Biotin works with some other B vitamins, such as folic acid, pantothenic acid (vitamin B5), and vitamin B12. However, no solid evidence indicates that people supplementing with biotin also need to take these other vitamins. Symptoms of pantothenic acid or zinc deficiency have been reported to be lessened with biotin, though people with these deficiencies should supplement with the nutrients in which they are deficient.
There is one report of a 76-year-old woman who developed a life-threatening condition (eosinophilic pleuropericardial effusion) while taking 10 mg of biotin per day and 300 mg of pantothenic acid per day. However, it is not clear whether the vitamins caused the problem.
Supplementing with folic acid in amounts as little as 300 to 800 mcg per day may increase vitamin B12 requirements. Therefore, it would be prudent for people taking folic acid to supplement with vitamin B12.
Supplementation with vitamin B12, even in relatively small amounts, can increase folic acid requirements, For that reason, people taking vitamin B12 supplements should also consider taking folic acid.
In addition, supplementing with folic acid can mask the laboratory diagnosis of vitamin B12 deficiency. Failure to identify and treat vitamin B12 deficiency in a timely manner can lead to permanent neurological damage. The relatively small amount of vitamin B12 present in most supplements is not sufficient to prevent or correct vitamin B12 deficiency in people who have pernicious anemia (a condition caused by vitamin B12 malabsorption). For that reason, people should tell their doctor if they are taking folic acid supplements, so that the doctor will order alternative laboratory tests if vitamin B12 deficiency is suspected.
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