Health Care Professional Information
Scientific Name
Cis-hexahydro-2-oxo-1H-thieno[3,4-d]-imidazole-4-valeric acid
Common Name
Vitamin H, coenzyme R, D-Biotin, W Factor
Clinical Summary
An important coenzyme in carbohydrate and lipid metabolism, biotin has been claimed to treat brittle finger nails, acne, seborrhoeic dermatitis, hair fragility, and alopecia.
Infants who died from sudden infant death syndrome (SIDS) were found to have significantly lower levels of biotin in their livers; however, evidence that biotin deficiency contributes to SIDS is lacking (1). Deficiency of biotinidase, an enzyme that converts biotin into its active form, has been implicated in myelopathy (13), epileptic encephalopathy (14), and spastic tetraparesis (15) in children.
A small randomized controlled trial showed that biotin was no more effective than placebo in the treatment of seborrheic dermatitis in infants (2).
Biotin supplementation may be effective in strengthening brittle nails (3). Preliminary data suggest biotin may have beneficial effects in patients with severe diabetic peripheral neuropathy (4), and when combined with chromium, it may be effective as an adjunct therapy to improve glycemic control in patients with type 2 diabetes (5).
Food Sources
Liver, kidney, eggs, soya beans, peanuts, wholegrain cereals, and dairy products (1).
Purported Uses
- Acne
- Alopecia
- Brittle nails
- Diabetic neuropathy
- Infantile seborrheic dermatitis
- Thyroid disorder
Mechanism of Action
Biotin is an essential part of carbohydrate and lipid metabolism via transporting carboxyl units and fixing carbon dioxide. It is commonly found in a wide variety of foods. Biotin is converted into the active form by an enzyme, biotinidase. It is also synthesized in the intestine by bacteria. Patients who are deficient in biotinidase or who have malabsorption syndrome may develop biotin deficiency. Although biotin deficiency is rare, symptoms include anorexia, nausea, vomiting, dermatitis, somnolence, seizures, ataxia, and increase in serum cholesterol levels and bile pigments (1). Biotin may also be deficient, inactive, or unavailable in patients with diabetes. Therefore, it is suggested that biotin supplementation may be effective against diabetic peripheral neuropathy (4); in neurons, biotin induces microtubule formation (7) and biotin deficiency slows myelination (8). However, biotin supplementation may reduce the activity of interleukins and interferons and reduce the number of leukocytes (9).
Pharmacokinetics
Absorption
Biotin is rapidly absorbed from the gastrointestinal tract through facilitated transport and passive diffusion. Absorption is greatest in the jejunum (1). Certain anticonvulsant drugs inhibit biotin transport in the human intestine by competitively binding with the human brush border membrane vesicles (10).
Distribution
Biotin binds to plasma proteins (1).
Excretion
Excess biotin is excreted via urine. It also appears in breast milk (1).
Warnings
- Ingestion of large amounts of raw egg whites (1) and long-term anticonvulsant therapy (11) can induce biotin deficiency.
Adverse Reactions
Reported (Oral): One case of eosinophilic pleuropericardial effusion was reported in a woman using biotin and pantothenic acid (vitamin B5) concomitantly (6).
Herb-Drug Interactions
Long term use of certain anticonvulsant drugs may accelerate biotin catabolism which theoretically could cause biotin deficiency (11).
Herb Lab Interactions
- Free Thyroxine (FT4): There is a report of a false-high FT4 on the assay by the Boehringer Mannheim ES 700 analyzer attributed to high serum biotin levels in a neonate (12).
- Thyroid Stimulating Hormone (TSH): There is a report of a false-low TSH on the assay by the Boehringer Mannheim ES 700 analyzer attributed to high serum biotin levels in a neonate (12).
Dosage (Inside MSKCC Only)
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References
- Mason P. Dietary Supplements. London: Pharmaceutical Press; 2001.
- Keipert JA. Oral use of biotin in seborrhoeic dermatitis of infancy: a controlled trial. Med J Aust. 1976;1:584-5.
