Biotin deficiency

Rare condition due to prolonged parenteral nutrition without biotin, malabsorption, raw egg consumption (avidin binds biotin) or genetic biotinidase deficiency in newborns. Presents with alopecia, periorificial dermatitis, conjunctivitis and neurological abnormalities.

ICD-10 E53.81 drug

Also known as: Vitamin B7 deficiency, Vitamin H deficiency

Drugs used for this condition

ABiotinFirst line · Vitamin B7 (H). Water-soluble vitamin, cofactor of four carboxylases. AEMPS registers biotin as a medicine for treating confirmed deficiency; in multivitamins and mono-supplements – dietary supplementConfirmed biotin deficiency is the only evidence-based indication. True deficiency is rare and presents with periorificial dermatitis, hair loss, conjunctivitis and neurological symptoms (ataxia, depression). Possible causes: prolonged biotin-free parenteral nutrition, chronic malabsorption, congenital biotinidase deficiency (newborns, diagnosed via neonatal screening), prolonged anticonvulsant use. AEMPS registered Medebiotin 5 mg for treatment of confirmed deficiency. Laboratory confirmation is advisable before prescribing: urinary 3-hydroxyisovaleric acid or serum biotin. Dose for adult deficiency is 1–10 mg/day orally; in newborns with biotinidase deficiency – 5–10 mg/day lifelong.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit