Biotin (patient information)

# What is it?
- Biotin is a vitamin that is found in small amounts in numerous foods.
- Biotin is used for preventing and treating biotin deficiency associated with pregnancy, long-term tube feeding, malnutrition, and rapid weight loss. It is also used orally for hair loss, brittle nails, skin rash in infants (seborrheic dermatitis), diabetes, and mild depression.

# How effective is it?
- Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
- The effectiveness ratings for BIOTIN are as follows:
- Likely effective for
- Treating and preventing biotin deficiency. Symptoms of deficiency include thinning of the hair (often with loss of hair color), and red scaly rash around the eyes, nose, and mouth. Other symptoms include depression, listlessness, hallucinations, and tingling in the arms and legs. There is some evidence that cigarette smoking may cause mild biotin deficiency.- Possibly ineffective for:- Skin rash in infants (seborrheic dermatitis).- Insufficient evidence to rate effectiveness for:- Hair loss. There is some preliminary evidence that hair loss can be reduced when biotin is taken by mouth in combination with zinc while a cream containing the chemical compound clobetasol propionate (Olux, Temovate) is applied to the skin.
- Diabetes. Biotin alone doesnt seem to affect blood sugar levels in people with type 2 diabetes. However, there is some evidence that a combination of biotin and chromium (Diachrome, Nutrition 21) might lower blood sugar in people with diabetes, whose diabetes is poorly controlled by prescription medicines. Other early evidence shows that the same combination reduces ratios of total cholesterol levels to good high-density lipoprotein (HDL) cholesterol, bad low-density lipoprotein (LDL) cholesterol to HDL cholesterol, and non-HDL to HDL cholesterol in people with type 2 diabetes.:- Diabetic nerve pain. There is some evidence that biotin can reduce nerve pain in people with diabetes.:- Brittle fingernails and toenails. Biotin might increase the thickness of fingernails and toenails in people with brittle nails.:- Other conditions.
- More evidence is needed to rate biotin for these uses.

# How does it work?
- Biotin is an important component of enzymes in the body that break down certain substances like fats, carbohydrates, and others.
- There isnt a good laboratory test for detecting biotin deficiency, so this condition is usually identified by its symptoms, which include thinning of the hair (frequently with loss of hair color) and red scaly rash around the eyes, nose, and mouth. Nervous system symptoms include depression, exhaustion, hallucinations, and tingling of the arms and legs. There is some evidence that diabetes could result in biotin deficiency.

# Are there safety concerns?
- Biotin is LIKELY SAFE for most people when taken appropriately and by mouth. Biotin is well tolerated when used at recommended dosages. It is POSSIBLY SAFE when injected into the muscles and used appropriately.
- Special precautions & warnings:
- Pregnancy and breast-feeding: Biotin is POSSIBLY SAFE when used in recommended amounts during pregnancy and breast-feeding.
- Kidney dialysis: People receiving kidney dialysis may need extra biotin. Check with your health care provider.

# Are there interactions with medications?

## Minor
- Be watchful with this combination.
- Medications changed by the liver (Cytochrome P450 1B1 (CYP1B1) substrates)
- Some medications are changed and broken down by the liver. Biotin might decrease how quickly the liver breaks down some medications. Taking biotin along with some medications that are changed by the liver might increase the effects and side effects of some medications. Before taking biotin, talk to your healthcare provider if you take any medications that are changed by the liver.
- Some of these medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.

# Are there interactions with herbs and supplements?

## Alpha-lipoic acid
- Alpha-lipoic acid and biotin taken together can each reduce the body's absorption of the other.

## Vitamin B5 (pantothenic acid)
- Biotin and vitamin B5 taken together can each reduce the body's absorption of the other.

# Are there interactions with foods?

## Egg whites
- Raw egg white contains a substance that binds biotin in the intestine and keeps it from being absorbed. Eating 2 or more uncooked egg whites daily for several months has caused biotin deficiency that is serious enough to produce symptoms.

# What dose is used?
- The appropriate dose of biotin depends on several factors such as the users age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for biotin. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
- There is no recommended dietary allowance (RDA) established for biotin. The adequate intakes (AI) for biotin are 7 mcg for infants 0-12 months, 8 mcg for children 1-3 years, 12 mcg for children 4-8 years, 20 mcg for children 9-13 years, 25 mcg for adolescents 14-18 years, 30 mcg for adults over 18 years and pregnant women, and 35 mcg for breast-feeding women.

# Other names
- Biotina, Biotine, Biotine-D, Coenzyme R, D-Biotin, Vitamin B7, Vitamin H, Vitamine B7, Vitamine H, W Factor, Cis-hexahydro-2-oxo-1H-thieno-imidazole-4-valeric Acid.