- Hochman LG, Scher RK, Meyerson MS. Brittle nails: response to daily biotin supplementation. Cutis 1993;51:303-5.
- Koutsikos D, Agroyannis B, Tzanatos-Exarchou H. Biotin for diabetic peripheral neuropathy. Biomed.Pharmacother. 1990;44:511-4.
- Albarracin CA, Fuqua BC, Evans JL, et al. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes Metab Res Rev. Jan-Feb 2008;24(1):41-51.
- Debourdeau PM, et al. Life-threatening eosinophilic pleuropericardial effusion related to vitamins B5 and H. Ann.Pharmacother. 2001;35:424-6.
- Braguer D, Gallice P, Yatzidis H, et al. Restoration by biotin of the in vitro microtubule formation inhibited by uremic toxins. Nephron. 1991;57(2):192-196.
- Desai S, Ganesan K, Hegde A. Biotinidase deficiency: a reversible metabolic encephalopathy. Neuroimaging and MR spectroscopic findings in a series of four patients. Pediatr Radiol. Aug 2008;38(8):848-856.
- Zempleni J, Helm RM, Mock DM. In vivo biotin supplementation at a pharmacologic dose decreases proliferation rates of human peripheral blood mononuclear cells and cytokine release. J Nutr 2001;131:1479-84.
- Said HM, Redha R, Nylander W. Biotin transport in the human intestine: inhibition by anticonvulsant drugs. Am J Clin Nutr 1989;49:127-31.
- Mock DM, et al. Disturbances in biotin metabolism in children undergoing long-term anticonvulsant therapy. J Pediatr.Gastroenterol.Nutr 1998;26:245-50.
- Henry JG, Sobki S, Arafat N. Interference by biotin therapy on measurement of TSH and FT4 by enzyme immunoassay on Boehringer Mannheim ES700 analyser. Ann.Clin Biochem. 1996;33 (Pt 2):162-3.
- Raha S, Udani V. Biotinidase deficiency presenting as recurrent myelopathy in a 7-year-old boy and a review of the literature. Pediatr Neurol. 2011 Oct;45(4):261-4.
- Singhi P, Ray M. Ohtahara syndrome with biotinidase deficiency. J Child Neurol. 2011 Apr;26(4):507-9.
- Komur M, Okuyaz C, Ezgu F, Atici A. A girl with spastic tetraparesis associated with biotinidase deficiency. Eur J Paediatr Neurol. 2011;5(6):551-3.
Consumer Information
How It Works
Bottom Line: Some studies suggest biotin may help to strengthen brittle nails and improve peripheral neuropathy (a disorder of the peripheral nerves) in diabetics. More studies are needed to confirm such effects.
Biotin is an important coenzyme involved in carbohydrate (sugar) and lipid (fat) metabolism. It is made in the intestines and is commonly found in a variety of foods. Consuming large amounts of egg whites or taking anticonvulsant (antiepileptic) drugs may lead to biotin deficiency, although this is rare. Patients with diabetes may have a greater chance of being biotin deficient. However, biotin supplementation may weaken the activity of immune signals (i.e., interleukins and interferons) and reduce the number of white blood cells.
Purported Uses
- To treat diabetic peripheral neuropathy
A small clinical study supports this claim; however, larger studies are needed to confirm the effects.
- To treat brittle nails
A small survey indicates that biotin may be effective; further studies are needed.
- To treat infantile seborrheic dermatitis (a skin disorder prevalent in the oily areas of the skin, resulting in itchy, scaly skin)
A small randomized trial showed that biotin is no more effective than placebo in treating seborrheic dermatitis in infants.
