Pantethine works by inhibiting cholesterol manufacture and accelerating the utilization of fat as an energy source. As the biologically active form of pantothenic acid and the direct precursor to Coenzyme A (CoA), pantethine plays a role in

1. the synthesis of fatty acids,
2. the degradation of fatty acids,
3. the Krebs cycle in which most of the body's energy is produced,
4. the acetylation of choline-the major neurotransmitter of the body,
5. the synthesis of antibodies,
6. the utilization of nutrients-including fats, proteins, and carbohydrates,
7. the maintenance of blood sugar levels,
8. the synthesis of porphyrin-a heme precursor of importance in hemoglobin synthesis,
9. the metabolism of some minerals and trace elements,
10. the synthesis of steroid hormones, and
11. the detoxification of drugs, including sulphonamides.

Other research has indicated that the activity of aldehyde dehydrogenase may be increased by supplementation with pantethine.[12] This enzyme is responsible for the breakdown of formaldehyde and as such pantethine may be helpful to those with formaldehyde sensitivity. Other research indicates that pantethine depletes cystine from cystinotic fibroblasts and as such may be effective in treating cystinosis.[13], [14] Pantethine has been shown to have promise in the treatment of alcoholism and Parkinson's disease.[15], [16]