I Was Wrong About Biotin for 10 Years

I owe about 1,000 patients an apology.

For a decade, I recommended biotin like it was hair growth candy. Patient losing hair? "Take 5,000mcg of biotin daily." Thinning? "Have you tried biotin?"

I was that doctor. The one who perpetuated the biotin myth because, hell, everyone else was doing it and it seemed harmless.

Then came the study that made me feel like a complete idiot.

My Biotin-Pushing Era (2010-2020)

Looking back, I cringe. My standard hair loss consultation included:

• Minoxidil? Check.
• Ketoconazole shampoo? Check.
• "And grab some biotin from CVS!" Check.

Why? Because every continuing education course mentioned it. Every hair loss forum swore by it. Patients asked for it by name.

Plus, the logic seemed sound:

• Biotin deficiency causes hair loss
• Therefore, extra biotin = extra hair
• Simple, right?

Wrong. So catastrophically wrong.

The Study That Ruined My Day

Journal of Dermatological Treatment, 2020. They followed 200 women with hair loss for 90 days. Half got 5,000mcg biotin, half got placebo.

The results? No statistical difference. None. Zero. Zip.

But here's what really got me: they tested baseline biotin levels. Only 3% were actually deficient.

I sat at my desk, staring at this paper, calculating how much money my patients had wasted on my recommendation. Conservatively? About $30,000 collectively.

For. Nothing.

Going Down the Biotin Rabbit Hole

I spent the next month reading every biotin/hair study I could find:

What I learned:

• True biotin deficiency is RARE (unless you eat raw eggs daily or have specific genetic conditions)
• Your gut bacteria make biotin
• You need tiny amounts (30mcg daily)
• Excess biotin is just expensive pee
• Most hair loss has nothing to do with biotin levels

The kicker: Biotin supplements can interfere with lab tests, including cardiac and thyroid markers. I'd been telling people to take something that could mask serious health issues.

The Awkward Conversation Era

Then came the fun part: telling patients I'd been wrong.

"Hey, remember that biotin I've been pushing for years? Yeah, about that..."

Reactions ranged from:

• "But my hairdresser says..."
• "My hair is definitely thicker!" (placebo is powerful)
• "I've spent $500 on biotin this year!"
• "So you were just guessing?"

That last one stung because... yeah, kind of.

What I Tell Patients Now

The honest truth about biotin:

"Unless you have a documented deficiency or eat 6 raw eggs daily, biotin supplements won't help your hair. Save your money. If you're convinced it's helping, it's likely because you're also doing other things right – better diet, less stress, proper hair care. The biotin is just along for the ride."

Who actually needs biotin:

• Pregnant/breastfeeding women
• People with biotinidase deficiency (genetic, rare)
• Chronic alcoholics
• People on certain seizure meds
• Raw egg enthusiasts (why???)

What to do instead:

• Get nutrient levels actually tested
• Focus on iron, vitamin D, zinc
• Ensure adequate protein intake
• Address underlying health issues
• Use proven treatments (minoxidil, finasteride, etc.)

The Supplement Industry's Dirty Secret

Here's why biotin became the go-to hair supplement:

1. It's cheap to produce
2. It's water-soluble (hard to overdose)
3. One rat study from 1991 showed promise
4. Deficiency DOES cause hair loss (just super rare)
5. Placebo effect is strong with hair
6. Profit margins are insane

A bottle of biotin costs $0.50 to produce, sells for $15-30. Do the math.

Real Nutrients That Actually Matter

After my biotin wake-up call, I dove into what deficiencies ACTUALLY cause hair loss:

Iron:

• 70% of my female hair loss patients are iron deficient
• Ferritin needs to be >70 for optimal hair growth
• Most doctors say >12 is "normal" (it's not for hair)

Vitamin D:

• Involved in follicle cycling
• Most people are deficient
• Needs to be >40ng/mL for hair health

Zinc:

• Critical for protein synthesis
• Often low in vegetarians
• But too much causes copper deficiency (also bad for hair)

My Current Supplement Protocol

Instead of blind biotin recommendations:

1. Comprehensive blood work:
   • CBC with ferritin
   • Vitamin D
   • Thyroid panel
   • Zinc/copper if indicated
2. Targeted supplementation:
   • Only supplement what's actually low
   • Retest in 3 months
   • Adjust based on results
3. Focus on diet first:
   • Protein at every meal
   • Iron-rich foods with vitamin C
   • Fatty fish for omega-3s
   • Colorful vegetables for antioxidants

The Patients Who Proved Me Right

Sarah, 32, came in after a year of biotin megadoses. Still losing hair.

Blood work revealed:

• Ferritin: 18 (terrible)
• Vitamin D: 22 (deficient)
• Biotin: Sky high (shocking nobody)

Three months after fixing her iron and D? New growth everywhere. The biotin? Discontinued.

The Bottom Line

I was wrong about biotin. Dead wrong. For a decade.

It's humbling to admit, but that's science – you follow the evidence, even when it makes you look like an idiot.

If you're taking biotin for hair loss and you're not in one of those specific deficiency groups, you're probably wasting money. That $20/month could go toward treatments that actually work.

But here's what pisses me off most: I'm still seeing new patients who were told by their doctors (in 2024!) to "just take biotin."

The myth persists because it's easier than running labs, cheaper than real treatments, and makes everyone feel like they're doing something.

Your hair deserves better than outdated recommendations and wishful thinking.

My Apology

To every patient I told to take biotin without checking levels first: I'm sorry. I fell for the same lazy thinking I now rail against.

Medicine is about admitting when you're wrong and doing better.

I was wrong about biotin.

Now you know better too.

P.S. - If biotin genuinely helped your hair, I'm not saying you're imagining it. Placebo effects are real effects. But maybe try stopping for 3 months and see what happens. Your wallet will thank you.