Coenzyme R

Related Terms

ARP [N-(aminooxyacetyl)-N-(D-biotinoyl) hydrazine], B vitamins, biocytin, bioepiderm, bios II, biot?n, biotin cadaverine, biotin nitrilotriacetic acid, biotin NTA, biotina, biotina, biotin-alkaline phosphate, biotin-PEO2-PPO2-amine, biotin-PEO3-maleimide, biotin-PEO4-amine, biotin-PEO4-propionate succinimidyl ester, biotinidase, biotyna, biyotin, carboxylic acids, cis-hexahydro-2-oxo-1H-thieno[3,4-d]-imidazole-4-valeric acid, coenzyme R, cofactors, D-biotin, cis-hexahydro-2-oxo-1H-thieno[3,4-d]-imidazole-4-valeric acid, Diachrome?, dUTP biotin, factor alpha, shengw? s? (Chinese), tripotassium salt (BNTA), vitamin B7, vitamin H, W factor.
Note: This monograph does not include the use of biotin as a laboratory or diagnostic reagent. The monograph does not discuss analytical methods for measuring biotin, e.g., in biological fluids.

Background

Biotin is an essential water-soluble B vitamin, also known as vitamin B7. Biotin binds to a number of enzymes and other proteins. Without biotin, these enzymes do not function properly. Biotin is available in a wide variety of plant- and animal-based foods. Among the richest sources are milk and liver. Biotin can also be obtained from bananas, brewer's yeast, cauliflower, cooked eggs, legumes, nuts and nut butters, sardines, and whole grains.
Biotin deficiency is rare. This is because daily biotin requirements are relatively small. Biotin is found in many foods, bacteria in the intestine also make biotin, and the body is able to recycle much of the biotin it has already used. Reports of significant toxicity with biotin are lacking, even with doses 600 times greater than the estimated daily intake of approximately 30 micrograms in a healthy adult.
Some populations are at greater risk of developing biotin deficiency. These include malnourished children in developing countries, those taking anticonvulsants or broad-spectrum antibiotics (such as sulfa drugs), and those who consume large amounts of raw egg white over months or years. Raw egg white contains the protein avidin. Avidin binds biotin very tightly and prevents its absorption in the digestive system. Marginal biotin deficiency, which is not severe enough to cause classic symptoms, may develop in up to 50% of women during normal pregnancies.
Biotin deficiency can be the result of inborn errors of metabolism, such as defects in any of the enzymes that bind to or process biotin in the body. The symptoms of biotin deficiency are similar, regardless of the underlying cause. Symptoms include conjunctivitis, developmental delay in infants and children, hair loss, low muscle tone, metabolic changes (such as impaired glucose tolerance), skin lesions around the mouth and other body openings, seizures, and uncoordinated body movements. Biotin deficiency due to inborn errors of metabolism can generally be treated with very high doses of biotin without adverse effects.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Biotin deficiency is rare in developed countries. The symptoms of biotin deficiency are similar, regardless of the underlying cause. Symptoms include conjunctivitis, developmental delay in infants and children, hair loss, low muscle tone, metabolic changes, skin lesions around the mouth and other body openings, seizures, and uncoordinated body movements. Biotin deficiency may generally be treated by biotin supplementation without adverse effects.

 A


Biotin deficiency is rare in developed countries. The symptoms of biotin deficiency are similar, regardless of the underlying cause. Symptoms include conjunctivitis, developmental delay in infants and children, hair loss, low muscle tone, metabolic changes, skin lesions around the mouth and other body openings, seizures, and uncoordinated body movements. Biotin deficiency may generally be treated by biotin supplementation without adverse effects.

 A


Inborn errors of metabolism, such as defects in any of the enzymes that bind to biotin, can cause functional biotin deficiency. Biotin-responsive basal ganglia disease has been reported. Biotin deficiency due to inborn errors of metabolism can generally be treated with very high doses of biotin without adverse effects.

