Biotin

Biotin/Drug Interactions:

  • AntibioticsAntibiotics: Broad-spectrum antibiotics, such as sulfa drugs, may alter the intestinal bacteria that synthesize biotin. Certain sulfonamides have been shown to be poorly absorbed from the gastrointestinal tract and to alter the local bacterial flora (46). In human research, the administration of sulfathalidine resulted in a decreased fecal excretion of biotin, while there was no decrease in urinary biotin levels (47).
  • AnticonvulsantsAnticonvulsants: In human research, excretion of the biotin metabolite bisnorbiotin increased in children receiving long-term treatment with carbamazepine, phenytoin, or phenobarbital, suggesting accelerated biotin catabolism (71). Accelerated catabolism may lead to biotin deficiency. Based on secondary sources, primidone (Mysoline?) and possibly valproic acid have been associated with reduced blood levels of biotin.
  • AntidiabeticsAntidiabetics: In a randomized, placebo controlled study, therapy consisting of chromium picolinate and biotin improved glycemic control in overweight and obese individuals with diabetes mellitus type 2 when used as an adjunct to standard diabetic treatment (98). In a randomized trial of patients with diabetes mellitus type 2 who were taking oral antihyperglycemic agents but had suboptimal glycemic control, treatment with chromium (as chromium picolinate) and biotin resulted in a statistically significant reduction of the area under the curve for glucose in a two-hour glucose tolerance test; statistically significant reductions were also seen in fructosamine (99).
  • AntilipemicsAntilipemics: In a randomized, placebo controlled trial, chromium picolinate and biotin therapy reduced the atherogenic index of plasma in obese individuals with diabetes mellitus type 2 when used in combination with standard oral hypoglycemic agents. Patients receiving chromium picolinate-biotin therapy showed reduced ratios of total to HDL cholesterol, LDL to HDL cholesterol, and non-HDL to HDL cholesterol (100). In a randomized trial of patients with diabetes mellitus type 2 who were taking oral antihyperglycemic agents but had suboptimal glycemic control, treatment with chromium as (chromium picolinate) and biotin resulted in a statistically significant reduction in triglycerides and in the ratio of triglycerides to high-density lipoprotein (HDL) (99).
  • CarbamazepineCarbamazepine: In human research, excretion of the biotin metabolite bisnorbiotin increased in children receiving long-term treatment with carbamazepine, phenytoin, or phenobarbital, suggesting accelerated biotin catabolism (71). Accelerated catabolism may lead to biotin deficiency.
  • Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In cultured Jurkat cells, biotin supplementation increased the abundance of cytochrome P450 1B1 mRNA (72).
  • IsotretinoinIsotretinoin: Results of human research suggest that isotretinoin (Roaccutane?) reduces biotinidase activity (73). Reduced biotinidase activity may lead to biotin deficiency.
  • PhenobarbitalPhenobarbital: In human research, excretion of the biotin metabolite bisnorbiotin increased in children receiving long-term treatment with carbamazepine, phenytoin, or phenobarbital, suggesting accelerated biotin catabolism (71). Accelerated catabolism may lead to biotin deficiency.
  • PhenytoinPhenytoin: In human research, excretion of the biotin metabolite bisnorbiotin increased in children receiving long-term treatment with carbamazepine, phenytoin, or phenobarbital, compared to healthy controls, suggesting accelerated biotin catabolism (71). Accelerated catabolism may lead to biotin deficiency.
  • PrimidonePrimidone: Accelerated catabolism may lead to biotin deficiency. Based on secondary sources, primidone (Mysoline?) has been associated with reduced blood levels of biotin.
  • Valproic acidValproic acid: Based on secondary sources, valproic acid may have been associated with reduced blood levels of biotin.

