✓ No active regulatory warningsFDA MedWatch, EMA EudraVigilance, WHO VigiBase, WADA Prohibited List · 2026-05-29
⚠ Patient on high-dose biotin with abnormal troponin or thyroid tests — suspect assay interference. Discontinue biotin 72 hours before retesting [4]
⚠ Newborn screening positive for biotinidase deficiency — lifelong biotin 5–20 mg/day prevents all sequelae [3]
⚠ Periorificial dermatitis + alopecia — consider biotin deficiency (resembles zinc deficiency clinically) [2]
⚠ Patient on chronic anticonvulsants with hair loss or dermatitis — check biotin status [2]
🥗 Food first — build your daily 30 mcg
Check the foods you regularly eat — the bar fills toward your daily target.
Beef liver (85g)30.8 mcg
Egg (1 whole, cooked)10 mcg
Salmon (85g)5 mcg
Pork chop (85g)3.8 mcg
Sweet potato (½ cup)2.4 mcg
Almonds (28g)1.5 mcg
Check your regular foods above
☑ Risk checker
Biotinidase deficiency (autosomal recessive, ~1:60,000) [3]
Chronic consumption of raw egg whites (avidin) [1]
Pregnancy (increased catabolism) [3]
Prolonged parenteral nutrition without biotin supplementation [2]
Chronic anticonvulsant therapy (carbamazepine, phenytoin) [2]
Short bowel syndrome [2]
Chronic alcoholism [2]
Select factors
🔬 Lab interpreter
Recommended test
Urinary 3-hydroxyisovaleric acid (3-HIA)
Urinary 3-hydroxyisovaleric acid (3-HIA)
Reference range / target
Normal range (elevated = biotin deficiency)
Normal range (elevated = biotin deficiency)
3-HIA is the most sensitive functional marker. Accumulates when 3-methylcrotonyl-CoA carboxylase (biotin-dependent) is impaired [2].
Full lab monitoring ↓⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Biotin is the most over-supplemented vitamin relative to its evidence base — hair growth claims in biotin-replete individuals are not supported by RCTs. The most clinically important fact is that high-dose biotin (>5 mg, common in OTC supplements) interferes with immunoassays, producing falsely low troponin (missed MI) and falsely abnormal thyroid tests. FDA safety alert issued 2017 [2] [4].
1 Am I deficient?
Biotinidase deficiency (genetic)100%
Pregnancy (marginal deficiency)50%
Chronic raw egg consumption40%
Prolonged parenteral nutrition20%
Anticonvulsant therapy (chronic)10%
General population (developed)1%
What happens as status declines
Marginal deficiency
Elevated urinary 3-HIA. Low-normal plasma biotin. No clinical symptoms. Common in pregnancy [3].
Mild deficiency
Thinning hair and alopecia. Periorificial dermatitis (around eyes, nose, mouth — resembles zinc deficiency). Brittle nails. Mild depression and lethargy [2].
Moderate deficiency
Generalized seborrheic dermatitis. Progressive alopecia. Paresthesias. Metabolic acidosis from impaired carboxylase function [3].
Severe deficiency (biotinidase deficiency)
Seizures, ataxia, developmental delay, hearing loss, optic atrophy. Complete alopecia. Lactic acidosis. Untreated, leads to coma and death [3].
Risk factors
• Biotinidase deficiency (autosomal recessive, ~1:60,000) [3]
• Chronic consumption of raw egg whites (avidin) [1]
• Pregnancy (increased catabolism) [3]
• Prolonged parenteral nutrition without biotin supplementation [2]
• Chronic anticonvulsant therapy (carbamazepine, phenytoin) [2]
• Short bowel syndrome [2]
• Chronic alcoholism [2]
🧬 How Biotin works ▼
2 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: Specific dosage data under clinical review
👦 Pediatric: See guidance
Infants 0–6 months: 5 µg/day AI; children 1–3 years: 8 µg/day; 4–8 years: 12 µg/day [1]. Biotinidase deficiency is screened in newborns in most developed countries — untreated, it causes se
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose
How to take
🍽 Timing: Can be taken at any time, with or without food [1].
💊 With food: No specific requirement [1].
