More information about biotin

Biotin is an emerging therapy for the treatment of secondary progressive MS.
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frodo
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More information about biotin

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Intersections of Pathways Involving Biotin and Iron Relative to Therapeutic Mechanisms for Progressive Multiple Sclerosis

http://www.discoverymedicine.com/Rebecc ... sclerosis/

Abstract:

While there are a variety of therapies for relapsing remitting multiple sclerosis (MS), there is a lack of treatments for progressive MS. An early study indicated that high dose biotin therapy has beneficial effects in approximately 12-15% of patients with progressive MS.

The mechanisms behind the putative improvements seen with biotin therapy are not well understood, but have been postulated to include: 1) improving mitochondrial function which is impaired in MS, 2) increasing synthesis of lipids and cholesterol to facilitate remyelination, and 3) affecting gene expression. We suggest one reason that a greater percentage of patients with MS didn't respond to biotin therapy is the inaccessibility or lack of other nutrients, such as iron. In addition to biotin, iron (or heme) is necessary for energy production, biosynthesis of cholesterol and lipids, and for some protective mechanisms.

Both biotin and iron are required for myelination during development, and by inference, remyelination. However, iron can also play a role in the pathology of MS. Increased deposition of iron can occur in some CNS structures possibly promoting oxidative damage while low iron levels can occur in other areas. Thus, the potential, detrimental effects of iron need to be considered together with the need for iron to support metabolic demands associated with repair and/or protective processes.

We propose the optimal utilization of iron may be necessary to maximize the beneficial effects of biotin. This review will examine the interactions between biotin and iron in pathways that may have therapeutic or pathogenic implications for MS.
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jimmylegs
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Re: More information about biotin

Post by jimmylegs »

High dose biotin as treatment for progressive multiple sclerosis (2017)
https://www.sciencedirect.com/science/a ... 4817302419

"Highlights
• Daily doses of high dose biotin, 300 mg per day, were well tolerated and safe.
• Daily high dosed biotin for up to a year did not induce sustained improvement in persons with progressive MS.
• One third of patients worsened, probably related to their disease.
• Several patients developed increased causalgic (constant, usually burning) facial pain on high dose biotin, with improvement on biotin cessation.

Abstract
Background
Published data suggested high dose biotin improved patients with progressive MS. We wished to determine benefits and side effects of administering daily high dose biotin to patients with progressive multiple sclerosis in a large MS specialty clinic.
Methods
Forty-three patients with progressive multiple scleroses were prescribed pharmaceutical grade biotin as a single daily dose of 300 mg/day. Brain MRIs were performed at baseline and after one year on biotin. Quantitative neurologic exams (EDSS) and blood work monitoring for biotin toxicity were performed at baseline and every three months thereafter.
Results
High dose biotin was safe, and well tolerated, with no evidence of toxicity on blood work and no new lesions on brain MRIs. None of the patients’ EDSS scores improved. One-third of patients (38–43%) worsened, most often with increased lower extremity weakness, worsened balance, and more falling, with two patients worsening sufficiently to increase their EDSS scores by 0.5. Several worsened patients improved after stopping biotin.
Conclusion
High dose biotin was safe and well tolerated, but of no demonstrable long-term benefit. More than one-third of patients worsened while on biotin, most likely due to their disease, but in some patients also possibly due to the inability of their injured central nervous systems to respond to the increased metabolic demands induced by biotin."

no info provided re participants' biotin status before, during and/or after this trial. just 'no evidence of biotin toxicity in any blood test' well, what *did* the blood tests look like? will have to go hunting for that article on best practices for nutrient study design, which includes getting (and one would imagine, reporting) baseline status info, plus whether/how the regimen affected nutrient status, as well as any effects on signs and symptoms.

thumbs up re cofactor considerations in the above. good ol iron dysregulation where have i heard about that before...
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ElliotB
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Re: More information about biotin

Post by ElliotB »

"Conclusion
High dose biotin was safe and well tolerated, but of no demonstrable long-term benefit. "

Ouch!
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