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Biotin Deficiency - Causes, Symptoms, Diagnosis, and Treatment

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Biotin deficiency is a rare inherited condition in which a body cannot utilize the biotin from food. Read the article to know more.

Written by

Dr. Osheen Kour

Medically reviewed by

Dr. Arpit Varshney

Published At March 7, 2023
Reviewed AtMarch 7, 2023

Introduction

Biotin belongs to B complex vitamins responsible for breaking down carbohydrates and fats from food and producing energy in the body. This energy acts as fuel for various other necessary body functions. Biotin is often called vitamin H, B-7, or coenzyme R. It is a water-soluble vitamin not stored in the body for a long period. Also, the body does not naturally produce biotin either. However, the bacteria present in the human gut, also known as intestinal flora, can produce biotin. The bacteria are known to have a beneficial impact on the human body. Biotin helps regulate blood sugar levels and bad cholesterol (LDL or low-density lipoprotein) and boosts good skin health.

What Are the Various Causes and Risk Factors of Biotin Deficiency?

Biotin deficiency can occur due to various reasons, which include:

  • Various medications, such as anti-seizure drugs and antibiotics, can prevent the body from absorbing the vitamins accurately. Also, antibiotics can even destroy the good bacteria in the gut that can produce biotin naturally.

  • Certain intestinal problems, such as colitis and Crohn's disease, can also prevent the absorption of biotin from food and lead to biotin deficiency.

  • People receiving intravenous or tube feeding can also develop B-7 or biotin deficiency; therefore, they have been prescribed supplements until they start eating solid food again.

  • Biotinidase (BTD) deficiency is a rare hereditary disorder that prevents the body from reusing the biotin. Usually, a body has the capability to reuse the biotin multiple times until it gets removed from the body in waste. Biotinidase deficiency disorder can be diagnosed in the early stages of life and even during a few months after birth, as it causes severe symptoms.

  • A person eating a strict diet or involved in long-term dieting may also develop biotin deficiency due to a lack of enough vitamins and minerals. Therefore, eating a balanced diet is essential to stay healthy and to maintain a healthy weight.

  • Other genetic disorders include phenylketonuria (most common), biotin transport deficiency, and holocarboxylase synthetase (rare). Therefore, newborns are screened during birth for biotin deficiency, which is also associated with neurological problems if not diagnosed and treated on time.

What Are the Symptoms of Biotin Deficiency?

The symptoms of biotin deficiency include:

  • Dry and scaly skin.

  • Brittle hair and nails.

  • Hair loss.

  • Dry eyes.

  • Depression.

  • Muscle pain.

  • Nausea.

  • Sleeping difficulty or insomnia.

  • Seizures.

  • Red rashes on the face and other skin areas.

  • Fatigue.

  • Difficulty walking.

  • Prickling or burning sensation in hands and feet.

  • Cracking in the corner of the mouth.

  • Frequent stomach upset.

What Is Biotinidase Deficiency?

Biotinidase deficiency (BTD) is a hereditary disorder that causes biotin deficiency in the body. The BTD gene mutation mainly causes it. This gene is mainly responsible for instructing the body to produce the enzyme biotinidase, which helps the body to extract biotin from the food the person consumes. BTD is a rare disorder that can occur in one million babies.

The newborns usually show the symptoms of BTD within a few weeks to months after birth. These symptoms include seizures, eczema, muscle weakness or hypotonia, developmental delay, and hair loss.

In addition, BTD may also cause hearing loss, poor coordination, ataxia, drowsiness or lethargy, and red eye or conjunctivitis in 20 to 25 percent of newborn babies. Also, in almost 10 percent of cases of newborn babies, biotinidase deficiency may cause speech problems, enlarged liver or hepatomegaly, and enlarged spleen or splenomegaly. Therefore the condition should be treated as and when diagnosed, as delay in medical intervention can lead to coma or even fatal consequences.

How Is Biotin Deficiency Diagnosed?

The diagnosis of biotin deficiency is very confusing as the symptoms resemble other disorders also. Therefore, the doctor begins by treating the symptoms; if they do not go away, another possible cause is ruled out. If a doctor suspects that a person is not getting enough biotin or B-7, they may recommend a blood test to measure the levels of biotin in the blood. In addition, various other blood tests are also advised to check other levels to rule out the diagnosis of biotin deficiency. In some cases, low levels of biotin occur due to another condition or disorder. Therefore a doctor may recommend various other tests to rule out the underlying cause of low levels of biotin.

How Is Biotin Deficiency Treated?

The doctor treats the biotin deficiency in multiple ways, such as:

  • Biotin supplements and multivitamins are prescribed to the person. Also, a balanced diet is recommended as it is a good source of vitamin B.

  • The doctor usually recommends 30 micrograms of biotin to adults, five micrograms to children, and 35 micrograms to pregnant women daily.

  • The doctor also advises the patient to consume food rich in biotin. These include bananas, mushrooms, nut butter, cauliflower, whole grains, peanuts, walnuts, nuts, sardines, cooked eggs, especially yolk, brewer’s yeast, black-eyed peas, and soybeans.

  • Cosmetic biotin supplements are also recommended to promote skin, hair, and nail growth.

  • In addition, a person receiving anticonvulsant therapy may also require life-long biotin therapy. Therefore, doctors should measure the biotin levels in such patients and start treatment accordingly. Also, antenatal biotin therapy is effective in people diagnosed with holocarboxylase synthetase deficiency.

Conclusion

Biotin deficiency is rare but can be treated effectively with initial diagnosis and timely treatment. The prognosis of the disorder is also good. Newborns diagnosed with a biotin deficiency may need immediate medical intervention and life-long treatment with biotin. If a child does not follow the complete treatment schedule, they may develop the symptoms of biotin deficiency again after a few weeks or months. Children showing symptoms of biotin often respond promptly to biotin therapy. In case of failure to diagnose the condition on time, and delayed treatment, biotin deficiency can cause developmental delays, neurodevelopmental abnormalities, and autism-like behavior in children. Therefore, children are screened for biotin deficiency at the time of birth to avoid the fatal complications in the future that the disorder may cause if not treated timely.

Dr. Arpit Varshney
Dr. Arpit Varshney

General Medicine

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