When it comes to hair loss, biotin seems to be one of the best marketed and best seller products both online and at pharmacies and retail shops with a wide range of shampoos or supplements that promise hair growth or marketed in general for healthy hair, skin and nails. Several doctors still recommend biotin as well, but is it really an evidence-based treatment and is biotin supplementation harmless and just a waste of money in the worst-case scenario? Well, short answer is no, keep reading for a more thorough explanation.
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What is biotin?
Biotin is also known as Vitamin B7 or as Vitamin H and it is a micronutrient important in our organism for the metabolism of fats, carbohydrates and amino acids. The Adequate Intake (AI) of biotin for healthy adults is around 30 micrograms (mcg) per day and it is estimated that the average intake of biotin following a western diet is around 35-70 mcg per day. Some of the foods rich in biotin are beef liver, pork, eggs, fish (salmon, tuna, sardines, …) nuts and seeds, legumes, rice, cereals, sweet potatoes, avocados, and more. Gut bacteria produce biotin as well.
Biotin deficiency is a rare condition and severe biotin deficiency in a healthy adult with a normal diet has never been reported.
Consuming raw egg whites can interfere with biotin absorption: egg whites contain a protein called avidin which binds to biotin not allowing it to be absorbed. By cooking the egg whites, you cause the denaturation (breaking down) of the avidin and allow for the absorption of the biotin of which the egg yolk for example is rich.
Other possible reasons for a biotin deficiency are alcoholism, rare genetic conditions that interfere with enzymes that allow for biotin to be used effectively, severe malnutrition, people on parenteral nutrition (IV nutrition), some medications, or conditions that may interfere with nutrient absorption like Chron’s disease.
Biotin deficiency can indeed lead to hair loss and skin and nail problems, but as said above it’s rare and it usually doesn’t just manifest with minor cosmetic issue, but also and most importantly with neurological symptoms, intestinal symptoms, and increased susceptibility to infections.
What are the health benefits of biotin?
Biotin, like all other micronutrients, is essential for the proper function of the human organism; it has a key role in the metabolism of fatty acids, amino acids and carbohydrates, aiding in ATP (energy) production in the cells, and there’s also a few thousands genes that are biotin-dependent. Moreover, biotin has a role in the regulation of the immune system and in lowering inflammation.
What does the science say about biotin supplements to treat hair loss?
This may come as a surprise seen the abundance of products and the marketing claims attached to them, but there’s little to no evidence to support the use of biotin to treat hair loss or to improve hair quantity or quality. While it is true that supplementing biotin in people suffering from its deficiency may help treat hair loss and other hair, nail and skin issues, this does not make it a universal cure. There is no evidence that biotin can help with androgenetic alopecia (AGA) which is the main cause of hair loss in men nor that biotin supplements can prevent hair loss.
You should ask your GP or dermatologist if it is advisable to take biotin for your specific case and you should not supplement with high doses of it unless it is prescribed by a doctor.
Biotin for longer and stronger hair
Like for the treatment of hair loss, there is also no evidence at all to support the use of biotin to have longer or stronger hair. Marketing, advertising and social medias are the only sources where you can read or hear claims about the benefits of such supplement; medical textbooks and science journals report no evidence to support the use of biotin for longer or stronger hair.
What are biotin side effects?
Even in high doses, biotin does not seem to cause any side effect. Being a water-soluble vitamin, all the excess you may be taking with a high dose supplement is eliminated with your urine. Being harmless for your body does not make it safe as the FDA has warned about the risks of high doses of biotin.
Biotin interference with blood test results – FDA Warning
Not only biotin is not effective in treating hair loss in the large majority of patients, but its supplementation is even dangerous as it interferes with blood test results. While a normal intake of 30-70 mcg per day through diet does not pose any danger, supplements marketing hair, skin and nails benefits often contain 10 mg to 100 mg which is over 3,000 to 30,000 times the adequate intake! At levels around or above 1 mg per day, biotin may interfere with lab test results like causing false negative results on troponin levels, a marker of cardiac injury: a myocardial infarction diagnosis could be impaired because of it and this already resulted in at least 1 documented death. Moreover, biotin supplementation seems to also cause falsely low TSH levels (Thyroid Stimulating Hormone) and falsely high T4 levels (Thyroxine) which are commonly measured to check thyroid function. Other tests that reportedly have been affected by high-dose biotin supplementation are FSH (follicle stimulating hormone), LH (luteinizing hormone), E2 (estradiol), progesterone, testosterone, cortisol, folates, vitamin b12, ferritin, cancer markers and more. This could lead to missed diagnosis, misdiagnosis, unnecessary tests, extra costs and other issues.
A normal multivitamin instead should not be dangerous as they often contain just around the recommended daily intake of 30 mcg of biotin per day and at this level it does not interfere with lab results.
Should you use biotin to treat hair loss?
Although some doctors still prescribe biotin for hair loss because it is not harmful (a recent poll results showed that about 20% of them still do it), unless you are suffering from a deficiency you are not going to benefit from it. There is no evidence to support the use of biotin for the treatment of androgenetic alopecia (AGA) or other causes of hair loss in men and women and if you are taking it you’re likely to be wasting your money and to risk having false results from your blood tests.
Hypothyroidism and iron deficiency for example can also cause hair loss, but again this does not mean that everyone suffering from it should take thyroid hormones or iron supplements. If you suffer from hair loss you should talk to a specialist and treat it according to current medical evidence. For AGA there are several medications available which are effective, plus other promising therapies like platelet-rich plasma, FDA approved devices like low-level laser therapy (LLLT) or in the worse case a hair transplant surgery, but biotin is not among the recommended treatments. Don’t fall for the marketing claims and instead rely on your doctor and on current medical evidence!
- Biotin Deficiency.
F Saleem – US National Library of Medicine, StatPearls, Mar 2022
- Biotin Interference with Troponin Lab Tests – Assays Subject to Biotin Interference.
U.S. Food and Drug Administration
- Biotin interference.
JL Gifford – College of Family Physicians of Canada, May 2018
- The Infatuation With Biotin Supplementation: Is There Truth Behind Its Rising Popularity? A Comparative Analysis of Clinical Efficacy versus Social Popularity.
T Soleymani – Journal of Drugs in Dermatology, May 2017