Inherited genetics is considered a primary cause of biotin deficiency, but other conditions or activities can result in biotin levels low enough to trigger hair loss. Clinical studies suggest that pregnancy itself is associated with insufficient biotin levels, and hormone changes post-delivery can lead to 30-40% loss of scalp hair in some women. Long-term nursing has also been associated with biotin and other nutritional deficiencies and chronic hair thinning.4, 20
Studies show that treating the underlying biotin deficiency with biotin may reverse or improve hair loss:20
- Biotinidase Deficiency. Biotinidase is the enzyme necessary to release biotin from the protein it is bound to, making it available for the body to use. It can result in alopecia and serious neurological disorders, but results of at least one case study suggest that supplementation of biotin can prevent and reverse some of the symptoms of this genetic condition. In the case discussed here, a 5-month old infant developed multiple daily convulsions and slipped into a coma. Doctors identified biotin deficiency due to insufficient biotinidase and treated him with 5-mg of biotin and 25-mg of vitamin B1 twice daily, effecting a full recovery and hospital discharge in three days. Although the parents were instructed to continue the biotin/B1 daily, at age six the boy was readmitted with drooling, severe neurological disorders, and total alopecia resulting from six months of non-supplementation. After six months of treatment with 10 mg supplemental biotin and 50 mg of B1 twice a day the child was again able to walk and talk, and hair had regrown on his scalp and eyebrows. Unfortunately he developed partial deafness, attributed to nerve damage during the time treatment had stopped.21
- Epilepsy Drugs. Research suggests that valproic acid (VPA), a drug used to treat epilepsy, appears to interfere with liver mitochondria and inhibit the enzyme biotinidase, which is necessary for the release of biotin. The resulting biotin deficiency causes hair loss and skin disorders. In one clinical trial involving 75 patients taking VPA, supplementation with 10 mg/day of biotin improved these symptoms.22
- Pancreaticoduodenectomy. Biotin and zinc are important protein carriers for certain micronutrients absorbed in the duodenum and proximal jejunum. In one case report, a sixteen-year old female patient was deficient in biotin and zinc after a pancreaticoduodenectomy and suffered from a number of symptoms - including scalp hair loss and total body alopecia. It was expected that biotin and zinc supplementation would provide clinical improvement.23
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