- Vitamin H
- Vitamin B7
- Coenzyme R
- W Factor
For Patients & Caregivers
What is it?
Biotin is a vitamin your body needs to process sugar and fats. It’s found in foods such as organ meats (like liver or kidney), eggs, almonds, soy beans, peanuts, wholegrain cereals, brewer’s yeast, and vegetables.
Biotin supplements are available as pills, soft gels or gummies. They are taken alone or combined with other vitamins for healthy skin, nails, and hair.
What is it used for?
Biotin is used to:
- Make brittle nails stronger
- Make hair healthy
- Treat skin rash
- Treat disability due to multiple sclerosis (a disease of brain and spinal cord)
- Treat nerve pain due to diabetes
While biotin has many uses, more research is needed to prove that it helps with these issues.
Biotin is generally safe.
Dietary supplements can interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.
What else do I need to know?
It’s important to talk to your healthcare provider before taking biotin supplements. They can cause incorrect results on some lab tests. This can affect your care by:
- Making it harder for your doctor to diagnose a disorder or disease that you may have
- Not showing how you’re responding to a treatment
- Making you go through additional testing
For Healthcare Professionals
Biotin is an essential B vitamin that acts as an important coenzyme in carbohydrate and lipid metabolism. It is often taken alone or in combination with other vitamins for skin, nail, and hair health. It is also thought to benefit patients with diabetes and neuromuscular disorders. Biotin is abundant in foods including meat, vegetables, and eggs. True deficiency is rare but can be caused due to genetic disorder (13) or due to malabsorption syndromes. Long-term use of certain anticonvulsant drugs can also induce biotin deficiency (11). However, these deficiencies can be treated with biotin supplementation.
Low serum levels of biotin have been associated with hair loss in some women (16), although the evidence demonstrating the efficacy of biotin for hair growth is limited (23) (24).
A small study showed utility of biotin for strengthening brittle nails (3); and preliminary findings suggest benefits of high-dose biotin for multiple sclerosis (17), but a review cited insufficient evidence to support this use (30).
Additional exploratory studies reported that biotin may benefit patients with severe diabetic peripheral neuropathy (4); and when taken with chromium, it may improve glycemic control in patients with type 2 diabetes (5). Randomized trials are needed to validate these observations. Some case reports also suggest utility of biotin for reducing skin rash due to chemotherapeutic agents, gefitinib and erlotinib (18). But it was ineffective against seborrheic dermatitis in infants (2); and the overall evidence to support biotin use for dermatological disorders has been deemed inadequate (31).
Several case reports have shown that consumption of biotin supplements can cause clinically significant errors in select biotinylated immunoassays.The American Association of Clinical Chemistry has issued a guidance document to help laboratories and clinicians identify and address biotin interference in laboratory testing (32).
Mechanism of Action
Biotin is an essential component in carbohydrate and lipid metabolism. It is converted to the free active form by the enzyme biotinidase (1).
Studies have shown that biotin induces microtubule formation in neurons (7), and deficiency slows myelination (8), which may result in neuropathy. Biotin may also reduce the activity of interleukins and interferons, decreasing the number of leukocytes (9).
Although biotin is generally safe, supplementation has been reported to interfere with certain lab tests, which may mask disease states, overestimate response to therapies, or subject patients to additional unnecessary diagnostic procedures (29).
Missed diagnosis of heart disease due to high intake of biotin: A patient death was related to false low troponin test results that were due to high intake of biotin (22). Additional reports have shown the susceptibility of cardiac troponin assays to biotin interference at levels achievable with over-the-counter supplements (28).
Tardive Reactivation of Progressive Multiple Sclerosis (MS): In a 41-year-old patient suffering from primary progressive MS following treatment with high doses of biotin. His expanding disability status scale (EDSS) score worsened along with appearance of a symptomatic new T2 pseudo-tumoural lesion on brain MRI, suggesting tardive inflammatory reactivation likely due to biotin (33).
Herb Lab Interactions
Immunoassay interference caused by high-dose biotin supplementation: Incorrect test results during routine follow-up of a 54-year-old female patient with progressive multiple sclerosis and Hashimoto’s thyroiditis (29).
Inaccurate troponin test results: Due to consumption of high dose biotin (22).
Free Thyroxine and Thyroid Stimulating Hormone (FT4/TSH) assay: False-high values were attributed to high serum biotin levels in a neonate (12).
Qualitative urine hCG tests: Biotin supplementation may cause an invalid test result with some pregnancy tests (25).
Immunoassay interference: Biotin taken in moderate to high doses can result in either false-high or -low values (19).
Clinically significant lab errors: In a 67-year-old female with a history of multiple endocrine issues following biotin supplementation. Blood tests showed low thyroid stimulating hormone (TSH), low parathyroid hormone (PTH), and mildly elevated calcium levels. These were normalized after discontinuing biotin (34).
Thyroid function tests consistent with hyperthyroidism and a positive radioactive iodine uptake (RAIU) scan: In a 34-year-old female with a history of anxiety and depression, while taking biotin supplements. Her labs normalized after stopping biotin (35).
Erroneous elevations of results in some commercial serum 25-hydroxyvitamin d (25OHD) assays: Due to biotin supplementation (36).