Biotin (vitamin H) : Dosing, Safety and Interactions

by MedlinePlus

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Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Dietary intake

Foods/supplements rich in biotin: Barley, brewer's yeast ( Saccharomyces cerevisiae ), egg yolks, kidney, liver, milk, pancreas, royal jelly, soy, wheat bran. Lesser amounts of biotin are found in avocado, bread, broccoli, cauliflower, cheeses, chicken, fish, legumes, mushrooms, nuts, pork, potatoes, and spinach. People observing vegan or lactoovovegetarian diets appear to obtain sufficient amounts of biotin in their diets.

Supplements: Biotin is available as capsules and tablets in various doses, and as lozenges.

Adults (18 years and older)

Daily Adequate Intake (AI): The U.S. Food and Nutrition Board of the National Academy of Science's Institute of Medicine recommends a daily AI of 30mcg in adults 19 years and older (a daily AI of 25mcg is recommended in those ages 14-18 years-old). In pregnant women older than 14 years, an AI of 30mcg is recommended. During breastfeeding, a daily AI of 35mcg is recommended. Most healthy non-pregnant individuals with regular diets obtain these amounts of biotin through dietary consumption.

Recommended Daily Allowance (RDA): The U.S. RDA for biotin is 300mcg daily. This is the dose used in many dietary supplements. However, the daily requirement of biotin has not been clearly established scientifically, largely because biotin is available in many foods and is ingested in adequate amounts by most individuals. In addition, biotin is made by bacteria in the gut, which may contribute to the human biotin requirement. No toxicity has been reported with biotin intake, and doses as high as 200mg daily have been used in patients with inborn errors of metabolism without significant reported toxicity.

Biotin deficiency: Should be under strict medical supervision. There is disagreement among experts about the proper dose. In adults, intramuscular doses as low as 150-300mcg daily have been suggested. Higher doses between 10-40mg of biotin daily have also been recommended (given orally, intramuscularly, or intravenously). Higher doses may lead to faster improvement. Dosing may be selected and adjusted depending on the duration and severity of the deficiency. Symptoms should improve within 3-5 days, and completely resolve after several months. Doses as high as 30mg daily for several months have been tolerated. The cause of the deficiency should be addressed, and supportive care should be provided as appropriate.

Children (younger than 18 years)

Daily Adequate Intake (AI): The U.S. Food and Nutrition Board of the National Academy of Science's Institute of Medicine recommends a daily AI of 5mcg daily (~0.7mcg/kg) in infants ages 0-6 months-old; 6mcg daily (~0.7mcg/kg) in infants ages 7-12 months-old; 8mcg daily in children ages 1-3 years-old; 12mcg daily in children ages 4-8 years-old; 20mcg daily in children ages 9-13 years-old; and 25mcg in adolescents ages 14-18 years-old. Most healthy non-pregnant individuals with regular diets obtain these amounts of biotin through dietary consumption.

Biotin deficiency: Should be under strict medical supervision. There is disagreement among experts about the proper dose. In children, doses as high as 6-30mg daily have been recommended, either orally, intramuscularly, or intravenously (depending on the duration and severity of the deficiency). Lower doses (closer to the AI) can also be considered on a case-by-case basis. Symptoms should improve within 3-5 days, and completely resolve after several months. The cause of the deficiency should be addressed, and supportive care should be provided as appropriate. Inborn errors of metabolism should be ruled-out.

Biotin-responsive inborn errors of metabolism: Treatment should be under strict medical supervision. Large doses of biotin (5-20mg daily) have been reported as used in patients with holocarboxylase synthetase deficiency or biotidinase deficiency. Doses between 10-100mg of biotin daily have been recommended in holocarboxylase synthetase deficiency. Approximately 20mg daily has been recommended in carboxylase deficiency. Treatment is generally continued indefinitely.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Individuals with hypersensitivity to constituents of biotin supplements should avoid these products.

Side Effects and Warnings

No significant toxicity has been reported with biotin intake, and very high doses (up to 200mg daily) have been used in patients with inborn errors of metabolism without reported toxicity. However, doses higher than the U.S. Food and Nutrition Board's recommended daily Adequate Intake (AI) should not be exceeded in healthy individuals unless under medical supervision.

Pregnancy and Breastfeeding

Pregnancy: Marginal biotin deficiency has been found to commonly occur during pregnancy. Serious concern has been focused on this finding, because biotin deficiency is teratogenic (causes birth defects) in many animals. It has been suggested by some experts that biotin supplements should be considered for widespread use in pregnant women, although as of 2004 the scientific evidence is not considered conclusive enough to make this recommendation. Biotin supplementation during pregnancy in not currently standard practice, and prenatal vitamins do not generally contain biotin. However, individual patients may be considered for biotin supplementation by health care practitioners on a case-by-case basis. The recommended daily adequate intake (AI) by the U.S. Food and Nutrition Board is 30mcg for pregnant women. This dose should not be exceeded unless under medical supervision.

Breastfeeding: The recommended daily adequate intake (AI) by the U.S. Food and Nutrition Board is 35mcg for breastfeeding women. This dose should not be exceeded unless under medical supervision.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Anti-seizure medications: The anticonvulsants phenytoin (Dilantin), primidone (Mysoline), carbamazepine (Tegretol), phenobarbital (Solfoton), and possibly valproic acid have been associated with reduced blood levels of biotin. This is due to reduced gut absorption of biotin and increased urinary excretion. Testing of biotin blood or urine levels should be considered in individuals using these drugs chronically, and biotin supplementation may be necessary if deficiency is found.

Broad-spectrum oral antibiotics: Broad-spectrum antibiotics such as sulfa drugs can alter the normal intestinal bacteria (flora) which make biotin. Although it is not clear if this flora-produced biotin can actually be used by humans, testing of biotin blood or urine levels should be considered in individuals using these drugs chronically. Biotin supplementation may be necessary if deficiency is found.

Isotretinoin (Accutane): May reduce biotinidase activity. It is not clear if biotin supplementation may be warranted during chronic use.

Interactions with Herbs/Supplements

Pantothenic acid: High-doses of pantothenic acid can lead to malabsorption of biotin in the gut, and can lower levels of biotin in the body.

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