Multiple sclerosis (MS) is a debilitating autoimmune disease that causes a loss of the covering that protects the nerve cells, myelin. This happens in both the brain and the spinal cord and results in a host of motor, mental, and sometimes psychological problems. While the cause of MS is not completely clear, research suggests that it is likely a mixture of genetic predisposition, environmental/nutritional factors, and infectious agents. (1)
While there are many different and effective ways to attack MS, this article is going to be about a particularly safe and easy supplement that has demonstrated the ability to lower disability and reduce disease progression: high dose biotin.
None of the information in this article, or any articles on this site, should be viewed as medical advice. Everyone is different, and medical decisions need to be made between you and your doctor. The information presented on this site is for informational purposes only.
The first study of this kind was done in 2015. Researchers hypothesized that, even though no drug thus far has demonstrated efficacy in slowing the progression of MS, high dose biotin (i.e. vitamin b7) might have a shot. Why would they guess this? Because biotin is involved in activating a particular enzyme called acetylCoA carboxylase, and this enzyme might be the bottleneck in the synthesis of myelin. Thus, taking more biotin might be able to increase the production of myelin to better match the amount of myelin that is being destroyed.
(As a side note, other researchers suspect that biotin may have a beneficial effect on MS due to its ability to activate the second messenger of nitric oxide, cGMP. cGMP has been shown to have neuroprotective properties in the brain and in neurons. (4))
Anyway, the researchers put 23 patients with MS on high dose biotin ranging from 100-300mg per day for an average of just over 9 months. (Just to put this in context, typically the highest dose of biotin that you can find in supplements is 10mg per pill. Thus, taking this “pharmaceutical dose of biotin” may require a prescription by your doctor.)
As the patients took the biotin, they kept improving in general. Patients with visual impairment related to optic nerve injury had improved visual acuity. Also, “sixteen patients out of 18 (89%) with prominent spinal cord involvement were considered as improved as confirmed by blinded review of videotaped clinical examination in 9 cases.” These improvements typically started to be seen 2-8 months after treatment was started. (2)
The main issue with this pilot study was that there was no control group (a group who took a placebo). Thus, this study is deemed “low-quality evidence”.
However, another group of researchers performed a randomised, double-blind, placebo-controlled study – the gold-standard in this type of research – on high dose biotin with MS in 2016.
They randomly gave 154 patients who had MS, an Expanded Disability Status Scale (EDSS) score of 4.5–7 and evidence of disease worsening within the previous 2 years either 100mg of biotin three times daily or a placebo for one year.
After a year, 12.6% of the patients who took biotin demonstrated a reversal of their disease progress versus none (0%) in the placebo group.
The researchers concluded that high dose biotin treatment reduced disease progression and improved the clinical impression of change compared with placebo. These beneficial effects were maintained over time, and the safety profile of high dose biotin was similar to that of placebo (meaning that it seemed entirely safe without significant side effects). (3)
However, it appears more research is needed. In 2017, another group of researchers found that 300mg of biotin (given all at once per day) did not improve the progression of MS, and some patients actually got better after stopping the biotin. (5)
So what to make of these conflicting results? For one thing, we need more research in this area. Particularly, we need to figure out the best dosing schedule for biotin. 300mg per day all at once may not be an ideal dosing strategy, as the 2016 study that got good results used 100mg three times a day. Also, there was no control group in the 2017 study, so the patients might have actually have gotten worse if they weren’t on the biotin. We just don’t know.
Furthermore, if you want to discuss biotin supplementation with your doctor, you may want to be cautious and start with a lower dose like 30mg three times a day and see how you respond. It is logical that any side effects of biotin would increase as the dose increases.
Lastly, make your doctor aware that biotin supplementation can artificially interfere with multiple blood lab results, such as thyroid hormone levels. It does not actually cause your blood levels to change but will cause the test to measure the results improperly. Just be aware of this. (6)
While biotin is very unlikely to drastically reverse MS, it does have some nice preliminary human evidence behind it. Keep in mind that biotin should be part of a fully integrative program that includes diet changes, exercise, and possibly some other useful tools such as cold laser. More on this to come in future articles.
As always, let me know if you have any comments, questions, or experiences below! I would love to hear from you!
References
- Ascherio A, Munger KL. Environmental risk factors for multiple sclerosis. Part I: the role of infection. Ann Neurol. 2007;61(4):288-99.
- Sedel F, Papeix C, Bellanger A, et al. High doses of biotin in chronic progressive multiple sclerosis: a pilot study. Mult Scler Relat Disord. 2015;4(2):159-69.
- Tourbah A, Lebrun-Frenay C, Edan G, et al. MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo-controlled study. Multiple Sclerosis (Houndmills, Basingstoke, England). 2016;22(13):1719-1731. doi:10.1177/1352458516667568.
- Mccarty MF, Dinicolantonio JJ. Neuroprotective potential of high-dose biotin. Med Hypotheses. 2017;109:145-149.
- Birnbaum G, Stulc J. High dose biotin as treatment for progressive multiple sclerosis. Mult Scler Relat Disord. 2017;18:141-143.
- Piketty ML, Prie D, Sedel F, et al. High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference. Clin Chem Lab Med. 2017;55(6):817-825.
