- Vitamin H
- Vitamin B7
- Coenzyme R
- W Factor
For Patients & Caregivers
How It Works
Biotin is widely available in foods. Biotin supplements are used to promote nail, skin, and hair health, but evidence is limited. Some people also use it for nerve, muscle, and diabetic symptoms. Patients should discuss use of this supplement beforehand with their doctor.
Biotin is an important coenzyme involved in sugar and fat metabolism. It is found in a variety of foods such as meat, vegetables, and eggs.
Some studies show that taking biotin can benefit patients with multiple sclerosis or may improve diabetic nerve pain. Patients with diabetes may have a greater chance of being biotin-deficient. Consuming large amounts of egg whites or taking epilepsy drugs may also lead to biotin deficiency. However, there is very limited evidence to suggest benefits with biotin supplements. In addition, too much biotin may weaken immune response and reduce the number of white blood cells.
Biotin was found to interfere in some lab tests leading to inaccurate results. Therefore, patients should discuss supplement use with their physician.
To treat multiple sclerosis
Preliminary data suggest that biotin is safe and may reduce symptoms in some patients.
To treat diabetic peripheral neuropathy
A small clinical study supports this claim. 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 hair loss
Evidence is limited. According to one study, some women with hair loss may have lower biotin levels in their blood. It is unclear if biotin is effective in preventing or treating hair loss in otherwise healthy people or in cancer patients due to chemotherapy.
To treat infantile seborrheic dermatitis (a skin disorder)
A small study showed that biotin was not effective in treating itchy, scaly skin.
Do Not Take If
- You are undergoing lab tests: Biotin supplementation has been reported to cause inaccurate test results with some blood tests. Therefore, it is important to tell your healthcare provider about any use of biotin supplements before the tests.
- You are taking a pregnancy test: Taking biotin supplements may cause an invalid test result.
Although biotin is generally safe, supplementation has been reported to interfere with certain lab tests.
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. Additional reports have shown the susceptibility of cardiac troponin assays to biotin interference at levels achievable with over-the-counter supplements.
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.
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).