Does Biotin supplementation actually help encourage hair growth or simply create expensive urine? (Biotin is water soluble and any excess consumed is excreted in the urine.)
Biotin was first recognized as an essential nutrient factor in mammals in 1936. 1
Biotin is one of the water-soluble B vitamins that helps the body to convert food (carbohydrates, fats and amino acids/protein) into fuel (glucose).. The body only needs a small amount of biotin for its metabolic functions. and is easily obtained through various foods such as yeast, whole-wheat bread, egg or yolk , leafy green vegetables, nuts, legumes, cheese, liver, port, salmon, avocado, raspberries and cauliflower. Also, the intestinal flora produce biotin that the body can use and the vitamin is essentially recycled every day. 3so deficiency is rare because the intestines produce biotin in excess of the body’s daily requirements.For this reason, most countries including the USA and Australia do not prescribe a recommended daily intake or allowance of biotin. The Adequate Intake level (AI) for adults is 30 mcg per day 2 that is usually available in most multi-vitamins and numerous foods. The recommended dose to treat deficiency for adults varies from 3,000 mcg per day for brittle fingernails up to 7,000 to 15,000 mcg per day for diabetics. 6The usual dose I see recommended for hair loss patients by physicians is 3000 mcg per day.
There are basically only a few causes of true biotin deficiency. The first is by inherited metabolic disorders where an individual’s metabolism of biotin is abnormal, such as a deficiency in the holocarboxylase synthetase enzyme or biotinidase which covalently links biotin onto carboxylase, where biotin acts as a cofactor. 6
Biotinidase or Holocarboxylase synthetase deficiency prevents the body’s cells from using biotin effectively, and thus interferes with multiple carboxylase reactions (these are complex bio-chemical reactions that occur to convert biotin to a usable form by the body). 7 2 This enzyme deficiency is rare and is usually discovered in infants when they present with symptoms. Clinical findings as described below are usually adequate to make the diagnosis but a serum assay is available. 6
The other causes of Biotin Deficiency are related to lack of consumption or more likely malabsorption, prolonged intravenous (parental) feeding without biotin supplementation and consumption of raw egg white for prolonged periods (many weeks to years). Raw egg whites contain avidin, a protein which binds strongly to biotin, making it unavailable to the body. Some anti-seizure medications and long-term antibiotic therapy can create a deficit. Additionally, conditions such as Crohn’s disease, partial gastrectomy and alcoholism make it hard to absorb nutrients and can cause deficiency.
Regardless of the etiology of biotin deficiency, clinical manifestations are essentially the same. The first symptoms of biotin deficiency are associated with the skin and hair. Symptoms develop within 3-5 weeks of the onset of deficient biotin intake or absorption. The most common cutaneous findings include the following:
- Dry skin
- Seborrheic dermatitis
- Fungal infections
- Rashes, including erythematous periorofacial macular rash
- Fine and brittle hair
- Hair loss or total alopecia
Approximately 1-2 weeks later, neurologic symptoms begin to develop. The most common neurologic findings include the following:
- Mild depression, which may progress to profound lassitude and, eventually, to somnolence
- Changes in mental status
- Generalized muscular pains (myalgias)
- Intestinal tract symptoms also develop and most commonly include the following:
- Nausea, occasionally severe
As indicated above, symptoms of biotin deficiency present as a syndrome or cluster of symptoms. Supplementation adequately treats and corrects these symptoms. 1,2
An isolated finding such as hair loss is not indicative of biotin deficiency but is most likely related to another cause.
Current literature is conflicting regarding the benefits of biotin supplementation for brittle nails and diabetes. No literature or scientific studies exist that show that biotin supplementation assists with hair growth. Some uses for biotin discussed are speculative but include studies that show biotin supplementation might help reduce blood sugar levels in people with either type 1 or type 2 diabetes and possibly reduce the symptoms of diabetic neuropathy. However, no double-blind, placebo-controlled studies have been reported on these potential uses of biotin. Two double-blind studies have found benefit for diabetes with a mixture of biotin and chromium; however it is not clear how much the biotin in this combination contributed. 9
Very weak evidence, too weak to rely upon , has been used to support biotin supplementation for brittle nails. Biotin has been proposed for treating cradle cap in infants.8 but there is no scientific evidence to support this theory,
Again, there are no studies to date that show improvement in hair loss while taking biotin supplements. However, biotin is one of the most frequent recommendations by health care providers for individuals suffering from hair loss.
Because biotin is a water-soluble vitamin, no risk for toxicity or overdose exists.10 as any excess biotin is excreted in the urine.
To date, very few treatment modalities are available to correct significant hair loss. Prescriptions such as minoxidil (Rogaine) and propecia have been shown beneficial for certain types of hair loss. Correcting other underlying disease processes that cause alopecia is key, however. Exhibiting a healthy lifestyle with regular exercise, proper nutrition while limiting alcohol intake and not smoking are also essential.
In all of my years of practicing medicine, first as an ICU surgeon and lastly as a hair transplant surgeon, I have never encountered a patient with a true biotin deficiency. While practicing as a critical care surgeon in ICU, most of our critically ill patients were routinely tested for vitamin B deficiencies but none of my patients ever had an abnormal result. I have not requested any serum laboratory testing for my hair transplant patients to check for biotin level deficiency, but there has been not ancillary reason to do so. As noted above, biotin deficiency seemingly creates a global set of symptoms that does include hair loss. Isolated hair loss not accompanied by the constellation of symptoms discussed here would not occur in this deficiency.
To date, 60-75% of the patients I see in my hair restoration practice take biotin supplementation as prescribed by their other health care providers and physicians in hopes that this would be the panacea to cure their hair loss. The data that even suggest it might be beneficial to hair is based on poor data at best for nail growth and brittle nail therapy.
Although no scientific evidence exists that supports biotin supplementation is beneficial to help treat hair loss, it certainly doesn’t cause any harm. Hopefully, this article will help us to better understand the scientific mechanism of biotin while we continue to seek more data and other treatments for hair loss.
4 Otten, JJ, Hellwig, JP and Meyers, LD., ed. (2006). Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. The National Academies Press. ISBN 0-309-10091-7
6 Beth Israel Deaconess Medical Center. “Biotin
”. Retrieved 15 May 2012.
9 Beth Israel Deaconess Medical Center. “Biotin
”. Retrieved 15 May 2012