Biotin

Biotin is a natural supplement belonging to the supplement category of the water-soluble B vitamins class.

Biotin is also called vitamin B7, coenzyme R and vitamin H.

A deficiency of biotin leads to biotin deficiency disorder, which is characterized by a variety of symptoms affecting the skin, hair, nails, and neurological system. Infants with a biotin deficit show sluggishness, delayed development, and decreased muscular tone.

Biotin is a vital component of many metabolic processes that break down food into glucose, the body's main energy source and the brain's primary source. Its involvement in carboxylation processes is necessary to create essential cellular and energy-production chemicals.

The small intestine is where biotin is predominantly absorbed and enters the circulatory system, where it is distributed. It is used in cellular metabolism, especially for the activity of enzymes. The excess biotin is excreted from the urine.

The common side effects of biotin include upset stomach or diarrhoea.

Biotin is available in various forms, like tablets and capsules.

Foods rich in biotin are cereals (wheat, oats), vegetables (spinach, tomatoes, soybeans, carrots, mushrooms), rice, egg yolk and liver. Dairy items and breast milk also contain biotin.

Biochemical action of biotin

Biotin belongs to the supplement class and acts as a coenzyme for multiple carboxylases. Biotin acts via the carboxylation pathway.

As a coenzyme for several carboxylases, biotin helps catalyze important metabolic reactions such as transforming acetyl-CoA into malonyl-CoA and other reactions. Further controlling epigenetic regulation and cell signalling have been revealed by a recent study. To be effective, biotin must bind to particular lysine residues. Biotin absorption in the human colonic epithelium is promoted via a carrier-mediated mechanism. Three important carboxylation events involving the conversion of pyruvate to oxalacetate, acetyl-CoA to malonyl-CoA, and propionyl-CoA to methyl malonyl-CoA all include biotin acts as a cofactor. Carbon is transferred during carboxylase processes with the help of biotin, converting food into glucose, the primary energy source for the brain and body.

Biotin is available in the form of tablets and capsules.

Tablets/ capsules will be swallowed whole with water/liquid, as applicable.

Biotin can be used as supplement support for various health purposes due to its essential role as a coenzyme in several metabolic processes.

• Supplementing biotin promotes cell metabolism, growth and development.
• Biotin supplement also enhances cognitive function and brain health.
• It is used as a prenatal supplement as it is essential for the embryo's growth.
• As a supplement, biotin may help lower blood sugar levels in people with diabetes.

Vitamins and natural supplements should not replace a balanced diet

This product is not intended to diagnose, treat or prevent any disease(s).

Biotin may be useful as a supplement for the following health benefits:

• Diabetes: According to studies, biotin may help treat diabetes symptoms. In certain diabetics, it helps control blood sugar levels and also aids in managing neurological diabetic symptoms, including neuropathy (damage or dysfunction of a nerve).
• Treating multiple sclerosis: High-dose biotin therapy might help multiple sclerosis(MS) patients experience fewer side effects, according to studies. This autoimmune condition affects the neurological system and causes muscle weakness and other issues.
• Brittle Nails (Onychoschizia): Supplementing with biotin seems to strengthen brittle nails, while the mechanism is uncertain.
• Dermatitis: It has been shown that vitamin B7 contributes to keeping healthy skin. There is, however, little proof that supplements with biotin can effectively treat or prevent dermatitis.
• Dyslipidemia: In both diabetic and non-diabetic participants, biotin significantly reduced triglycerides and very low-density lipoproteins (VLDL), according to several clinical studies.

Biotin is commonly administered orally before or after meals for all oral solid forms.

The dosage and duration of treatment should be as per the clinical judgment of the treating healthcare professional.

Vitamins and natural supplements should not replace a balanced diet

This product is not intended to diagnose, treat or prevent any disease(s).

• Tablets: 1mg, 5mg, 10mg
• Capsules: 5mg, 10mg

Biotin is available in the form of tablets and capsules.

• Limit the consumption of drinks that include caffeine, such as coffee, tea, chocolate, and alcoholic beverages, as this substance could hinder the absorption of biotin.
• Avoid consuming foods high in fat or cholesterol, or biotin will be less effective.
• Stay within your daily calorie needs.
• Avoid spicy foods.

The dietary restriction should be individualized as per patient requirements.

Recommended Daily Allowance (RDA)

RDA for adults is 30 μg/day.

Upper Tolerable Intake (UTL):

No UTL is set for biotin, as data concerning adverse effects is insufficient.

• Biotin administration may be contraindicated by an individual's hypersensitivity to the substance or its formulation.
• Overconsumption of raw egg whites (which includes avidin, which binds biotin) prevents biotin’s absorption in the gastrointestinal tract.
• People receiving kidney dialysis might be deficit and may need a biotin supplement.
• A genetic condition called biotinidase deficiency prevents the body from metabolizing biotin. People suffering from this disease may have low biotin levels and require a supplement.
• Insufficient excretion of extra biotin may occur in kidney failure.

