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Biotin
Aka: Biotin, Vitamin B7, Vitamin H, Coenzyme R
- Physiology
- Water-soluble B-Vitamin
- Biotin is found in many foods (nuts, whole grains, fruits, vegetables)
- Biotin is a Cofactor in multiple enzymes (e.g. Glucose and Fatty Acid production)
- Only small amounts of Biotin are needed
- Recommended daily intake: 30 mcg/day (men and women, including pregnancy)
- Pathophysiology: Biotin Deficiency
- Biotin deficiency is rare
- Biotin deficiency may manifest as hair thinning
- Risk Factors
- Pregnancy (but Prenatal Vitamins have adequate Biotin)
- Consumption of raw egg whites
- Raw egg whites contain avidin protein which prevents Biotin absorption
- Cooking egg whites denatures and deactivates the avidin protein
- Precautions
- No high quality evidence for Biotin supplementation
- Many OTC products contain high dose Biotin (>300 up to 5000 mcg/day)
- High dose Biotin is found in supplements marketed for hair, skin or Nail Growth
- Low dose Biotin (e.g. 30 mcg in Multivitamins)
- High dose Biotin Interferes with lab assays (see below)
- Hold Biotin 3 days before lab testing
- Labs: High Dose Biotin (>300 mcg/day) falsely LOWERS other lab levels
- Thyroid Stimulating Hormone (TSH)
- Beta-HCG
- Procalcitonin
- Serum Troponin
- Labs: High Dose Biotin (>300 mcg/day) falsely RAISES other lab levels
- Serum Free T3
- Serum Free T4
- Serum Folate
- References
- (2018) Presc Lett 25(2)
- LoVecchio Crit Dec Emerg Med (2018) 32(5): 32