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What are the side effects of too much biotin. Biotin Side Effects: Understanding the Risks of Excessive Intake

What are the potential side effects of consuming too much biotin. How does biotin function in the body. Can biotin supplements improve hair and nail health. Is biotin supplementation necessary for most people. What are the recommended daily intake levels for biotin.

What is Biotin and How Does it Function in the Body?

Biotin, also known as vitamin B7 or vitamin H, is a water-soluble vitamin that plays crucial roles in various metabolic processes in the human body. As a coenzyme for multiple carboxylases, biotin is involved in several important biochemical reactions.

How does biotin work at the molecular level? Biotin attaches to specific lysine residues and facilitates the transfer of carbon in carboxylase reactions. Some key functions include:

  • Converting pyruvate to oxaloacetate
  • Transforming acetyl-CoA to malonyl-CoA
  • Changing propionyl-CoA to methylmalonyl-CoA

These conversions are essential for breaking down food into glucose, which serves as the primary energy source for the brain and body. Beyond its metabolic functions, recent research has uncovered new roles for biotin in cell signaling and epigenetic regulation.

Biotin Deficiency: Symptoms and Risk Factors

While biotin deficiency is rare in healthy individuals consuming a balanced diet, certain conditions can increase the risk of inadequate biotin levels. What are the signs of biotin deficiency?

Symptoms of severe biotin deficiency may include:

  • Conjunctivitis
  • Ataxia (loss of muscle coordination)
  • Seizures
  • Skin infections
  • Developmental delays in children
  • Hair loss
  • Brittle nails

Who is at higher risk of biotin deficiency? Certain groups may require increased biotin intake:

  1. Pregnant women
  2. Breastfeeding mothers
  3. Smokers
  4. Individuals with biotinidase deficiency (a rare genetic disorder)
  5. People with malabsorption disorders

Biotin Supplementation: Efficacy and Recommendations

Despite its popularity as a supplement for hair and nail health, scientific evidence supporting biotin’s effectiveness in these areas remains limited. Are biotin supplements necessary for most people?

Current research suggests that biotin supplementation may only be beneficial for individuals with diagnosed biotin deficiency or certain genetic disorders. For healthy individuals with adequate dietary intake, additional biotin supplementation is generally unnecessary.

What are the recommended daily intake levels for biotin? While the U.S. Food and Drug Administration (FDA) has not established a daily recommended intake for biotin, some guidelines exist:

  • General population: 30-100 micrograms per day
  • Pregnant and breastfeeding women: 5-35 micrograms per day

It’s important to note that these are general recommendations, and individual needs may vary based on health status, age, and other factors.

Potential Side Effects of Excessive Biotin Intake

While biotin is generally considered safe, even at high doses, excessive intake may lead to some adverse effects. What are the potential side effects of consuming too much biotin?

Reported side effects of high biotin intake include:

  • Upset stomach
  • Nausea
  • Diarrhea
  • Skin rashes (in rare cases)

It’s worth noting that biotin is considered to have very low toxicity, and severe side effects from overconsumption are extremely rare. However, high doses of biotin can interfere with certain laboratory tests, potentially leading to false results.

Biotin Interference with Lab Tests

One of the most significant concerns regarding excessive biotin intake is its potential to interfere with various laboratory tests. How does biotin affect lab results?

High levels of biotin in the blood can cause inaccuracies in tests that use biotin-streptavidin technology. This interference can lead to falsely high or low results in tests for:

  • Thyroid function
  • Cardiac troponin levels
  • Hormone levels
  • Vitamin D levels

To avoid potential misdiagnosis or inappropriate treatment, it’s crucial to inform healthcare providers about any biotin supplementation before undergoing laboratory tests.

Biotin and Hair Health: Separating Fact from Fiction

Biotin has gained popularity as a supplement for promoting hair growth and improving hair health. However, scientific evidence supporting these claims is limited. Can biotin supplements really improve hair health?

While biotin is essential for healthy hair growth, supplementation may only be beneficial for individuals with diagnosed biotin deficiency. For those with adequate dietary intake, additional biotin is unlikely to provide significant benefits.

Some conditions where biotin supplementation might be helpful include:

  • Pathologic brittle hair syndrome
  • Uncombable hair syndrome
  • Trichothiodystrophy (a rare genetic disorder)

It’s important to note that many factors contribute to hair health, including genetics, overall nutrition, and underlying health conditions. Addressing these factors may be more effective than relying solely on biotin supplementation.