Side Effects
- One woman who took biotin along with Vitamin B5 had a serious side effect, eosinophilic pleuropericardial effusion (inflammation and filling of the lining around the heart and lungs with fluid)
Last updated: July 13, 2012
adjunct therapy (A-junkt THAYR-uh-pee)
Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. Also called adjunctive therapy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)anticonvulsant (AN-tee-kun-VUL-sunt)
A drug or other substance used to prevent or stop seizures or convulsions. Also called antiepileptic.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)assay (A-say)
A laboratory test to find and measure the amount of a specific substance.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)biotin (BY-oh-tin)
A nutrient in the vitamin B complex that the body needs in small amounts to function and stay healthy. Biotin helps some enzymes break down substances in the body for energy and helps tissues develop. It is found in yeast, whole milk, egg yolks, and organ meats. Biotin is water-soluble (can dissolve in water) and must be taken in every day. Not enough biotin can cause skin, nerve, and eye disorders. Biotin is present in larger amounts in some cancer tissue than in normal tissue. Attaching biotin to substances used to treat some types of cancer helps them find cancer cells. Also called vitamin H.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)breast (brest)
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)carbohydrate (KAR-boh-HY-drayt)
A sugar molecule. Carbohydrates can be small and simple (for example, glucose) or they can be large and complex (for example, polysaccharides such as starch, chitin or cellulose).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)clinical (KLIH-nih-kul)
Having to do with the examination and treatment of patients.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)deficiency (dih-FIH-shun-see)
In medicine, a shortage of a substance (such as a vitamin or mineral) needed by the body.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)dermatitis (DER-muh-TY-tis)
Inflammation of the skin.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)diabetes (dy-uh-BEE-teez)
Any of several diseases in which the kidneys make a large amount of urine. Diabetes usually refers to diabetes mellitus in which there is also a high level of glucose (a type of sugar) in the blood because the body does not make enough insulin or use it the way it should.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)effusion (eh-FYOO-zhun)
An abnormal collection of fluid in hollow spaces or between tissues of the body. For example, a pleural effusion is a collection of fluid between the two layers of membrane covering the lungs.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)encephalopathy (en-SEH-fuh-LAH-puh-thee)
A disorder of the brain that can be caused by disease, injury, drugs, or chemicals.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)enzyme (EN-zime)
A protein that speeds up chemical reactions in the body.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)ingestion (in-JES-chun)
Taking into the body by mouth.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)intestine (in-TES-tin)
The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called bowel.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)lipid (LIH-pid)
Fat.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)membrane (MEM-brayn)
A very thin layer of tissue that covers a surface.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)metabolism (meh-TA-buh-lih-zum)
The chemical changes that take place in a cell or an organism. These changes make energy and the materials cells and organisms need to grow, reproduce, and stay healthy. Metabolism also helps get rid of toxic substances.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)neuropathy (noor-AH-puh-thee)
A nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness in different parts of the body. It usually begins in the hands or feet and gets worse over time. Neuropathy may be caused by physical injury, infection, toxic substances, disease (such as cancer, diabetes, kidney failure, or malnutrition), or drugs, including anticancer drugs. Also called peripheral neuropathy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)peripheral neuropathy (peh-RIH-feh-rul noor-AH-puh-thee)
A nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness in different parts of the body. It usually begins in the hands or feet and gets worse over time. Peripheral neuropathy may be caused by physical injury, infection, toxic substances, disease (such as cancer, diabetes, kidney failure, or malnutrition), or drugs, including anticancer drugs. Also called neuropathy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)placebo (pluh-SEE-boh)
An inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)plasma (PLAZ-muh)
The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)randomized
Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments.
(http://www.cancer.gov/dictionary)serum (SEER-um)
The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)side effect (side eh-FEKT)
A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)supplementation (SUH-pleh-men-TAY-shun)
Adding nutrients to the diet.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)therapy (THAYR-uh-pee)
Treatment.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)thyroid (THY-royd)
A gland located beneath the larynx (voice box) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism. Also called thyroid gland.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)TSH
A hormone produced by the pituitary gland. TSH stimulates the release of thyroid hormone from thyroglobulin. It also stimulates the growth of thyroid follicular cells. An abnormal TSH level may mean that the thyroid hormonal regulation system is out of control, usually as a result of a benign condition (hyperthyroidism or hypothyroidism). Also called thyroid-stimulating hormone.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)urine (YOOR-in)
Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)vitamin (VY-tuh-min)
A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)
