Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol

I’m sorry, I don’t understand your point.
A randomized, triple-blinded, placebo-controlled study and another triple-blinded, placebo-controlled investigation demonstrate that Pantethine lowers LDL, triglycerides, and total cholesterol. This is complementary to the body’s production.

Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation. (Vascular health and risk management, 2014)

“Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation”

“A one-year clinical trial ([11]) found that pantethine treatment led to consistent and statistically significant reductions in total cholesterol, LDL-C, and apolipoprotein B, with parallel increases in HDL-C and apolipoprotein A in patients with various types of dyslipidemia, with or without diabetes mellitus.”

Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation - PubMed

Effectiveness of long-term treatment with pantethine in patients with dyslipidemia - PubMed"

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Who really knows whether that’s the dominating effect? It’s not well studied. For example, pantethine also breaks down into cysteamine which has been shown to increase growth rates in many types of mammals (and increasing insulin and IGF-1 levels which would be anti-longevity). Cysteamine also interferes with the liver’s production of cholesterol and triglycerides, so that pathway could actually be responsible for the lipid effects. Mechanistically, this wouldn’t be as good as increasing fatty acid oxidation IMO. Separately, there’s also some research that pantethine directly inhibits HMCGR, though I haven’t looked into what concentrations.

There are a bunch of things you can take to get lipids down, so I’d be selective and look for ones with data or at least mechanisms that suggest positive outcomes on CV/aging and that are safe otherwise.

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Indeed, pantethine’ s beneficial effects on lipids seem to be through creation of cysteamine https://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=6388&context=etd

However, when cysteamine is supplemented to a relatively close mammal, pigs, the negative anti-aging effects mentioned by gris are manifested. Also, mTOR signaling is promoted. Excerpts further down.

But a not deep search yields no shown connection between pantethine supplementation and IGF1, insulin, or mTOR activation.

Is absence of evidence an indication that the pig study on cysteamine supplementation is of no concern for pantethine supplementation for humans?

A study showing the effects of pantethine supplementation on over-all health (as opposed to only lipid values) or mortality would be revealing, but I can’t find one which is not surprising.

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From “Effects of Dietary Crude Protein Levels and Cysteamine Supplementation on Protein Synthetic and Degradative Signaling in Skeletal Muscle of Finishing Pigs”:

“CS (cysteamine) supplementation also increased the concentrations of plasma insulin-like growth factor 1 (IGF-1) (P <0.001), and reduced the concentrations of leptin, SS, and PUN (P <0.001). Increased mRNA abundance of Akt1 and IGF-1 signaling (P <0.001) and decreased mRNA abundance of Forkhead Box O (FOXO) 4 (P <0.01) and muscle atrophy F-box (P< 0.001) were observed in pigs receiving CS. Additionally, CS supplementation increased the protein levels for the phosphorylated mammalian target of rapamycin (mTOR), eIF-4E binding protein 1, and ribosomal protein S6 kinase 1 (P <0.001). … In conclusion, dietary protein levels and CS supplementation influenced growth and protein metabolism through independent mechanisms in pigs…

Moreover, CS supplementation improved growth performance, possibly by mediating plasma IGF-1 concentrations, thereby promoting mTOR signaling and suppressing Akt/FOXO signaling in skeletal muscle of finishing pigs”.