 A


Inborn errors of metabolism, such as defects in any of the enzymes that bind to biotin, can cause functional biotin deficiency. Biotin-responsive basal ganglia disease has been reported. Biotin deficiency due to inborn errors of metabolism can generally be treated with very high doses of biotin without adverse effects.

 A


Biotin has been routinely included in parenteral nutrition for over 25 years. Biotin deficiency associated with parenteral nutrition has not been reported since this practice was adopted.

 B


Biotin has been routinely included in parenteral nutrition for over 25 years. Biotin deficiency associated with parenteral nutrition has not been reported since this practice was adopted.

 B


Biotin has been used as a treatment for brittle fingernails. Additional studies are needed before a conclusion can be made.

 C


Biotin has been used as a treatment for brittle fingernails. Additional studies are needed before a conclusion can be made.

 C


Treatment with biotin and the nutritional supplement chromium picolinate reduced cholesterol and blood lipids in patients with diabetes mellitus type 2 who were also taking standard blood sugar-lowering agents by mouth. Additional research on the effect of biotin alone is needed.

 C


Treatment with biotin and the nutritional supplement chromium picolinate reduced cholesterol and blood lipids in patients with diabetes mellitus type 2 who were also taking standard blood sugar-lowering agents by mouth. Additional research on the effect of biotin alone is needed.

 C


Biotin may play a role in maintenance of glucose tolerance. Treatment with biotin and the nutritional supplement chromium picolinate improved glycemic control in overweight and obese individuals with diabetes mellitus type 2 who were also taking standard blood sugar-lowering agents by mouth. Additional research on the effect of biotin alone is needed.

 C


Biotin may play a role in maintenance of glucose tolerance. Treatment with biotin and the nutritional supplement chromium picolinate improved glycemic control in overweight and obese individuals with diabetes mellitus type 2 who were also taking standard blood sugar-lowering agents by mouth. Additional research on the effect of biotin alone is needed.

 C


Biotin has been included in a therapeutic treatment plan for newborn infants with convulsions and epileptic syndromes. Additional research is required.

 C


Biotin has been included in a therapeutic treatment plan for newborn infants with convulsions and epileptic syndromes. Additional research is required.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
General: The U.S. Food and Drug Administration (FDA) has not established a recommended dietary allowance (RDA) for biotin. The Food and Nutrition Board of the Institute of Medicine of the National Academies recommends a daily adequate intake (AI) of 30 micrograms in adults 19 years of age and older. In pregnant women 14 years of age and older, a daily AI of 30 micrograms is recommended. In breastfeeding women 14 years of age and older, a daily AI of 35 micrograms is recommended. Most healthy nonpregnant individuals with regular diets obtain these amounts of biotin through dietary consumption.
Treatment of biotin deficiency or inborn errors of metabolism should only take place under medical supervision.
In human research, single doses that are 600-fold greater than the normal dietary intake have been taken by mouth (2.1, 8.2, or 81.9 micromoles) or intravenously (18.4 micromoles) by healthy adults. Daily injections of at least 150 micrograms have been used to reverse experimental biotin deficiency. Five to 10 milligrams of biotin per kilogram daily has been used to treat biotin-responsive basal ganglia disease. A daily dose of 2.5 milligrams of biotin has been used to treat brittle nail syndrome. Biotin has been used as a skin- and hair-conditioning agent in cosmetic products at concentrations ranging from 0.0001% to 0.6%.

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.

Interactions

Interactions with Drugs
Biotin may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Biotin may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Biotin may also interact with broad-spectrum antibiotics (such as sulfa drugs, sulfathalidine), anticonvulsants (such as carbamazepine, phenytoin, phenobarbital, primidone (Mysoline?), or valproic acid), isotretinoin (Roaccutane?), or lipid- or cholesterol-lowering agents.
Note: Smoking may lead accelerate biotin breakdown in women and cause marginal biotin deficiency.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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