Last year I saw a ton of patients in my office who told me they were taking 1 tbsp of apple cider vinegar in the morning or evening to treat everything from obesity to wrinkles. There is still little to no evidence that apple cider vinegar helps with most health concerns, and in fact one study suggests it MIGHT WORSEN sugar control in some patients with type 1 diabetes (1). In 2018 we have seen the dawn of a new sweeping health trend: biotin. This sweetheart of social media’s health and beauty empire is being taken in droves by many of the patients I have seen this year, and I am officially dubbing it the new apple cider vinegar.
WHERE DO WE GET BIOTIN
Biotin is actually a B vitamin – it is otherwise known as B7 or Vitamin H (short form for the German ‘Haar and Haut’ for hair and skin). Like most B vitamins, biotin is ‘water-soluble’, which means that your body absorbs what it needs to maintain a minimal level and excretes the rest through urine. (2) Biotin is absorbed very easily in the intestine and is stored in the liver. It is found in many foods like egg yolks, liver, soybeans, yeast, nuts and seeds, dairy products and others. The recommended intake of biotin in Canada is 30-100 mcg per day for adults. Most biotin supplements available supply between 1000mg-10,000 mcg in one tablet. The amount in different food sources vary, and for example one whole egg can have 10 mcg of biotin. In addition to consuming biotin from foods or supplements, the healthy gut bacteria in our intestine also make a small amount of biotin for us too! (3)
Biotin supplements have risen to fame in the incredibly popular realm of ‘beauty’ on Instagram and on blogs describing ‘celebrity health secrets’. Sites advertising their capsules, tablets and gummies of biotin regularly clutter social media streams, bolstering the billion dollar supplement industry. It is also a supplement you can easily find in any drugstore. Patients entering my office are usually taking large doses of biotin hoping to their hair will grow thicker, longer and stronger.
BIOTIN IN THE BODY
This B vitamin is actually important for many functions in the body, including the formation of fuel sources that allow us to have energy for physical activity and growth. It may also help the body break down carbohydrates and support metabolism. Only small amounts of biotin is needed for these functions, and there is no evidence that taking large amounts of biotin will help give you MORE energy or enhance metabolism. Deficiency of biotin is very rare in North America because we really need so little of it, but symptoms may include loss of hair, heart issues or skin rashes. Some medical conditions like extreme malnutrition and intestinal absorption disorders (inflammatory bowel disease), or chronic use of anticonvulsant or antibiotic medications may increase the risk of biotin deficiency. Excessive intake of raw, uncooked egg whites can also deplete the body of biotin because they contain a compound called avadin that binds biotin and makes it hard for the body to absorb. Cooking the egg whites eliminates this issue. (2)
BIOTIN AND HAIR
The problem with taking biotin supplements in hopes that your hair will grow longer and stronger is that there is absolutely no clinical evidence to suggest that taking large amounts of Vitamin B7 is likely to help. Clinical trails involving humans have yet to be conducted on hair loss or breakage and supplementation of biotin. In one study examining blood levels of biotin in over 500 women with hair loss, biotin deficiency was found in just over 1/3 of the sample but it did not seem to be connected to their hair loss. In women who do seem to respond positively when supplementing with biotin, the underlying cause of their hair thinning may be a condition called sebbhoric dermatitis which does seems to benefit from biotin supplementation. (3) The only other situation where biotin may benefit hair loss would be a true biotin deficiency. Hair loss can also result from underlying issues concerning thyroid health, hormone balance or nutrient deficiencies like low iron levels – none of which are addressed through biotin supplementation.
IS BIOTIN SAFE?
While biotin supplements are relatively safe, one concern about taking large amounts may be how it might affect the results of certain blood tests. High levels of biotin in the blood samples may interfere with testing methods. Research shows that taking oral biotin may interfere with certain testing procedures and skew results of tests for levels of thyroid hormone, PTH (parathyroid hormone) and troponin (used to detect damage to heart muscle). This could potentially lead to misdiagnosis of medical conditions. (4)
The bottom line for hair loss is that biotin should not be something everyone with hair loss is taking, and it is unlikely to help. It may be clinically applicable if blood work shows that your biotin levels are low, or if you are diagnosed with sebbhoric dermatitis on the scalp – or even if you have any risk factors for biotin deficiency. This should be evaluated on a case-by-case basis.
For now, keep calm and come talk to a naturopathic doctor about whether biotin might be right for you.
Dr. Sarah Penney, ND
REFERENCES
1. Hlebowicz, J., Darwiche, G., Björgell, O., et al. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterology. 2007;7(46)
2. The Infatuation With Biotin Supplementation: Is There Truth Behind Its Rising Popularity? A Comparative Analysis of Clinical Efficacy versus Social Popularity
J Drugs Dermatol. 2017;16(5):496-500.
3. Int J Trichology. Trueb, R.M. Serum Biotin Levels in Women Complaining of Hair Loss. 2016; 8(2): 73–77.
4. Trambas, C., Lu, Z., Yen, T., Sikaris, K. Characterization of the scope and magnitude of biotin interference in susceptible Roche Elecsys competitive and sandwich immunoassays. – Ann Clin Biochem. 2018; 55(2): 205-215