDL-cholesterol and triglyceride levels (type IIB hyperlipoproteinemia) and 3 patients with an isolated reduction of HDL cholesterol were randomly assigned to receive, in double-blind fashion, pantethine (300 mg 3 times a day) or placebo for 8 weeks, and then the alternate treatment for an additional 8 weeks. In type IIB patients, pantethine lowered total serum cholesterol and LDL cholesterol by 13.5% and increased HDL cholesterol by 10%. Pantethine did not increase HDL cholesterol in type IV patients or in those with an isolated reduction of HDL. In both type IIB and type IV patients, plasma triglycerides were reduced by about 30% if pantethine was given first, and by 13.0-17.8% if pantethine was given after placebo.

Comment: Pantethine is the stable disulfide form of pantetheine, which is a metabolite of pantothenic acid and a major component and precursor of coenzyme A. Numerous studies have shown that pantethine can lower LDL-cholesterol and triglyceride levels and increase HDL-cholesterol levels. Although the lipid-lowering effect of pantethine is not as pronounced as that of statin drugs, it is non-toxic and can be used in combination with other nutritional supplements and dietary changes, with the potential for additive or synergistic effects. In addition to its favorable effect on lipid levels, pantethine has been shown to inhibit platelet aggregation.

Other natural substances that can reduce serum cholesterol include niacin, chromium, calcium, policosanol, beta-sitosterol, psyllium, and red yeast rice. Foods that have been shown to lower cholesterol levels include soy, oat bran or whole oats, whole rye, garlic, onion, rice bran oil, grapefruit and apples (sources of pectin), raw carrots, nuts (including walnuts, almonds, pecans, hazelnuts, and macadamia nuts), yogurt, high-chromium brewer’s yeast, and alfalfa sprouts.

Gaddi A, et al. Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia. Atherosclerosis 1984;50:73-83.