Biotin Availability

• The characterization of biotin as a vitamin was based on the discovery that biotin deficiency causes a clinical syndrome, which is mediated by deficiencies of several carboxylase enzymes.
• Sources — Biotin can be found in a variety of plants but is found in highest levels in the liver, egg yolk, soybean products, and yeast

Deficiency

• was first noted in patients who were on long-term parenteral nutrition prior to routine biotin supplementation. It is now reported only rarely.
• Consumption of large amounts of raw egg whites (which contain avidin, a substance that binds to biotin and prevents its utilization), can also lead to biotin deficiency.
• secondary biotin deficiency can occur due to lack of a specific enzyme (biotinidase), which is required for recycling of biotin
• classic clinical manifestations of biotin deficiency include dermatitis around the eyes, nose and mouth, conjunctivitis, alopecia, and neurological symptoms, including changes in mental status, lethargy, hallucinations, and paresthesias
• Other manifestations may include myalgia, anorexia, and nausea

Requirements:

The recommended intake for biotin is expressed as Adequate Intake (AI) rather than Recommended Dietary Allowance (RDA), indicating that there is not adequate data to specify the percentage of individuals whose requirement is met by this intake

 Choice of Therapy

• No medication available in Hospital Keningau (not a constituents of oral and IV multivitamins)
• No readily available formulation in FUKKM
• Recommended to use infant formulas enriched with biotins

Product	Biotin Content per 100g
Anmum Infacare Step 1	16.6 mcg
Bebelac 1	13 mcg
Dulac Infant Step 1	17 mcg
Dupro 1	17 mcg
Dutch Baby 0-6 bulan	11 mcg

 *list not exhaustive of all products in market with biotin content

References:

1. MIMS Gateway
2. www.uptodate.com