Natural Sources of Biotin in the Diet

For most people, obtaining adequate biotin through a balanced diet is sufficient to meet their needs. What are some good dietary sources of biotin?

Biotin can be found in various foods, including:

  • Egg yolks
  • Nuts (especially almonds, peanuts, and walnuts)
  • Whole grains
  • Legumes (such as soybeans and lentils)
  • Organ meats (like liver and kidney)
  • Salmon and other fatty fish
  • Avocados
  • Sweet potatoes
  • Mushrooms

By incorporating a variety of these foods into your diet, you can help ensure adequate biotin intake without the need for supplements.

Biotin Absorption and Metabolism

Understanding how the body processes biotin can provide insight into its effectiveness and potential side effects. How is biotin absorbed and metabolized in the human body?

Biotin absorption primarily occurs in the small intestine through a carrier-mediated process. Once absorbed, biotin is widely distributed throughout the body, with a significant portion being protein-bound in the plasma.

Key aspects of biotin metabolism include:

  1. Absorption: Occurs mainly in the small intestine
  2. Distribution: Widely distributed throughout the body
  3. Metabolism: Primarily in the liver
  4. Excretion: Mainly through the kidneys in urine

The body’s ability to store biotin is limited, which is why regular intake through diet or supplementation is necessary to maintain adequate levels.

Factors Affecting Biotin Absorption

Several factors can influence the body’s ability to absorb and utilize biotin effectively. What conditions might impair biotin absorption?

  • Inflammatory bowel diseases (e.g., Crohn’s disease, ulcerative colitis)
  • Certain medications (e.g., anticonvulsants)
  • Excessive alcohol consumption
  • Raw egg white consumption (contains avidin, which binds to biotin and prevents absorption)

Understanding these factors can help identify individuals who might be at higher risk of biotin deficiency and may benefit from supplementation under medical supervision.

Biotin and Nail Health: Examining the Evidence

Like its purported benefits for hair, biotin is often marketed as a supplement for improving nail strength and growth. Is there scientific evidence supporting the use of biotin for nail health?

While anecdotal reports suggest that biotin may help strengthen brittle nails, clinical studies on the subject are limited. Some research has shown potential benefits for individuals with brittle nail syndrome, but results are not conclusive for the general population.

Factors to consider regarding biotin and nail health:

  • Biotin deficiency can lead to brittle nails
  • Supplementation may help in cases of diagnosed deficiency
  • For individuals with adequate biotin intake, additional supplementation may not provide significant benefits
  • Other nutrients, such as protein and minerals, also play crucial roles in nail health

As with hair health, addressing overall nutrition and underlying health conditions may be more effective for improving nail strength and appearance than relying solely on biotin supplementation.

Biotin in Pregnancy and Breastfeeding

Biotin requirements may increase during pregnancy and lactation due to increased metabolic demands. How does biotin intake affect pregnant and breastfeeding women?

During pregnancy, biotin is essential for normal fetal development. Biotin deficiency during pregnancy has been associated with an increased risk of birth defects in animal studies, although human data is limited.

Key points regarding biotin in pregnancy and breastfeeding:

  • Increased biotin requirements during pregnancy and lactation
  • Recommended intake ranges from 5 to 35 micrograms per day
  • Biotin is transferred to breast milk, making adequate maternal intake important for infant nutrition
  • Severe biotin deficiency is rare but can occur in women with certain genetic disorders

Pregnant and breastfeeding women should consult with their healthcare providers to determine appropriate biotin intake based on their individual needs and health status.

Biotin Supplementation in Infants

While biotin is crucial for infant development, supplementation is generally unnecessary for healthy infants. When might biotin supplementation be recommended for babies?

Biotin supplementation may be necessary for infants in specific cases:

  • Premature infants
  • Infants with biotinidase deficiency
  • Infants receiving total parenteral nutrition (TPN)

In these cases, biotin supplementation should be administered under close medical supervision to ensure appropriate dosage and monitoring.

Interactions Between Biotin and Other Nutrients

Understanding how biotin interacts with other nutrients can help optimize its absorption and effectiveness. What are some important nutrient interactions involving biotin?