Biotin is a vitamin present in multivitamins. When biotin levels exceed the recommended daily allowance, laboratory test results may be falsely high or low.

Smoking also increases biotin metabolism; therefore, higher doses may be required when necessary if the patient smokes.

Diabetes patients must give biotin cautiously since it may make patients thirstier when their blood sugar levels are high.

• Caution is advised when consuming alcohol with biotin.

• Biotin is likely safe when taken by mouth while breastfeeding but should not take in excess unless recommended by the doctor.

• Biotin is safe to use during pregnancy but should not take in excess unless recommended by the doctor.

Biotin supplementation is reported to be well-tolerated and safe to use.

The adverse reactions related to biotin can be categorized as-

• Common: Nausea, diarrhoea, upset stomach and skin rash or itching
• Less common: Allergic reactions, such as hives or swelling and abnormal liver function tests
• Rare: Difficulty breathing and anaphylaxis.

Anticonvulsant medication such as causes carbamazepine, phenobarbital, phenytoin, and primidone increases biotin catabolism, which lowers biotin status and prevents intestinal absorption of biotin.

The common side effects associated with biotin include:

• Nausea
• Diarrhea
• Upset stomach
• Skin rash or itching
• Hives
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

• Pregnancy: The recommended daily intake of biotin in pregnancy is 30 mcg.

• Paediatrics: Biotin deficiency is higher in children, especially babies; it plays a critical role in promoting brain growth, sustaining cell function, and developing and protecting the body's nervous system.

The recommended daily intake of biotin in paediatrics ranges from 5-25 mcg/day.

Dosage Adjustment for Paediatric Patients

There are no specific dosage adjustments provided.

• Geriatrics: There is no sufficient scientific evidence traceable regarding the use and safety of biotin for use in special populations.

• Lactating mothers: The recommended daily intake of biotin in lactating mothers is 35 mcg.

Dosage Adjustment in Kidney Impairment

There are no specific dosage adjustments provided.

Dosage Adjustment in Hepatic Impairment

There are no specific dosage adjustments provided.

Dosage Adjustment in Adult Patients

There are no specific dosage adjustments provided.

Overdosage of biotin supplements is rare, and since it is water soluble, excess biotin is easily excreted from the body via urine. Extreme high doses of biotin may show potential symptoms like itching, nausea, excessive thirst, urination, insomnia and GI disturbances which are self-limiting.

There is no specific treatment in the event of an overdose. In the event

of an overdose, the mainstay treatment is stopping the exogenous biotin supplementation and treating the patient symptomatically, and supportive measures are instituted as required.

Biochemistry profile of biotin:

Biotin is a bicyclic molecule; its chemical structure has one ring containing a ureido group (-N-CO-N-), and the other sulfur (a tetrahydrothiophene ring). Only one of the eight potential biotin stereoisomers exists naturally and is metabolically active: d-(+)-biotin (commonly referred to as "D-biotin").

Biotin functions as a prosthetic group for four key carboxylase enzyme metabolic processes like gluconeogenesis, fatty acid synthesis, and amino acid catabolism. Three of these enzymes are present in the mitochondria, and the fourth, acetyl-CoA carboxylase, is found in both the cytosol and mitochondria. By converting bicarbonate into acetyl-CoA and, ultimately malonyl CoA, the ACC helps to synthesize fatty acids and lengthen their chains. In addition to supporting other carboxylases, decarboxylases, and transcarboxylase, biotin is a critical component of numerous enzymatic pathways required for cellular metabolism.

Kinetic profile:

• Absorption: After ingestion, biotin is mainly absorbed in the small intestine through carrier-mediated processes.

• Distribution: It then circulates through the bloodstream to different tissues, where it serves as a cofactor for enzymes called carboxylases, essential for gluconeogenesis, fatty acid synthesis, and amino acid catabolism.
• Metabolism: After being absorbed by cells, biotin combines with proteins to produce biotin-protein complexes necessary to activate carboxylase enzymes. These biotin-protein complexes break down during metabolism, releasing free biotin for enzymatic processes.
• Excretion: Excess biotin that is not used in enzymatic reactions is eliminated in the urine, whereas a lesser portion is expelled in faeces. The amount of biotin in the body is strictly regulated, and any excess that is ingested is rapidly eliminated to avoid toxicity.

1. https://ods.od.nih.gov/factsheets/Biotin-HealthProfessional/
2. https://altmedrev.com/wp-content/uploads/2019/02/v12-1-73.pdf
3. https://ods.od.nih.gov/factsheets/Biotin-Consumer/
4. https://www.ncbi.nlm.nih.gov/books/NBK554493/
5. https://reference.medscape.com/drug/coenzyme-r-vitamin-h-biotin-345061#7
6. https://www.webmd.com/vitamins/ai/ingredientmono-313/biotin