Can high-dose biotin supplementation help patients with primary or secondary progressive multiple sclerosis (MS)? According to a recent study, patients receiving very high doses, 300 mg of pharmaceutical-grade biotin, showed improvement in disease symptoms. Study results were presented at the 67th Annual meeting of the American Academy of Neurology (AAN), held on April 24, 2015. At the Clinical Trials Plenary Session, study authors presented on how biotin supplementation resulted in not only a halt in MS disease progression but also a slight improvement in disability in patient’s receiving biotin, compared to placebo. The study followed patients for 12 months and assessed clinical improvement on the Expanded Disability Status Scale (EDSS). Among patients in the biotin treatment group, 14.9% met the primary endpoint of disease improvement on the EDSS; by comparison, 0.0% of patients in the placebo group met the primary endpoint. Results seemed to confirm findings from an earlier “proof of concept” study, which showed significant clinical improvement on the EDSS in 22% of patients treated with a mean of 300 mg of biotin per day for about 9 months.
Biotin, also known as vitamin H or coenzyme R, is classified as a B vitamin and is a dietary component important for the metabolism of carbohydrates, fats, and amino acids. Biotin is found naturally occurring in foods like organ meats (liver, kidney), eggs, nuts, soybeans and other legumes, and oat bran. It is an essential element needed for proper cellular function. The role of biotin supplementation in the treatment of MS is little understood, however, its mechanism in the body indicates it may be playing a role in promoting myelination (the process of forming a myelin sheath around a nerve to allow nerve impulses to move more quickly) and increasing energy production.
Patients receiving 300 mg of biotin as part of clinical trials were reported to have tolerated the very high doses well; typical doses of biotin used in the treatment of biotin deficiency max out at 40 mg/day. However, ALL BIOTIN IS NOT CREATED EQUAL! Experts warn MS patients against running out to buy biotin supplements and self-administering at high doses. For starters, commercially available products are not tested for purity, the biotin supplement being purchased may not even actually contain any biotin. In addition, the supplement may contain several other inactive ingredients, which at high doses, may not be well tolerated. To decrease the chances of experiencing adverse events from high-dose biotin supplementation, MS patients should seek the counsel of a prescribing physician. A physician can monitor for side effects, drug interactions, and potential responses to therapy. Pharmaceutical-grade biotin, produced in a compounding pharmacy, is prepared without unnecessary bulking agents or excipient, making it the safest mode for high-dose biotin supplementation currently available. A patient, physician, and compounding pharmacy can work closely together to tailor a biotin regimen for an MS patient.
1. Elsevier/ Gold Standard. Biotin. Clinical Pharmacology [database online]. Available at: http://www.clinicalpharmacology.com. Accessed: June 6, 2015.
2. B Vitamin Promising in Progressive Multiple Sclerosis. Medscape. Apr 30, 2015.