Key interactions to consider include:

  1. Pantothenic acid (vitamin B5): May compete with biotin for absorption
  2. Lipoic acid: May decrease biotin absorption
  3. Alcohol: Excessive consumption can impair biotin absorption
  4. Raw egg whites: Contain avidin, which binds to biotin and prevents absorption

Additionally, certain medications may interact with biotin metabolism or absorption. It’s important to consult with a healthcare provider about potential interactions when considering biotin supplementation.

Future Research and Potential Applications of Biotin

While current evidence for biotin’s benefits in hair and nail health is limited, ongoing research is exploring its potential applications in various health conditions. What are some promising areas of biotin research?

Emerging areas of biotin research include:

  • Multiple sclerosis: Some studies suggest high-dose biotin may help improve disability and progression in progressive MS
  • Diabetes management: Biotin may play a role in glucose metabolism and insulin sensitivity
  • Neuropathy: Potential benefits for diabetic and other forms of neuropathy
  • Skin health: Possible applications in treating certain skin conditions

As research progresses, our understanding of biotin’s roles in human health and potential therapeutic applications may expand. However, it’s crucial to approach these potential benefits with caution until more robust clinical evidence is available.

Conclusion: Balancing Biotin Intake for Optimal Health

While biotin is an essential nutrient with important roles in metabolism and overall health, excessive intake through supplementation is generally unnecessary for most people. The potential side effects of too much biotin, while typically mild, can include gastrointestinal discomfort and interference with laboratory tests.

For individuals considering biotin supplementation, it’s important to:

  • Consult with a healthcare provider before starting any new supplement regimen
  • Focus on obtaining biotin through a balanced diet rich in natural sources
  • Be aware of potential interactions with medications and other nutrients
  • Inform healthcare providers about biotin supplementation before undergoing laboratory tests

By maintaining a balanced approach to biotin intake and overall nutrition, individuals can support their health without risking the potential side effects of excessive supplementation.

Biotin – StatPearls – NCBI Bookshelf

Karlyle G. Bistas; Prasanna Tadi.

Author Information and Affiliations

Last Update: May 23, 2023.

Continuing Education Activity

Biotin is an alternative medication used in the management and treatment of pathological hair conditions. It is in the vitamin class of drugs. This activity reviews the indications, action, and contraindications for biotin as a valuable agent in the therapy of biotin deficiency and hair conditions. In addition, this activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for members of the healthcare team in the management of patients with brittle hair and related conditions.

Objectives:

  • Review the treatment considerations for patients with brittle hair and nails.

  • Explain the indications for biotin use.

  • Outline the typical presentation of a patient with biotin deficiency.

  • Summarize the importance of collaboration and communication amongst the interprofessional team to enhance the delivery of care for patients affected by pathological hair conditions and patients receiving biotin.

Access free multiple choice questions on this topic.

Indications

Biotin (B7 or vitamin H) is a water-soluble vitamin, which has received publicity for promoting the growth of hair and nails. There are limited studies, which confirm the exact indications of biotin.[1] Biotinidase deficiency is uncommon but has been documented. Frank deficiency of biotinidase may present as conjunctivitis, ataxia, seizure, skin infections, and developmental delay in children.[2] Biotin may have benefits in those suffering from pathologic brittle hair syndrome or uncombable hair syndrome.[3][4] Otherwise, indications for supplementation remain unnecessary in healthy individuals. [1] Biotin deficiencies would require inborn errors of metabolism. Documentation on supplementation in healthy individuals remains unclear. To date, there have been no trials supporting claims of biotin supplementation being used to improve hair quality or quantity, or nail growth.[5] The U.S. Food and Drug Administration does not recommend daily biotin usage, although breastfeeding or pregnant patients are recommended to take from 5 mcg/ to 35 mcg/day. Pregnancy and smoking increase the metabolism of biotin and would require increased intake, although controversial.[6][7] There is limited evidence to suggest biotin can provide a benefit to hair and nail growth.

