Biotin is a naturally occurring vitamin found in a wide range of foods, including meats, fruits, dairy products, and vegetables. Because it is found in so many foods, it is rare for a patient to be deficient in biotin (deficiency is most frequent in patients with inherited predispositions towards deficiency). Biotin is essential for cell growth and supports fingernail and hair health. It is also necessary for promoting such bodily functions as processing carbon dioxide and maintaining blood sugar levels. There is evidence that taking extra biotin, even for patients who are not biotin deficient, can be helpful. However, much of this evidence is inconclusive. Because biotin is so easy to obtain many patients try using the supplement to treat everything from acne to diabetic pain anyway.
Biotin was first recognized in a study done on rats in 1926, which saw biotin-deficient rats suffer from hair loss, dermatitis, and poor coordination. It wouldn’t be until 1988 that a daily recommended allowance for biotin would be established. In 2017, that daily recommended allowance was revised to 30 micrograms daily.
Biotin is sold in tablet form in doses of up to 10,000 micrograms per tablet. Because biotin is so readily available in food products it is considered a supplement and can be freely purchased from any store or pharmacy that sells it. Biotin is sometimes referred to as vitamin H. Additionally, biotin is sometimes sold under the name “Appearex”, along with simply being labeled as a hair and nail supplement.
The side effects of biotin have been measured in clinical trials which had patients take as much as 10 milligrams of biotin daily. These trials found no noticeable side effects occur as a result of biotin supplementation. The side effects of biotin are unknown in doses beyond 10 micrograms daily. Patients should consult their doctor before beginning to take biotin.
Additionally, patients who begin supplementing with biotin should consult with their doctor immediately if they begin to experience any new or unwanted effects.
Some patients have experienced an upset stomach or mild rash after beginning to supplement with biotin. The incidence of these side effects, or even their link to biotin, has not been established. The dosage of biotin these patients took is unknown and may have exceeded the 10 milligram maximum dose measured in the clinical trials.
Some side effects may not yet be reported. Patients can report new side effects to the FDA online at www.fda.gov/medwatch.
The adequate intake progressively grows with age along the following scale:
There is some evidence that pregnant and breastfeeding women may require as much as 35 micrograms of biotin daily. Nearly everyone gets their daily recommended dose of biotin through food. In most cases, only people who are malnourished or genetically predisposed to biotin deficiency ever become biotin deficient.
Patients who are biotin deficient should consult their doctor before beginning to supplement with biotin for dosage advice. The dosage of biotin they need will be determined by how deficient they are without the supplement.
Patients who are attempting to use biotin to help with hair loss, fingernail health, acne, eczema, dermatitis, or any other medical condition should consult their doctor for dosage advice. The dosage of biotin the patient should take will be determined by the condition they are attempting to treat, the severity of that condition, and the biotin intake they already have.
Biotin is sold in tablet form in strengths of as much as 10,000 micrograms per tablet, with the average sitting at or below 5,000 micrograms per tablet. In all cases, the recommended serving is one tablet. These numbers are well above the daily recommended allowance, but at or below the level that clinical studies have examined and deemed largely harmless.
In the event a patient misses their dose of biotin, they should take it as soon as they remember. In the event that it is already time for their next dose, they should not attempt to retroactively make up for their missed dose by taking more biotin. The patient should simply take their regularly scheduled dose of biotin.
Biotin is water soluble and exits the body easily through the urine. Biotin overdose is all but unheard of.
Biotin may react negatively with medications that are metabolized by the liver. This is because biotin may decrease the rate at which the liver breaks down medication. This can lead to an increased concentration of the medication which may lead to increased effects, side effects or, in extremely rare cases, overdose. Patients should disclose the full list of drugs, medications, and supplements they are currently taking to their doctor before beginning to supplement with biotin.
Biotin may react negatively with vitamin B5 and alpha-lipoic acid. By taking biotin and either of the aforementioned supplements concurrently, the patient may experience decreased absorption of both supplements, and thus decreased effects. Patients should disclose the full list of drugs, medications, and supplements they are currently taking to their doctor before beginning to supplement with biotin.
Some medications can lower the level of biotin that is absorbed. Patients who are taking carbamazepine, phenobarbital, phenytoin, or primidone should consult their doctor to determine the appropriate dose of biotin for them to take. Additionally, patients should disclose the full list of drugs, medications, and supplements they are currently taking to their doctor before beginning to supplement with biotin.
Raw egg whites interact negatively with biotin. A substance in egg whites seeks out and binds with biotin in the body, which keeps the biotin from being absorbed. This substance is destroyed by heating the eggs, and thus only raw egg whites are a concern. By consuming two or more raw eggs on a daily basis across a multiple month period patients may become deficient in biotin.
The medicinal use of biotin has not been evaluated or approved by the FDA. Patients should never attempt to use biotin as a replacement for their prescribed medication. Patients should not misconstrue biotin’s label as a supplement or the fact that biotin is found in food as a sign that biotin is uniformly safe. The effectiveness of biotin supplementation in doing anything other than treating biotin deficiency has not been established.
Patients should disclose any and all medical conditions they suffer from along with the full list of drugs, medications, and supplements they are taking to their doctor before they begin to supplement with biotin.
Severe allergic reactions have been known to occur as a result of supplementing with biotin. Patients should stop taking biotin and contact their doctor immediately if they begin to experience symptoms of an allergic reaction, including:
Kidney disease can alter the daily recommended intake of biotin. Patients with kidney disease should consult with their doctor for dosage advice before they begin to supplement with biotin.
Patients who have had stomach surgery may have a different recommended daily dose of biotin than the average person. Patients who have undergone stomach surgery should consult with their doctor and receive dosage guidance before they begin to supplement with biotin.
Smoking can alter the daily recommended dose of biotin. Patients who smoke should consult with their doctor to receive dosage guidance before they begin to supplement with biotin.
Biotin needs can be affected in patients who are pregnant or breastfeeding. However, the safety of biotin supplementation for unborn fetuses and breastfeeding babies is not firmly established, and there is evidence of adverse effects. Pregnant or breastfeeding patients should not supplement with biotin unless otherwise instructed by a medical professional. Instead, pregnant mothers should take a prenatal vitamin that contains biotin that isn’t in the massive doses that are common in purely biotin tablets.
Biotin should never be given to an infant or to children except on the advice of a trained medical professional.
Biotin should be stored at room temperature and be kept away from both moisture and heat.
Biotin is an extremely important vitamin with clear signs of deficiency including brittle fingernails and hair loss. Biotin deficiency is easily remedied by biotin supplementation. Beyond treating biotin deficiency, though, there is no clear evidence that biotin can treat another condition.
Because biotin is so forgiving (it has no confirmed side effects and overdose is exceedingly rare) and relatively inexpensive, patients who want to use biotin to treat other conditions such as acne should feel free to do so, though it is recommended they speak to a healthcare professional first. Nevertheless, patients who want to treat additional conditions with biotin should be prepared to wait up to six months before they begin to experience improvement.