High dose supplementation of biotin shows promise in alleviating effects of progressive multiple sclerosis

A new pilot study treated patients with multiple sclerosis (MS) with high doses of the water-soluble vitamin biotin. Improvements were noted in vision and degree of paralysis. The results were encouraging enough to initiate new randomised controlled trials.

Multiple Sclerosis (MS) is a chronic, progressive, autoimmune disease of the central nervous system characterized by disseminated, multifocal inflammatory demyelination and axonal lesions. It disrupts the ability of the nerve to conduct electrical impulses. Symptoms include paralysis, sensations of tingling or numbness, pain and unilateral optic neuritis. The cause is not known but is likely to be a combination of genetic predisposition and exogenous factors that induce an inappropriate immune response to one or more central nervous system autoantigens.

Around 2,300,000 people worldwide currently suffer from MS. There are ca 33 cases per 100,000, persons with the condition being fourfold more common in women than men. The age of onset is usually between 20 and 40 years of age (2).

There are various forms of the disease. Primary-progressive MS (PPMS) has a slow onset but continuously worsens. Secondary-progressive MS (SPMS) involves occasional relapses but symptoms progress steadily without remission. There are no effective therapies for these forms.

A proof of concept pilot study by Sedel et al. (1) involved 23 patients with PPMS or SPMS who were treated with between 100 and 600 mg/day biotin over a period of 2 to 36 months. Improvements were noted in terms of vision and degree of paralysis at a threshold intake of 300mg biotin/day. Results indicate that high dose biotin intervention could impact the progression of the disease and help ameliorate some of the symptoms. A larger,randomized trial, MS-SPI, is now taking place with a cohort of 154 people with an intervention of 300mg/day of biotin that will hopefully confirm these results.

Biotin (also known as vitamin B7 or vitamin H) is a water-soluble vitamin found in many foods. Biotin acts as a co-enzyme for carboxylases featuring in energy metabolism and synthesis of fatty acids.

1. Sedel F, Papeix C, Bellanger A et al., “High doses of biotin in chronic progressive multiple sclerosis: A pilot study”, Multiple Sclerosis and Related Disorders 2015, Mar 4(2): 159-169.
2. Multiple Sclerosis International Federation, 2013