Mechanism of Action

Biotin also acts as a coenzyme for multiple carboxylases in humans, and it changes the irreversible carboxylation of acetyl-CoA to malonyl-CoA.[2] These enzymes are vital in numerous metabolic processes. Recently, the new roles of biotin have been acknowledged, in particular, the roles in cell signaling and epigenetic regulation. [8] Biotin’s mechanism of action occurs by attaching to specific lysine residues.[9] The side effects of ingesting too much biotin could include an upset stomach, although it remains a vitamin with very low side effects. Biotin uptake by human colonic epithelial is a carrier-mediated process.[10] Vitamin B7 is a cofactor for three significant carboxylation reactions, which include the conversion of pyruvate to oxalacetate, acetyl-CoA to malonyl-CoA, and propionyl-CoA to methylmalonyl-CoA. A carboxylase reaction includes the transfer of carbon with the assistance of biotin. Essentially these conversions assisted by biotin break down food into glucose, the primary carbohydrate source for the brain and body.

Administration

Biotin appears to be widely protein-bound.[4] Recommendations for biotin intake range from 5 ug to 35 ug per day, depending on circumstances. For example, there is no daily recommendation, but biotin use may be appropriate and warranted for a breastfeeding mother due to increased demand for nutrients. Biotin is also required for the normal development of the fetus when the mother is pregnant. When needed, the most common route of administration for biotin is orally, but biotin administration can also be in an IV form. Therefore, there is no indication for daily use by the U.S. Food and Drug Administration, but when indicated, its administration is usually via the oral route. The IV form is for cases where biotin deficiency is apparent and symptomatic. It can also be useful when treating trichothiodystrophy (TDD), a rare autosomal recessive disorder, which appears to benefit from biotin intake. The tablet form of biotin usually comes in the forms of 10, 50, or 100 mcg. It is metabolized by the liver and excreted by the kidneys.

Adverse Effects

Biotin consumption for beneficial means remains unclear, but it has been considered a very difficult drug to overdose on or cause injury to the body. When taking anticonvulsants such as carbamazepine or phenobarbital, the requirements for biotin increase due to these medications inhibiting uptake into the brush borders of membrane vesicles. [4] Smoking also metabolizes biotin quickly; therefore, increased doses may be warranted when indicated if the patient is a smoker. Information on other drug interactions is minimal. There have been no reported injuries for taking too much biotin, but there are documented cases of biotin deficiency. 

Biotin can interfere with some hormone assays. In immunoassays using the streptavidin-biotin interaction, the interference may induce both false-positive and false-negative results. The hormone levels affected may include thyroid functions, gonadotrophins, and vitamin D.[11][12]

Contraindications

Research supporting claims for the use of biotin for nails and hair remains ambiguous, but there has been well-documented research on the interactions of biotin and other drugs. There are no evident contraindications to taking this vitamin. Biotin is a safe and nontoxic vitamin that the body excretes when in excess. There are no known herbal interactions with biotin. Although not a contraindication, it is important to note that if a person is taking biotin and smoking, they may require increased doses due to increased biotin metabolism.

Monitoring

Dermatologic manifestations appear to be the first sign of biotin deficiency. Biotin plasma concentration levels range from 400 to 1200 ng/L.[1] The daily recommendation for biotin if and when indicated has undergone research, although there appears to be no specific therapeutic index. In circumstances where biotin deficiency is a concern, the urinary biotin concentrations are testable. Although rare, if deficient, a patient may present with dermatitis, enteritis, or alopecia. Antibiotic use or extreme, excessive intake of raw egg whites may induce a state of deficiency, which is very rare.

Toxicity

There is no specific antidote for overdosing on biotin. Excess in the body is rare, and since biotin is a water-soluble vitamin, it is excreted in the urine when in excess. Signs and symptoms of biotin overdose may include and are not limited to insomnia, excessive thirst, and urination. Since biotin has documentation in playing a role in postprandial glucose control, it bears mention that excess would cause signs and symptoms of a person experiencing hyperglycemia (e. g., increased thirst).[13] Diabetic patients should, therefore, be cautious before taking biotin. Although not impossible, it would be very difficult to overdose on biotin. Anaphylaxis is always a common concern with any medication but would present with systemic signs and symptoms. In rare cases, eosinophilic pleuropericardial effusion, a life-threatening condition, may occur.[14] Poison control centers should always be contacted with a suspected overdose.

Enhancing Healthcare Team Outcomes

Clinicians, nurses, physician assistants, and pharmacists must educate patients when confronted with the matter that regular biotin use is not indicated and also not well-documented. Interprofessional team members should be aware that biotin marketing often claims it is “a magic pill for hair and nails,” but the benefits remain unclear. Without the research to support regular usage, heavily marketed claims by the beauty and supplementation industry need to be challenged to examine the efficacy and safety of this drug, which they advertise for regular use. With the epidemic of type 2 diabetes in the United States, further exploration regarding biotin’s role in glucose control requires investigation since studies have concluded it may be beneficial for obese patients and those with type 2 diabetes.[13]

Review Questions

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References

1.

Patel DP, Swink SM, Castelo-Soccio L. A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017 Aug;3(3):166-169. [PMC free article: PMC5582478] [PubMed: 28879195]

2.

Zempleni J, Wijeratne SS, Hassan YI. Biotin. Biofactors. 2009 Jan-Feb;35(1):36-46. [PMC free article: PMC4757853] [PubMed: 19319844]

3.

Al-Eitan LN, Alqa’qa’ K, Amayreh W, Khasawneh R, Aljamal H, Al-Abed M, Haddad Y, Rawashdeh T, Jaradat Z, Haddad H. Identification and Characterization of BTD Gene Mutations in Jordanian Children with Biotinidase Deficiency. J Pers Med. 2020 Jan 21;10(1) [PMC free article: PMC7151559] [PubMed: 31973013]

4.

Zempleni J, Mock DM. Biotin biochemistry and human requirements. J Nutr Biochem. 1999 Mar;10(3):128-38. [PubMed: 15539280]

5.

Soleymani T, Lo Sicco K, Shapiro J. The Infatuation With Biotin Supplementation: Is There Truth Behind Its Rising Popularity? A Comparative Analysis of Clinical Efficacy versus Social Popularity. J Drugs Dermatol. 2017 May 01;16(5):496-500. [PubMed: 28628687]

6.

Sealey WM, Teague AM, Stratton SL, Mock DM. Smoking accelerates biotin catabolism in women. Am J Clin Nutr. 2004 Oct;80(4):932-5. [PMC free article: PMC1450014] [PubMed: 15447901]

7.

Zempleni J, Mock DM. Bioavailability of biotin given orally to humans in pharmacologic doses. Am J Clin Nutr. 1999 Mar;69(3):504-8. [PubMed: 10075337]

8.

Zempleni J. Uptake, localization, and noncarboxylase roles of biotin. Annu Rev Nutr. 2005;25:175-96. [PubMed: 16011464]

9.

Lamhonwah AM, Quan F, Gravel RA. Sequence homology around the biotin-binding site of human propionyl-CoA carboxylase and pyruvate carboxylase. Arch Biochem Biophys. 1987 May 01;254(2):631-6. [PubMed: 3555348]

10.

Said HM, Ortiz A, McCloud E, Dyer D, Moyer MP, Rubin S. Biotin uptake by human colonic epithelial NCM460 cells: a carrier-mediated process shared with pantothenic acid. Am J Physiol. 1998 Nov;275(5):C1365-71. [PubMed: 9814986]

11.

Piketty ML, Polak M, Flechtner I, Gonzales-Briceño L, Souberbielle JC. False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences. Clin Chem Lab Med. 2017 May 01;55(6):780-788. [PubMed: 27732554]

12.

Samarasinghe S, Meah F, Singh V, Basit A, Emanuele N, Emanuele MA, Mazhari A, Holmes EW. BIOTIN INTERFERENCE WITH ROUTINE CLINICAL IMMUNOASSAYS: UNDERSTAND THE CAUSES AND MITIGATE THE RISKS. Endocr Pract. 2017 Aug;23(8):989-998. [PubMed: 28534685]

13.

Xiang X, Liu Y, Zhang X, Zhang W, Wang Z. [Effects of biotin on blood glucose regulation in type 2 diabetes rat model]. Wei Sheng Yan Jiu. 2015 Mar;44(2):185-9, 195. [PubMed: 25997216]

14.

Debourdeau PM, Djezzar S, Estival JL, Zammit CM, Richard RC, Castot AC. Life-threatening eosinophilic pleuropericardial effusion related to vitamins B5 and H. Ann Pharmacother. 2001 Apr;35(4):424-6. [PubMed: 11302404]

Disclosure: Karlyle Bistas declares no relevant financial relationships with ineligible companies.

Disclosure: Prasanna Tadi declares no relevant financial relationships with ineligible companies.

Biotin Side Effects: How Safe Is This Supplement?