3 Which form?
| Form | Bioavailability | Vegan | Cost |
|---|---|---|---|
| ['D-Biotin', 'preferred', 'The only biologically active stereoisomer. Standard supplemental form [1].'] | Standard | Check label | |
| ['Biocytin', '', 'Protein-bound form found in food. Released by biotinidase in the intestine [1].'] | Standard | Check label |
4 Common questions
Will biotin make my hair grow? ▼
If you have biotin deficiency, supplementation will restore hair growth. However, for individuals with normal biotin status, no randomized trial has demonstrated that biotin supplements improve hair growth or quality [2]. The widespread marketing of biotin for hair far exceeds the evidence.
Can biotin interfere with blood tests? ▼
Yes — this is a critical safety concern. High-dose biotin (>5 mg/day, common in OTC supplements) interferes with streptavidin-biotin-based immunoassays, including troponin, TSH, T4, and some hormone tests [4]. This can produce falsely low troponin (leading to missed heart attack diagnosis) or falsely abnormal thyroid tests. The FDA issued a safety alert in 2017. Discontinue biotin supplements at least 72 hours before lab tests [4].
Why is biotinidase deficiency screened at birth? ▼
Biotinidase deficiency prevents recycling of biotin from biocytin. Without treatment, it causes irreversible neurological damage (seizures, developmental delay, hearing loss). Treatment with 5–20 mg/day biotin completely prevents all sequelae if started early [3]. It is included in newborn screening panels in most developed countries.
Do raw eggs really cause biotin deficiency? ▼
Avidin in raw egg whites binds biotin with one of the strongest non-covalent interactions in nature. Consuming 2+ raw eggs daily for several weeks can cause clinical deficiency. Cooking denatures avidin and eliminates this risk [1]. This is primarily relevant to bodybuilders who consume large amounts of raw egg whites.
5 Clinical evidence
Strong
Treatment of biotinidase deficiency: lifelong biotin supplementation (5–20 mg/day) prevents neurological and dermatological sequelae [3]. Treatment of biotin-responsive multiple carboxylase deficiency [3]. Resolution of dermatitis and alopecia in documented biotin deficiency states [2]. HIGH
Moderate
Improvement in nail brittleness: a small trial (n = 35) showed 25% increase in nail thickness with 2.5 mg/day biotin over 6–15 months [6]. Diabetic neuropathy: high-dose biotin combined with chromium showed blood glucose improvements in some small studies [2]. MODERATE
Insufficient
Hair growth in individuals without biotin deficiency: despite widespread marketing, no randomized controlled trial has demonstrated that biotin supplementation improves hair growth in biotin-replete individuals [2]. Skin health and acne: no controlled evidence [2]. Multiple sclerosis: high-dose biotin (300 mg/day) showed mixed results in Phase III trials (SPI2 trial did not meet primary endpoint) [7]. LOW
6 Safety, toxicity & adverse events
Relative
⚠ CRITICAL: Biotin >5,000 mcg/day causes FALSE RESULTS on troponin, TSH, and other immunoassays using streptavidin-biotin technology. Stop biotin 48 hours before blood tests.
🚩 Red flags
● Patient on high-dose biotin (>5 mg) with negative troponin despite chest pain — suspect assay interference [4]
● Unexplained thyroid test abnormalities (low TSH, high T4) in a supplement user — check for biotin interference [4]
● Infant with seizures, dermatitis, and alopecia — check biotinidase activity (newborn screening should have caught this) [3]
● Bodybuilder consuming multiple raw egg whites daily with hair loss — avidin-induced biotin deficiency [1]
7 Interactions
Drug interactions
Immunoassays (troponin, TSH, T4, hormones, tumor markers) Major
Mechanism: Most modern immunoassays use streptavidin-biotin chemistry. Excess biotin in the sample competes with biotinylated reagents, skewing results. [4]
Effect: Falsely low results for sandwich assays (troponin, TSH in some platforms). Falsely high results for competitive assays (free T4, some cortisol assays). Missed MI diagnosis (most dangerous). [4]
Action: Discontinue biotin ≥72 hours before any immunoassay-based blood test. Alert lab about supplement use [4].
Carbamazepine Moderate
Mechanism: Increases biotin catabolism through hepatic enzyme induction. [2]
Effect: Marginal biotin deficiency with chronic use. Hair and skin changes possible. [2]
Action: Consider biotin supplementation (30–300 µg/day) during chronic anticonvulsant therapy [2].