    • Biotin/Herb/Supplement Interactions:

  • AntilipemicsAntilipemics: In a randomized, placebo controlled trial, chromium picolinate and biotin therapy reduced the atherogenic index of plasma in obese individuals with diabetes mellitus type 2 when used in combination with standard oral hypoglycemic agents. Patients receiving chromium picolinate-biotin therapy showed reduced ratios of total to HDL cholesterol, LDL to HDL cholesterol, and non-HDL to HDL cholesterol (100). In a randomized trial of patients with diabetes mellitus type 2 who were taking oral antihyperglycemic agents but had suboptimal glycemic control, treatment with chromium as (chromium picolinate) and biotin resulted in a statistically significant reduction in triglycerides and in the ratio of triglycerides to high-density lipoprotein (HDL) (99).
  • Avidin: Avidin: Avidin is a protein in egg white that binds biotin with a Kd of 10-15M, preventing its absorption (75; 76). Consumption of large amounts of raw egg white over months results in biotin deficiency in humans (74; 1). Denaturation of avidin, e.g., by heating or cooking, destroys avidin's biotin-binding capacity.
  • ChromiumChromium: In a randomized, placebo controlled study, therapy consisting of chromium (as chromium picolinate) and biotin improved glycemic control in overweight and obese individuals with diabetes mellitus type 2 when used as an adjunct to standard diabetic treatment (98). In a randomized trial of patients with diabetes mellitus type 2 who were taking oral antihyperglycemic agents but had suboptimal glycemic control, treatment with chromium as (chromium picolinate) and biotin per resulted in a statistically significant reduction of the area under the curve for glucose in a two-hour glucose tolerance test; statistically significantly greater reductions were also seen in fructosamine. Treatment also resulted in a statistically significant reduction in triglycerides and in the ratio of triglycerides to high-density lipoprotein (HDL) (99). In a randomized, placebo controlled trial, chromium picolinate and biotin therapy reduced the atherogenic index of plasma in obese individuals with diabetes mellitus type 2 when used in combination with standard oral hypoglycemic agents. Patients receiving chromium picolinate-biotin therapy showed reduced ratios of total to HDL cholesterol, LDL to HDL cholesterol, and non-HDL to HDL cholesterol (100).
  • Cytochrome-modifying agentsCytochrome-modifying agents: In cultured Jurkat cells, biotin supplementation increased the abundance of cytochrome P450 1B1 mRNA (72).
  • Hyperglycemics/hypoglycemics: Hyperglycemics/hypoglycemics: In a randomized, placebo controlled study, therapy consisting of chromium picolinate and biotin improved glycemic control in overweight and obese individuals with diabetes mellitus type 2 when used as an adjunct to standard diabetic treatment (98). In a randomized trial of patients with diabetes mellitus type 2 who were taking oral antihyperglycemic agents but had suboptimal glycemic control, treatment with chromium as (chromium picolinate) and biotin resulted in a statistically significant reduction of the area under the curve for glucose in a two-hour glucose tolerance test; statistically significantly greater reductions were also seen in fructosamine (99).
  • Lipoic acidLipoic acid: Biotin shares the sodium-dependent multivitamin transporter (SMVT) with lipoic acid. According to a review, theoretically this may reduce biotin absorption (101; 1).
  • Vitamin B5Vitamin B5: Biotin shares the sodium-dependent multivitamin transporter (SMVT) with vitamin B5, also known as pantothenic acid (102). According to a review, theoretically this may reduce biotin absorption (101; 1). According to a review, biotin deficiency may be exacerbated by vitamin B5 deficiency (103). In a case report, potentially life-threatening eosinophilic pleuropericarditis was observed in a 76 year-old woman who had been taking vitamin B5 and biotin for two months. Once the vitamins were withdrawn, the eosinophilia disappeared and the patient recovered (104).

    • Biotin/Food Interactions:

  • Raw egg whiteRaw egg white: Raw egg white contains avidin, a protein that binds biotin with a Kd of 10-15M, preventing its absorption (75; 76). Consumption of large amounts of raw egg white over a period of months results in biotin deficiency in humans (74; 1). Denaturation of avidin, e.g., by heating or cooking, destroys avidin's biotin-binding capacity.

    • Biotin/Lab Interactions:

  • Free thyroxine (FT4)Free thyroxine (FT4): There is a report of a false-high FT4 on the assay by the Boehringer Mannheim ES 700 analyzer attributed to high serum biotin levels in a neonate (105).
  • Thyroid-stimulating hormone (TSH)Thyroid-stimulating hormone (TSH): There is a report of a false-low TSH on the assay by the Boehringer Mannheim ES 700 analyzer attributed to high serum biotin levels in a neonate (105).
  • Serum fatty acidsSerum fatty acids: According to a review, biotin deficiency due to total parenteral nutrition altered serum fatty acid composition (106). However, biotin is routinely included in parenteral nutrition; biotin deficiency associated with parenteral nutrition has not been reported since this practice was adopted (107).