Vitamin H (Biotin)

Introduction

Overview

Vitamin H, more commonly known as biotin, is part of the B complex group of vitamins. All B vitamins help the body to convert food (carbohydrates) into fuel (glucose), which is "burned" to produce energy. These B vitamins, often referred to as B complex vitamins, also help the body metabolize fats and protein. B complex vitamins are necessary for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.

Your body needs biotin to metabolize carbohydrates, fats, and amino acids (the building blocks of protein). Biotin is often recommended for strengthening hair and nails and it's found in many cosmetic products for hair and skin. It is a water-soluble vitamin, meaning the body does not store it; however, bacteria in the intestine can make biotin. It is also available in small amounts a number of foods. Biotin is also important for normal embryonic growth, making it a critical nutrient during pregnancy.

Biotin deficiency is rare. Symptoms include 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. People who have been on parenteral nutrition (nutrition administered intravenously rather than through the mouth or stomach) for a long period of time, those taking anticonvulsant medication or antibiotics long-term, and people with malabsorption syndromes are more likely to be deficient in biotin.

There are few good quality studies evaluating biotin, so many of its proposed uses are based on preliminary evidence or case reports:

Hair and Nail Problems

Preliminary evidence suggests that biotin supplements may improve thin, splitting, or brittle toe and fingernails, as well as hair. Biotin, combined with zinc and topical clobetasol propionate, has also been used to combat alopecia (partial or complete loss of hair) in both children and adults.

Cradle Cap (Seborrheic Dermatitis)

Infants who don't have enough biotin often develop this scaly scalp condition. Although no studies have confirmed that biotin supplements -- given in formula or breast milk -- effectively treat cradle cap, preliminary studies show some improvement with this treatment.

Biotinidase Deficiency

Biotinidase deficiency, a rare inherited condition, is often associated with seizures, skin disorders, bald spots, hearing loss, visual disturbances, and developmental delay. Biotin supplements may improve symptoms of the inherited form of biotinidase deficiency, seen most commonly in people from Saudi Arabia.

Another rare inherited metabolic disorder (which resembles biotinidase deficiency) is called holocaroxylase synthetase deficiency. It also alters biotin metabolism. Infants with this condition tend to improve from biotin supplements.

Diabetes

Preliminary research indicates that a combination of biotin and chromium might improve blood sugar control in some people with type 2 diabetes, but biotin alone doesn't seem to have the same effect. More research is needed to know for sure whether biotin has any benefit.

Peripheral Neuropathy

There have been reports that biotin supplements improve the symptoms of peripheral neuropathy for some people who developed this condition from either diabetes or ongoing dialysis for kidney failure. Peripheral neuropathy occurs when the nerves of the extremities (often the feet) are damaged. Numbness, tingling, burning or strange sensations, pain, muscle weakness, and difficulty walking are some symptoms. However, more research is needed to know for sure whether biotin can help treat this condition.

Dietary Sources

Biotin can be found in brewer's yeast; cooked eggs, especially egg yolk; sardines; nuts (almonds, peanuts, pecans, walnuts) and nut butters; soybeans; other legumes (beans, blackeye peas); whole grains; cauliflower; bananas; and mushrooms.

Raw egg whites contain a protein called Avidin that interferes with the body's absorption of biotin.

Food-processing techniques can destroy biotin. Less-processed versions of the foods listed above contain more biotin.

Available Forms

Biotin is available in 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 health care provider before giving biotin to a child.

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

Pediatric

• Infants birth - 6 months: 5 mcg
• Infants 7 - 12 months: 6 mcg
• Children 1 - 3 years: 8 mcg
• Children 4 - 8 years: 12 mcg
• Children 9 - 13 years: 20 mcg
• Adolescents 14 - 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 health care provider may recommend as much as 100 - 1,000 mcg of this supplement. Safety has been established only for dosages of 30 - 600 mcg.

Precautions

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.

That said, biotin has not been associated with side effects (even in high doses) and is considered to be non-toxic.

Possible Interactions

Although there is no evidence that biotin interacts with any medication, there are some medications that may deplete biotin levels. If you are being treated with any of the following medications, you should not use biotin without first talking to your health care provider.

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

Anticonvulsant Medications -- Long-term use of anticonvulsant medications can reduce the body's stores of biotin. Valproic acid can cause biotinidase deficiency, which may be helped by biotin supplements. Anticonvulsant medications include:

• Carbamazepine (Carbatrol)
• Phenobarbital
• Phenytoin (Dilantin)
• Primidone (Mysoline)

Supporting Research

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.

Head KA. Peripheral neuropathy: pathogenic mechanisms and alternative therapies. Altern Med Rev. 2006 Dec;11(4):294-329. Review.

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

Keligman: Nelson Textbook of Pediatrics, 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

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. 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.

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.

Singer GM, Geohas J. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther. 2006 Dec;8(6):636-43.

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.

Taniguchi A, Watanabe T. Roles of biotin in growing ovarian follicles and embryonic development in domestic fowl. J Nutr Sci Vitaminol. 2007;53(6):457-63.

Taniguchi A, Watanabe T. Transplacental transport and tissue distribution of biotin in mice at midgestation. Congenit Anom. 2008;48(2):57-62.

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.

Wolverton: Comprehensive Dermatologic Drug Therapy, 2nd ed. Philadelphia, PA: Saunders Elsevier; 2008.

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.

Alternative Names