Biotin

WHAT IT DOES

Biotin is a cofactor for five carboxylase enzymes critical to metabolism: pyruvate carboxylase, acetyl-CoA carboxylases (1 and 2), propionyl-CoA carboxylase, and 3-methylcrotonyl-CoA carboxylase. True deficiency is rare in developed countries, biotin is widely distributed in foods and produced by gut bacteria.

Populations at risk: pregnant women (accelerated biotin catabolism), individuals on long-term anticonvulsants (carbamazepine, phenytoin), chronic alcohol users, and people consuming large amounts of raw egg whites (avidin binds biotin).

OPTIMAL DOSAGE

DRUG INTERACTIONS

SAFETY PROFILE

Drug Interactions

⚠️ CRITICAL: Laboratory Test Interference

This is biotin's most important safety concern. Biotin at doses ≥1,000mcg interferes with streptavidin-biotin immunoassays used in most clinical laboratories:

• Troponin (heart attack marker): FALSE LOW results → may miss diagnosis of MI (UNCITED: the cited PMID did not support this claim and was removed; this statement is not currently sourced)
• Thyroid tests (TSH, free T4, free T3): May show FALSE hyperthyroid pattern
• PSA (prostate cancer): FALSE LOW → may miss elevated PSA
• BNP (heart failure marker): FALSE results

The FDA issued a safety communication in November 2017 about this interference. Patients taking high-dose biotin should stop supplementation 72 hours before any blood work.

Side Effects

• No adverse effects from biotin itself at any dose
• All safety concerns relate to lab test interference

Pregnancy & Lactation

• Marginal biotin deficiency is common in pregnancy. The AI during pregnancy is 30mcg/day. Supplementation at this level is safe and often included in prenatals.

WADA Status

Not Prohibited

HOW AVELOR SCORES THIS

CLINICAL REFERENCES

Reference identifiers on this page are being re-verified against PubMed. Some may not yet link to the paper named beside them.