Isotretinoin (Accutane) Minor
Mechanism: May reduce biotinidase activity, impairing biotin recycling. [2]
Effect: Marginal biotin depletion possible. [2]
Action: Monitor for hair thinning or dermatitis (already common with isotretinoin) [2].
Supplement synergies
B-complex vitamins · Standard B-complex
Biotin works in concert with other B vitamins in energy metabolism. B-complex provides balanced supplementation [1].
Biotin works in concert with other B vitamins in energy metabolism. B-complex provides balanced supplementation [1].
Zinc · 11 mg/day (men), 8 mg/day (women)
Biotin and zinc deficiency present with overlapping clinical features (periorificial dermatitis, alopecia). Both should be assessed together [2].
Biotin and zinc deficiency present with overlapping clinical features (periorificial dermatitis, alopecia). Both should be assessed together [2].
8 Laboratory monitoring
Urinary 3-hydroxyisovaleric acid (3-HIA) Primary
Target: Normal range (elevated = biotin deficiency) · If deficiency suspected [2].
Plasma biotin Secondary
Target: >200 pmol/L
Biotinidase activity (serum) Secondary
Target: Normal activity (lab-specific range)
9 Regulatory
United States (FDA): Classified as a dietary supplement. No UL established. FDA safety communication (2017) regarding high-dose biotin interference with immunoassays [4]. AI: 30 µg/day [1].
European Union (EFSA): Authorized health claims for energy metabolism, nervous system function, psychological function, hair maintenance, skin maintenance, and mucous membranes [8]. No UL established.
Japan (MHLW): Eligible for Foods with Function Claims. Adequate intake: 50 µg/day for adults.
South Korea (MFDS): Registered health functional food ingredient. Approved claims: energy metabolism and skin health.
10 US supplement products
2,166
on-market products containing Biotin (NIH DSLD)
Brands carrying Biotin (531)
Click a brand to see its Biotin products.
11 Frequently paired with
12 References (8)
[1]Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academies Press; 1998. doi:10.17226/6015 REVIEW Accessed: 2026-05-29
[2]National Institutes of Health, Office of Dietary Supplements. Biotin — Fact sheet for health professionals. Updated 2024. ods.od.nih.gov REVIEW Accessed: 2026-05-29
[3]Wolf B. Biotinidase deficiency: 'if you have to have an inborn error of metabolism, this is the one to have.' Genet Med. 2012;14(6):565-575. doi:10.1038/gim.2011.6 REVIEW Accessed: 2026-05-29
[4]U.S. Food and Drug Administration. The FDA warns that biotin may interfere with lab tests. FDA Safety Communication. 2017; updated 2019. www.fda.gov GOVERNMENT Accessed: 2026-05-29
[5]U.S. Department of Agriculture. FoodData Central. fdc.nal.usda.gov GOVERNMENT Accessed: 2026-05-29
[6]Colombo VE, et al. Treatment of brittle fingernails and onychoschizia with biotin: scanning electron microscopy. J Am Acad Dermatol. 1990;23(6 Pt 1):1127-1132. doi:10.1016/0190-9622(90)70345-I REVIEW Accessed: 2026-05-29
[7]Tourbah A, et al. MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: a randomised, double-blind, placebo-controlled study. Mult Scler. 2016;22(13):1719-1731. doi:10.1177/1352458516667568 REVIEW Accessed: 2026-05-29
[8]EFSA Panel on Dietetic Products, Nutrition and Allergies. Scientific opinion on the substantiation of health claims related to biotin. EFSA J. 2009;7(9):1209. doi:10.2903/j.efsa.2009.1209 GOVERNMENT Accessed: 2026-05-29
13 Related articles
Auto-populated from GMJ Newsroom. Articles tagged "Biotin".
14 Cite this page
Vancouver: Pkhakadze G. Biotin — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Jun 01]. Available from: https://supplement.ge/ingredients/biotin/
APA 7th: Pkhakadze, G. (2026). Biotin — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/biotin/
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Institution: Public Health Institute of Georgia (PHIG)
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: December 2026
References: 8 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Biotin — Safety Profile." SupplementIndex, PHIG, 2026. https://supplement.ge/ingredients/biotin/ CC BY 4.0.
GP
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG