Vitamin H (Biotin)
   

Vitamin H (Biotin)
Overview
Uses
Dietary Sources
Available Forms
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

Vitamin H, more commonly known as biotin, is a water-soluble vitamin produced in the body by certain types of intestinal bacteria and obtained from food. Considered part of the B complex group of vitamins, biotin is necessary for the metabolism of carbohydrates, fats, and amino acids (the building blocks of protein).

Deficiency, uncommon in humans, may result in hair loss, dry scaly skin, cracking in the corners of the mouth (called cheilitis), swollen and painful tongue that is magenta in color (glossitis), dry eyes, loss of appetite, fatigue, insomnia, and depression. Animals deficient in biotin during pregnancy are more likely to deliver newborns with birth defects such as a cleft palate. Research in this area for pregnant women is underway. One situation in which biotin deficiency does often develop is in people who have been on parenteral nutrition (nutrition administered intravenously rather than through the mouth or stomach) for a long period of time. It may also been seen in people who have been on long-term therapy with anticonvulsants, antibiotics, and sulfa drugs.

Interestingly, vegetarians are able to absorb more biotin from the gastrointestinal tract than meat eaters. Biotin is often recommended for strengthening hair and nails and is found in many cosmetic products for hair and skin.


Uses

Below is a partial list of the health problems biotin may help treat:

Hair and Nail Problems
Biotin supplements may improve thin, splitting, or brittle toe and fingernails as well as hair health. Biotin has also been used to combat alopecia (partial or complete loss of hair) in both children and adults.

Cradle Cap (Seborrheic Dermatitis)
Infants deficient in biotin often develop this scaly scalp condition. Some infants may respond to biotin supplementation either through formulas or breast milk. While studies have not confirmed the value of biotin for treating cradle cap, there are individual reports of some infants doing better with this treatment.

Similarly, children with a rare inherited metabolic disorder called phenyulketonuria (PKU; in which one is unable to break down the amino acid phenylalanine) often develop skin conditions such as eczema and seborrheic dermatitis in areas of the body other than the scalp. The scaly skin changes that occur in people with PKU may be related to poor ability to use biotin. Increasing dietary biotin in the diet seems to improve seborrheic dermatitis.

Biotinidase Deficiency
Biotin supplementation is usually given to babies and children with this unusual inherited condition. Biotinidase deficiency is often associated with seizures, skin disorders, bald spots, hearing loss, visual disturbances, and developmental delay. The inherited form of biotinidase deficiency is seen most commonly in people from Saudi Arabia.

Use of valproic acid, a medication for seizure disorders, can cause a biotinidase deficiency leading to skin rashes and hair loss. Biotin supplements may prevent or treat some of the side effects from this prescription drug.

Another rare inherited metabolic disorder (which looks very much like biotinidase deficiency) is called holocaroxylase synthetase deficiency. This type of deficiency also alters biotin metabolism and infants with this condition tend to improve from biotin supplements.

Diabetes
People with type 2 diabetes often have low levels of biotin. Biotin may be involved in the synthesis and release of insulin. Preliminary studies in both animals and people suggest that biotin may help improve blood sugar control in those with diabetes, particularly type 2 diabetes. More research in this area would be helpful.

Peripheral Neuropathy
There have been reports of biotin supplements improving the symptoms of peripheral neuropathy for some people who developed this condition from either long-standing diabetes or on-going hemodialysis for kidney failure. Peripheral neuropathy refers to damage to the nerves of the extremities, most commonly the feet and calves. It is felt as numbness, tingling, burning or strange sensations, and may be accompanied by pain, muscle weakness, and difficulty walking. People who have taken biotin for these purposes tend to notice improvement as early as 1 to 3 months after starting the supplement.

Candida Infections
Candida infections affect the skin, mouth, and vagina and are caused by a yeast-like fungus. Possible symptoms include white patches in the mouth or on the throat, painful cracks at the corners of the mouth, skin rashes found commonly in the groin, between fingers and toes, and under the breasts, and vaginal itching and irritation with a curd-like discharge. Some believe that people with a biotin deficiency may be more likely to become infected with candida. It is not clear, however, whether increasing biotin in the diet or taking biotin supplements will prevent or treat this condition. There has been one case report of a woman with frequent, recurrent vaginal candida infections who did improve after taking biotin supplements for three months.

High Cholesterol
Animal studies and a few human studies suggest that low levels of biotin are associated with high total and LDL ("bad") cholesterol. It is not known, however, if biotin supplementation or increased biotin in the diet improves cholesterol.


Dietary Sources

These foods contain a significant amount of biotin:

  • Brewer's yeast
  • Organ meets (liver, kidney)
  • Cooked eggs, especially egg yolk
  • Nuts (almonds, peanuts, pecans, walnuts) and nut butters
  • Soybeans
  • Other legumes (beans, blackeye peas, peanuts)
  • Oatbran

Note that raw egg whites contain a protein called Avidin that interferes with the absorption of biotin. It is always recommended that people avoid eating raw eggs because of food poisoning caused by Salmonella. Food-processing techniques can destroy biotin. Less-processed versions of the foods listed above will contain more biotin.


Available Forms

Biotin is available within multivitamins and B-vitamin complexes, and as individual supplements.

Standard preparations are available in 10 mcg, 50 mcg, and 100 mcg tablets and contain either simple biotin or a complex with brewer's yeast.


How to Take It

As with all supplements, check with a healthcare provider before giving biotin to a child.

Adequate daily intakes for biotin from the diet are listed below.

Pediatric

  • Infants birth to 6 months: 5 mcg
  • Infants 7 to 12 months: 6 mcg
  • Children 1 to 3 years: 8 mcg
  • Children 4 to 8 years: 12 mcg
  • Children 9 to 13 years: 20 mcg
  • Adolescents 14 to 18 years: 25 mcg

Adult

  • 19 years and older: 30 mcg
  • Pregnant females: 30 mcg
  • Breastfeeding females: 35 mcg

For biotin deficiencies or to treat one of the conditions described in the Uses section, a healthcare provider may recommend as much as 100 to 1,000 mcg of this supplement. Safety has only been established for dosages between 30 and 600 mcg.


Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider. That said, biotin has not been associated with side effects (even in high doses) and is considered to be nontoxic.


Possible Interactions

Although there are no reports in the medical literature of interactions between biotin and conventional medications, there are some medications that may deplete biotin levels. If you are currently being treated with any of the following medications, you should not use vitamin A without first talking to your healthcare provider.

Antibiotics
Long- term antibiotic use may decrease biotin levels by destroying the bacteria in the gut that produces biotin.

Anticonvulsant Medications
Long-term use of anticonvulsant medications such as phenytoin, primidone, carbamezepine, and phenobarbital can deplete the body's stores of biotin, possibly by interfering with absorption and increasing urinary excretion. Similarly, valproic acid can cause biotinidase deficiency which may be helped by biotin supplements.


Supporting Research

Benton D, Haller J, Fordy J. The vitamin status of young British adults. Int J Vitam Nutr Res. 1997;67(1):34-40.

Camacho FM, Garcia-Hernandez MJ. Zinc aspartate, biotin, and clobetasol propionate in the treatment of alopecia areata in childhood. Pediatr Dermatol. 1999;16(4):336-338.

Covington T, ed. Nonprescription Drug Therapy Guiding Patient Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.

Erlichman M, Goldstein R, Levi E, Greenberg A, Freier S. Infantile flexural seborrhoeic dermatitis. Neither biotin nor essential fatty acid deficiency. Arch Dis Child. 1981;56(7):560-562.

Fiume MZ, Cosmetic Ingredient Review Expert Panel. Final report on the safety assessment of biotin. Int J Toxicol. 2001;20 Suppl 4:1-12.

Forbes GM, Forbes A. Micronutrient status in patients receiving home parenteral nutrition. Nutrition. 1997;13(11-12):941-944.

Gulati S, Passi GR, Kumar A, Kabra M, Kalra V, Verma IC. Biotinidase deficiency - a treatable entity. Indian J Pediatr. 2000;67(6):464-466.

Houchman LG, et al. Brittle nails: response to biotin supplementation. Cutis. 1993;51:303-307.

oshi S, Al-Essa MA, Archibald A, Ozand PT. Biotinidase deficiency: a treatable genetic disorder in the Saudi population. East Mediterr Health J. 1999;5(6):1213-1217.

