Normal Biotin Dosing
For healthy adults, the adequate intake is 30 mcg/day, with typical Western diets providing 35-70 mcg/day, which meets or exceeds requirements without supplementation. 1, 2
Standard Maintenance Doses
Adults
- Adequate daily intake: 30 mcg/day for general health maintenance 1, 2
- Typical dietary intake in Western populations ranges from 35-70 mcg/day, which is sufficient for most individuals 2
- For enteral nutrition support: at least 30 mcg/day in 1500 kcal (ESPEN Grade B recommendation) 1
- For parenteral nutrition: 60 mcg/day (ESPEN Grade B recommendation) 1
Special Populations
- Pregnancy: up to 300 mcg/day may be required based on metabolic markers 1
- Breastfeeding: at least 35 mcg/day orally 1
- Renal replacement therapy patients: may require additional amounts beyond standard dosing 1
Therapeutic Doses for Deficiency
The European Society for Clinical Nutrition and Metabolism (ESPEN) provides clear treatment algorithms based on clinical context:
Oral Treatment (First-Line)
- Standard deficiency with normal absorption: 10 mg/day orally 1
- Malabsorption or short bowel syndrome: 10 mg/day orally (higher doses needed due to impaired absorption) 1
Intravenous Treatment (Reserved for Specific Cases)
- Parenteral nutrition-dependent patients only: up to 200 mg/day IV for 2-3 weeks 1
- IV biotin is not used for routine deficiency treatment when oral intake is possible 1
Safety Profile
Biotin has no established upper limit and demonstrates excellent safety even at pharmacological doses. 1, 3
- No adverse effects reported with oral or IV doses up to 5 mg/day for prolonged periods 1, 3
- Biotin toxicity is unlikely even at high doses 3
- High-dose biotin (10,000 times the RDI, approximately 10-20 mg/day) is used therapeutically in progressive multiple sclerosis 4
Important Clinical Caveat: Laboratory Interference
High-dose biotin supplementation (typically >5 mg/day) can cause significant interference with immunoassays, producing falsely abnormal thyroid function tests, parathyroid hormone, and vitamin D levels. 4, 5
- Biotin interference can mimic Graves' disease with suppressed TSH and elevated free T4 4
- Can cause falsely elevated 25-hydroxyvitamin D and falsely suppressed parathyroid hormone levels 5
- Patients should discontinue biotin for at least 1 week before laboratory testing to avoid spurious results 4
- Always obtain a supplement history when laboratory results don't match the clinical picture 4