Biotina, y ...

Journal Scan / Research · November 09, 2019

Consumer Perception of Biotin Supplementation

Journal of cutaneous medicine and surgery

TAKE-HOME MESSAGE

• To determine the perception of biotin by consumers, the Amazon reviews on the top 1% of biotin products (16 products) were analyzed in this study. The mean review score was 4.38. The mean percentages of reviews on biotin helping hair, nails, and skin were 27.2%, 15.03%, and 2.8%, respectively. There were no FDA warnings regarding the potential to interfere with laboratory results on the reviewed products, and this warning was referred to by 1 reviewer.

• Biotin supplementation is prevalent despite limited evidence of improvement. No mention of the FDA warning by the biotin manufacturers highlights the importance of physicians' role in public and patient education regarding biotin's potential for laboratory interference.

– InYoung Kim, MD, PhD

Dermatology

Written by

 

 

Peter A Lio MD, FAAD

Etiam capillus unus habet umbram suam.

(Even a single hair casts a shadow.)

-Publilius Syrus

Although dermatologists remain the undisputed experts on hair and nail disorders in addition to the skin, there is no doubt that hair loss, in particular, can be extremely daunting from both a diagnostic and therapeutic perspective. Biotin represents an inexpensive and relatively safe vitamin that is frequently recommended in situations that lack a more specific therapy or as an adjunctive treatment. It is widely available in numerous over-the-counter nutritional supplements that promise to support hair and nail growth despite the fact that it may not do much outside of a fairly narrow set of rare conditions.1 Importantly, although biotin deficiency is thought to be rare in healthy patients, one provocative study suggested that some 38% of women presenting with hair loss may be biotin-deficient on laboratory testing.2 Finally, although biotin may be suggested because it "can't hurt," more recent evidence suggests that it is not totally benign and can potentially cause issues by interfering with diagnostic laboratory tests, including those for troponin and thyroid.3

A recent publication found that, of those surveyed taking biotin, 57% reported no noted improvement in the condition they for which they were taking it.4 In this clever paper by John and Lipner, they take this a step further by studying customer reviews on the online marketplace Amazon.com for biotin supplements. Through this strikingly modern (and somewhat unconventional) approach to research, what they found is fascinating. There were over 2000 biotin products on the marketplace, so they focused on the 16 products in the top 1 percentile. The mean review score was a surprisingly positive 4.38 out of 5 stars, with over 27% of the reviews specifically stating that the biotin helped their hair. Remarkably, not a single product examined listed a warning about the ability of biotin to interfere with laboratory testing. Their conclusion supports the idea that biotin supplementation is extremely common and, despite the lack of robust scientific evidence, seems to be well-liked by the patients who are using it. As we move toward a world where patient-reported outcomes are looming larger and "customer satisfaction" has very much become a part of medicine, it is increasingly difficult to disregard such findings. As the authors suggest, further studies are clearly called for; but, in the meantime, education about the potential effects on laboratory testing is critical since clearly patients are taking biotin whether we recommend it or not.

References

1. Patel DP, Swink SM, Castelo-Soccio L. A review of the use of biotin for hair loss. Skin Appendage Disord. 2017;3(3):166-169. https://www.karger.com/Article/FullText/462981
2. Trüeb RM. Serum biotin levels in women complaining of hair loss. Int J Trichology. 2016;8(2):73-77. http://www.ijtrichology.com/article.asp?issn=0974-7753;year=2016;volume=8;issue=2;spage=73;epage=77;aulast=Tr%FCeb
3. Li J, Wagar EA, Meng QH. Comprehensive assessment of biotin interference in immunoassays. Clin Chim Acta. 2018;487:293-298. https://www.sciencedirect.com/science/article/abs/pii/S0009898118305394
4. John JJ, Cooley V, Lipner SR. Assessment of biotin supplementation among patients in an outpatient dermatology clinic. J Am Acad Dermatol. 2019;81(2):620-621. https://www.jaad.org/article/S0190-9622(19)30008-8/fulltext

Abstract 

BACKGROUND

Biotin is an essential cofactor for metabolic pathways in humans. It is frequently self-prescribed by consumers and often recommended by dermatologists and primary care physicians, despite limited evidence of its effect on skin, hair, and nail disorders. A recent Food and Drug Administration (FDA) warning stated that biotin can interfere with laboratory tests.

OBJECTIVES

Our objectives were to determine the perception of biotin by Amazon consumers, including perception of improvement in hair, skin, or nails with biotin supplementation and consumers' awareness of the FDA warning on biotin.

METHODS

The keyword biotin was searched on Amazon.com, and the top 1 percentile of biotin products according to average consumer review were analyzed for dosage, indications, price, quantity, warnings, number, and average score of reviews.

RESULTS

From 16 biotin products analyzed, the mean review score was 4.38. The mean percentage of reviews stating that biotin helped hair, nails, and skin was 27.2%, 15.03%, and 2.8%, respectively. No biotin products mentioned the FDA warning, and only 1 reviewer referenced the warning.

CONCLUSIONS

These findings suggest that biotin supplementation is prevalent and perceived as helpful despite limited evidence of improvement. The majority of biotin users were unaware that biotin interacted with laboratory testing demonstrating the need for biotin manufacturers to include a warning label about the FDA warning and for physicians to warn their patients on the risks and benefits of biotin supplementation.

Journal of cutaneous medicine and surgery

Consumer Perception of Biotin Supplementation

J Cutan Med Surg 2019 Aug 13;[EPub Ahead of Print], JJ John, SR Lipner 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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