Who Is at Risk of Biotin Deficiency?

Although biotin deficiency is considered rare, some dietary situations or conditions can cause biotin insufficiency or deficiency:⁵

• Antibiotics: Oral antibiotics dramatically reduce the biotin synthesized by bacteria in the intestines and can cause biotin deficiency since most foods are not good sources of biotin.⁴
• Anticonvulsants: Long-term use of anticonvulsant drugs can increase the risk of biotin deficiency.⁴
• Diabetes: Evidence suggests that diabetes may cause biotin deficiency.⁵
• Dialysis: Patients on dialysis may have low levels of biotin.¹
• Eating raw eggs: Consuming raw egg whites daily for several months or more can create biotin deficiency due to the egg protein avidin, which binds with biotin and prevents it from being absorbed. Conversely, eating cooked egg whites will not cause biotin deficiency because heat disrupts the chemical composition of avidin.^{1, 5}

• Hereditary disorders: Recessive inherited metabolic disorders, generally labeled as multiple carboxylase deficiency, can cause biotin deficiencies if untreated.⁵⁵
• High-carbohydrate diets: Since much of the biotin found in high-carbohydrate grains is not easily digested and bioavailable, those who rely on a diet high in grains without eating enough eggs, meat, and/or dairy products can develop biotin insufficiency.⁷
• Insufficient dietary intake: People experiencing rapid weight loss and patients on long-term intravenous feeding may develop biotin deficiency.¹
• Malabsorption: Surgical removal of the stomach or large sections of the small intestine (short gut syndrome) which renders a person unable to absorb biotin will cause biotin deficiency.^{3, 5}
• Normal pregnancy: Studies suggest that low levels of biotin may actually be fairly common in pregnant women - occurring in over 30% of pregnancies, by some estimates, to almost 70% in some studies.^4-5
• Smoking: Studies suggest that smoking increases the breakdown of biotin, which may create borderline deficiency.¹