Introduction
Biotin (vitamin H) is a water-soluble vitamin that is usually classified as a B vitamin. It is required by all living organisms, but can be synthesized by plants and microorganisms. It plays multiple important roles in the body. Biotin is the coenzyme for four carboxylases (a category of enzymes) – acetyl-CoA carboxylase, pyruvate carboxylase, propionyl-CoA carboxylase, and methylcrotonyl-CoA carboxylase. These enzymes respectively play important roles in fatty acid synthesis; gluconeogenesis; amino acid, cholesterol, and fatty acid metabolism; and leucine metabolism. Biotin also plays a role in gene expression and glucokinase synthesis, among other things.
Organ meats such as liver and kidney are the best dietary sources of biotin. Some other foods, such as wheat, contain considerable amounts of biotin but with very low bioavailability. Other meats, vegetables, and fruits usually contain low amounts of biotin.
Deficiency
Deficiency of biotin is associated with hair loss, skin irritation, impaired immune function, increased risk of sudden infant death syndrome, fatty liver and kidney, abnormal bone growth, and of course, death [1-4]. A common misconception is that biotin is not needed from external sources because it is synthesized by bacteria; multiple studies have shown that the amount provided by bacteria is insufficient for various reasons [1]. Still, biotin deficiency is very rare, but has been found in some circumstances. Multiple carboxylase deficiency, a hereditary disorder, results in increased biotin needs. Sometimes deficiency is seen in patients on long-term parenteral nutrition. Consuming uncooked egg whites for long periods can also result in biotin deficiency, because a protein found in egg whites binds to biotin and prevents absorption. Chronic alcohol ingestion may also increase biotin requirements.
Although clinical deficiency is rare, subclinical biotin deficiency may be quite common. Studies in animals are finding that the optimal amount for health may be well above that needed to just alleviate classical deficiency symptoms [1]. Suboptimal biotin intake or a marginal deficiency may impair leucine metabolism, affect insulin sensitivity, and increase the risk of birth defects [1, 2, 5-6]. It is also important to note that two common supplements, alpha lipoic acid (ALA) and pantothenic acid (vitamin B5), may both compete with biotin. Specifically, ALA administration to rats results in decreased activity of the biotin-dependent carboxylases, presumably due to structural similarity [7].
Insulin sensitivity
In theory, high doses of biotin may improve insulin sensitivity. This is because biotin induces the synthesis of glucokinase, which leads to increased glucose uptake [2]. However, the data is presently very limited. It is quite likely that biotin improves insulin sensitivity in an insulin resistant state [8-9]; while the data on this is limited, there is almost no data in normoglycemic individuals. One study in normoglycemic hemodialysis patients found biotin to have a beneficial effect on glucose metabolism [10], but it is not unlikely that the biotin status of these patients was suboptimal to begin with. It will take further research to establish whether or not biotin can have a beneficial effect in this regard.
Dosage and toxicity
Studies in animals have found no toxicity from acute, short-term, and subchronic administration of large doses of biotin, and no adverse events from biotin supplementation (even from commonly utilized dosages of 5-20 mg) have been reported [11]. Levels as high as 200 mg daily have been reported without any side effects. The adequate intake for biotin has been set at 35-60 micrograms daily, but this is based solely on the average biotin intake of the population (which is presumed to be adequate, since deficiency is uncommon) so it has limited utility in defining optimal levels.
As a supplement, biotin even in large doses is ~100 percent bioavailable [12]. Taking a multivitamin that provides biotin should provide one with enough to avoid suboptimal status. The general recommendation for biotin supplementation to prevent deficiency due to ALA is 1 mg or more per 100 mg of ALA. If one is taking more than a gram of pantothenic acid daily, a biotin supplement providing at least 1 mg is warranted, and 3-5 mg may be best to stay on the safe side (it should also be noted that biotin and pantothenic acid exhibit a synergistic relationship under some circumstances). Because large amounts adminstered at a time might increase renal excretion, biotin is more effective when taken as two or three smaller doses throughout the day [12].
REFERENCES:
1. Annu Rev Nutr. 2002;22:221-39. Epub 2002 Jan 04. Biotin in metabolism and molecular biology. McMahon RJ.
2. Proc Nutr Soc. 1999 May;58(2):427-33. Optimum nutrition: thiamin, biotin and pantothenate. Bender DA.
3. Nutr Rev. 1989 May;47(5):157-9. A role for biotin in bone growth. [No authors listed]
4. J Chemother. 2001 Nov;13 Spec No 1(1):12-6. Immune system and surgical site infection. Esposito S.
5. Proc Soc Exp Biol Med. 2000 Jan;223(1):14-21. Marginal biotin deficiency is teratogenic. Zempleni J, Mock DM.
6. J Nutr. 1992 Jul;122(7):1493-9. Biotin deficiency in rats: disturbances of leucine metabolism are detectable early. Mock NI, Mock DM.
7. J Nutr. 1997 Sep;127(9):1776-81. Lipoic acid reduces the activities of biotin-dependent carboxylases in rat liver. Zempleni J, Trusty TA, Mock DM.
8. Nippon Rinsho. 1999 Oct;57(10):2385-9. [Vitamin and dermatology] [Article in Japanese] Yoshikawa K.
9. McCarty MF. High-dose biotin, an inducer of glucokinase expression, may synergize with chromium picolinate to enable a definitive nutritional therapy for type II diabetes. Med Hypotheses. 1999 May;52(5):401-6.
10. Ren Fail. 1996 Jan;18(1):131-7. Oral glucose tolerance test after high-dose i.v. biotin administration in normoglucemic hemodialysis patients. Koutsikos D, Fourtounas C, Kapetanaki A, Agroyannis B, Tzanatos H, Rammos G, Kopelias I, Bosiolis B, Bovoleti O, Darema M, Sallum G.
11. Int J Toxicol. 2001;20 Suppl 4:1-12. Final report on the safety assessment of biotin. Fiume MZ; Cosmetic Ingredient Review Expert Panel
12. Am J Clin Nutr. 1999 Mar;69(3):504-8. Bioavailability of biotin given orally to humans in pharmacologic doses. Zempleni J, Mock DM.