Koutsikos D, Agroyannis B, Tzanatos-Exarchou H. Biotin for diabetic peripheral neuropathy. Biomed Pharmacother. 1990;44:511-514.

Koutsikos D, Fourtounas C, Kapetanaki A, et al. Oral glucose tolerance test after high-dose i.v. biotin administration in normoglucemic hemodialysis patients. Ren Fail. 1996;18:131-137.

Krause KH, Berlit P, Bonjour JP. Impaired biotin status in anticonvulsant therapy. Ann Neurol. 1982;12(5):485-486.

Krause KH, Kochen W, Berlit P, Bonjour JP. Excretion of organic acids associated with biotin deficiency in chronic anticonvulsant therapy. Int J Vitam Nutr Res. 1984;54(2-3):217-222.

Levy HL. Nutritional therapy for selected inborn errors of metabolism. J Am Coll Nutr. 1989;8 Suppl:54S-60S.

Maebashi Y et al. Therapeutic evaluation of the effect of biotin on hyperglycemia in patients with non-insulin dependent diabetes mellitus. J Clin Biochem Nutr. 1993 May; 14(3):211-218.

Marshall MW, Kliman PG, Washington VA, Mackin JF, Weinland BT. Effects of biotin on lipids and other constituents of plasma of healthy men and women. Artery. 1980;7(4):330-351.

McCarthy MF. Toward practical prevention of type 2 diabetes. Med Hypotheses. 2000;54(5):786-793.

Mock DM. Biotin. In Luft F, Ekhard ZE, Filer LJ, eds. Present Knowledge in Nutrition. 7th edition. Washington, DC: ILSI Press; 1996:220-235.

Mock DM. Skin manifestations of biotin deficiency. Semin Dermatol. 1991;10(4):296-302.

Mock DM, Quirk JG, Mock NI. Marginal biotin deficiency during normal pregnancy. Am J Clin Nutr. 2002;75(2):295-299.

Oloyo RA, Ogunmodede BK. Preliminary investigation on the effect of dietary supplemental biotin and palm kernel oil on blood, liver and kidney lipids in chicks. Arch Tierernahr. 1992;42(3-4):263-272.

Pizzorno JE, Murray MT. Textbook of Natural Medicine. New York, NY: Churchill Livingstone; 1999:1208-1209;1541-1542.

Reavley N. Vitamins etc. Melbourne, Australia: Bookman Press; 1998.

Said HM. Biotin: the forgotten vitamin. [editorial] Am J Clin Nutr. 2002;75(2)179-180.

Salbert BA, Pellock JM, Wolf B. Characterization of seizures associated with biotinidase deficiency. Neurology. 1993;43(7):1351-1355.

Schulpis KH, Karikas GA, Tjamouranis J, Regoutas S, Tsakiris S. Low serum biotinidase activity in children with valproic acid monotherapy. Epilepsia. 2001;42(10):1359-1362.

Schulpis KH, Nyalala JO, Papakonstantinou ED, et al. Biotin recycling impairment in phenylketonuric children with seborrheic dermatitis. Int J Dermatol. 1998;37:918-921.

Strom CM, Levine EM. Chronic vaginal candidiasis responsive to biotin therapy in a carrier of biotinidase deficiency. Obstet Gynecol. 1998;92(4 Pt 2):644-646.

Suchy SF, Wolf B. Effect of biotin deficiency and supplementation on lipid metabolism in rats: cholesterol and lipoproteins. Am J Clin Nutr. 1986;43(5):831-838.

Watanabe T, Yasumura S, Shibata H, Fukui T. Biotin status and its correlation with other biochemical parameters in the elderly people of Japan. J Am Coll Nutr. 1998;17(1):48-53.

Yatzidis H, Koutsicos D, Agroyannis B, Papastephanidis C, Francos-Plemenos M, Delatola Z. Biotin in the management of uremic neurologic disorders. Nephron. 1984;36(3):183-186.

Zempleni J, Mock DM. Advanced analysis of biotin metabolites in body fluids allows a more accurate measurement of biotin bioavailability and metabolism in humans. J Nutr. 1999;129:494-497.


Review Date: April 2002
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH; Margie Ullmann-Weil, MS, RD, specializing in combination of complementary and traditional nutritional therapy, Boston, MA. All interaction sections have also been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 
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