The Buzz about Biotin
A new study is investigating biotin as a treatment for progressive MS, according to an announcement at the June meeting of the European Academy of Neurology in Berlin (Tourbah and colleagues. EAN 2015; abstract O1216). Preliminary results were presented at the American Academy of Neurology meeting in April (Tourbah and colleagues. AAN 2015; abstract PL2.002).
Biotin is a vitamin found in many foods, such as green leafy vegetables, peanuts and liver. It’s so common in food that extra biotin is rarely needed. So until now, biotin supplements have been consigned to hair and nail products, although there’s little evidence that biotin is effective for split ends and cracked fingernails.
Biotin deficiency is very rare. However, one study found that biotin levels were low in the cerebrospinal fluid of people with MS (and those with epilepsy) (Anagnostouli and colleagues. Acta Neurol Scand 1999;99:387-392). No one else has investigated this, so it isn’t clear if this is a true finding.
It was subsequently reported at a meeting in Geneva in 2011 that high doses of biotin provided some benefit in one person who was later found to have secondary-progressive MS (SPMS) (Sedel and colleagues. J Inherit Metab Disord 2011;34[3 suppl]: abstract S267). One theory that emerged from this serendipitous observation was that biotin, which is involved in energy metabolism, may be able to supply needed energy to nerves fibres to repair myelin. Nerve damage in progressive MS (SPMS and primary-progressive MS) occurs when nerve fibres (axons) are stripped of their insulation (myelin), and it has been suggested that this causes an energy drain in much the same way as a stripped wire will blow a fuse.
This series of suppositions led to a “proof-of-concept” study of high-dose biotin in people with progressive MS (Sedel and colleagues. Mult Scler Relat Disord 2015;4:159-169). A total of 23 people with SPMS and PPMS were enrolled (including the person already treated in the earlier study). All received high doses of biotin (100-300 mg per day, or about 10,000 times the usual daily intake) for up to three years. Overall, various improvements were reported in 21 of 23 people after an average of three months of continuous treatment.
According to the preliminary results of the phase III trial, 12.6% of people receiving high-dose biotin showed some improvement in disability after nine months of treatment compared to 0% of those taking a placebo (Tourbah 2015). Four percent of people had worsening disability while taking biotin compared to 13% with placebo; the study wasn’t large enough to determine if this difference was significant.
While these results appear promising, it’s too early to tell if the benefits can be attributed to biotin supplements. More research is needed and a second phase III trial is now underway.
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