Highlights
- •Daily doses of high dose biotin, 300 mg per day, were well tolerated and safe.
- •Daily high dosed biotin for up to a year did not induce sustained improvement in persons with progressive MS.
- •One third of patients worsened, probably related to their disease.
- •Several patients developed increased causalgic facial pain on high dose biotin, with improvement on biotin cessation.
Abstract
Background
Published data suggested high dose biotin improved patients with progressive MS. We
wished to determine benefits and side effects of administering daily high dose biotin
to patients with progressive multiple sclerosis in a large MS specialty clinic.
Methods
Forty-three patients with progressive multiple scleroses were prescribed pharmaceutical
grade biotin as a single daily dose of 300 mg/day. Brain MRIs were performed at baseline and after one year on biotin. Quantitative
neurologic exams (EDSS) and blood work monitoring for biotin toxicity were performed
at baseline and every three months thereafter.
Results
High dose biotin was safe, and well tolerated, with no evidence of toxicity on blood
work and no new lesions on brain MRIs. None of the patients’ EDSS scores improved.
One-third of patients (38–43%) worsened, most often with increased lower extremity
weakness, worsened balance, and more falling, with two patients worsening sufficiently
to increase their EDSS scores by 0.5. Several worsened patients improved after stopping
biotin.
Conclusion
High dose biotin was safe and well tolerated, but of no demonstrable long-term benefit.
More than one-third of patients worsened while on biotin, most likely due to their
disease, but in some patients also possibly due to the inability of their injured
central nervous systems to respond to the increased metabolic demands induced by biotin.
Keywords
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Article info
Publication history
Published online: September 29, 2017
Accepted:
September 27,
2017
Received in revised form:
June 1,
2017
Received:
April 21,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
