Can High Dose Biotin used for treating Multiple Sclerosis Symptoms?

What is Biotin?

Biotin goes by several other names: vitamin H, vitamin B7, and coenzyme R. Biotin is an essential molecule to biological processes which cannot be produced in the body. Like all vitamins, it must be ingested in the diet. Currently, high dose biotin at a dose of 300 mg every day is being clinically investigated for the improvement of symptoms in progressive forms of multiple sclerosis (MS). This dose is 10,000 times higher than the adequate daily intake recommendations. Current disease-modifying therapies are used only to delay progression of primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS) or for active progressive disease. There is currently no disease-modifying therapy for patients with non-active progressive MS. Preliminary evidence has suggested biotin may be able to improve symptoms in PPMS and SPMS while being well tolerated. Still, these results are in their infancy and high dose biotin is not yet FDA approved for this indication.

How Dose Biotin Work?

Biotin is a cofactor for four essential enzymes in the human body which help the body build fatty acids from smaller molecular building blocks. Without biotin these enzymes cannot function. The destruction of the fatty myelin sheath surrounding nerves is thought to be the underlying pathology of MS. It is theorized that supplying large amounts of biotin helps these enzymes function to recreate the myelin sheath thereby increasing overall function for the patient.

The Role of the Compounding Pharmacy

Because high dose forms of biotin are not currently commercially available due to its investigational status, 300 mg biotin capsules must be compounded in a compounding pharmacy. Over the counter supplemental preparations come in 10 mg doses which would require the user to ingest 30 pills per day to follow a “high dose” regimen. Compounding pharmacies have the tools to provide a full daily dose in a single capsule. Additionally, compounding pharmacies follow much stricter practices than companies that sell over the counter nutritional supplements ensuring that your product is USP (United States Pharmacopeia) grade, and is confirmed to be precisely what your doctor prescribed.

References:

  1. Chataway J. Biotin in progressive multiple sclerosis: A new lead? Mult Scler 2016;22(13):1640-41.
  2. Tourbah A, Lebrun C, Egan G, et al. MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo controlled study. Mult Scler 2016; 22: 1719–1731.
  3. Mock DM. Biotin. In: Shils M, Shike M. (2006). Modern nutrition in health and disease (10th ed., 50th anniversary ed.). Philadelphia: Lippincott Williams & Wilkins.
  4. Willeman T, Casez O, Faure P. Biotin in multiple sclerosis and false biological hyperthyroidism: Mind the interference. Revue Neurologique 2017;173(3):173-174
  5. Wingerchuk DM and Carter JL. Multiple sclerosis: Current and emerging disease-modifying therapies and treatment strategies. Mayo Clin Proc 2014; 89: 225–240.


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