Marginal Biotin Deficiency Successfully Induced by Avidin Supplementation in an Outpatient Design

Abstract

Previous studies experimentally inducing marginal biotin deficiency have been labor intensive and have utilized an expensive inpatient design. In the current study, we sought to determine the efficacy of inducing marginal biotin deficiency using an outpatient design in which subjects consumed a self‐selected diet. Five healthy adults (3 females) consumed an uncooked egg‐white beverage with all meals and snacks for 28 days. Uncooked egg white contains avidin, which prevents absorption of biotin originating from both the diet and intestinal microbes. A research dietician counseled subjects on avoidance of high biotin foods. Established indicators of biotin status were monitored; urinary excretion of biotin was determined weekly, and lymphocyte activity of the biotin‐dependent enzyme propionyl‐CoA carboxylase (PCC) was determined at two‐week intervals. Urinary biotin decreased steadily and significantly (P< 0.0001 by repeated measures ANOVA); values for 4 of 5 subjects decreased to below the normal range by day 7. PCC activities decreased significantly (P= 0.0052); values for all 5 subjects decreased to below the normal range by day 14. No signs or symptoms of biotin deficiency appeared in any subject. This study provides evidence that successful induction of marginal biotin deficiency is possible in a safe, cost‐effective, outpatient design. NIH DK 36823 and MO1 RR14288