A 2018 national survey reported the reasons that people are taking natural medicines. The third most popular reason for those eighteen to thirty-four and the fourth most popular reason for those thirty-five to fifty-four was for hair, skin, and/or nails. A striking 28 percent of the former age group and 23 percent of the latter group reported using one or more of these types of products daily.
Consumer Reports states, “There’s no shortage of products on the market that are claimed to thicken hair, remove wrinkles, and fix dry, brittle nails. Among these are a slew of dietary supplements, some topping $100.”
Supplements for hair, skin, and nail health commonly contain vitamins A, C, or E, coenzyme Q10, or biotin (vitamin B7). For hair, products including manganese and selenium along with fatty acids such as fish oil and flaxseed oil are not uncommon. The companies that are selling these products often advertise that deficiency of these and other nutrients causes unsightly hair, skin, and nail changes that they claim can be prevented or mitigated by their products. What they don’t mention is that a deficiency in any of these vitamins or minerals is extremely uncommon in the US.
Most dermatologists tell me there’s no compelling evidence that natural medicines can make any difference whatsoever for the vast majority of people who have no deficiency in any of these vitamins or supplements. Pieter Cohen, MD, an assistant professor of medicine at Harvard Medical School and an expert on dietary supplements, told Consumer Reports, “I’m not aware of any robust data suggesting that any supplements can treat natural, aging-related hair loss or nail damage, or give you healthier skin.”
Furthermore, there are myriad medical reasons for hair, nail, or skin problems. If you’re experiencing chronic hair, nail, or skin problems for no apparent reason, talk with your family physician or a dermatologist before trying any natural medicines. Why? Once again, early treatment is far more effective!
I have also reviewed a lot of dietary supplements, if you are interested, you might check them out.
Multivitamins for Skin and Nails
For the reasons I discussed earlier (see chapter 5, “An Overall Approach to Wellness and Multivitamins”), I consider multivitamins to be “Possibly Unsafe” and “Possibly Ineffective” for most consumers. Nevertheless, for those choosing a multivitamin for hair, skin, or nail health, Labdoor tested “Hair Vitamins” and “Certified” Do Vitamins® VitaBeard®. They gave a “B-plus” rating to VitafusionTM Gorgeous Hair, Skin, & Nails Multivitamin and a “B” rating to Nature’s Bounty® Optimal Solutions Hair, Skin & Nails.
One popular product, SugarBearHair® Hair Vitamin, was not “Approved” by ConsumerLab.com in a 2020 review as the product “contained 160.5 percent of its listed amount of pantothenic acid and 163 percent of its listed amount of vitamin B-6 [pyridoxine].” ConsumerLab advises, “This indicates a high overage of those vitamins but does not pose a health risk. Like other hair and nail formulas, the focus of this product is on its very high dose of biotin (5,000 mcg).” And it is “very expensive,” costing “50 cents per gummy.” In addition, taking biotin can affect several common lab tests.
USP® has “Verified” two multivitamins sold for “hair, skin, and nails” (both are from Nature Made® and contain 2,500 mcg of biotin and 100 mg of Vitamin C: Nature Made® Hair, Skin and Nails Gummies and Nature Made® Hair, Skin and Nails Mini Softgels).5 Natural Medicines lists several “Hair, Skin & Nails Gummies” products that are NMBER® rated 8 out of 10, including products from Nature’s Bounty®, Optimal Solutions, and Vitamin World®.
For those who wisely, in my opinion, do not take a multivitamin for hair, skin, or nails, what supplement options are there?
Aging Skin and Wrinkles
People spend a lot of money on skincare. On the low side, Statista (a German online portal for statistics) said that in 2019, 1.66 million Americans paid $2,000 or more on skincare products.
One-third (33 percent) spent $400 or more, while a whopping 75 percent spent $200 or more.6 A SkinStore survey reported that the average American woman spent an average of $5 a day toward skincare products (and this does not include makeup)—amounting to just under $2,000 a year in 2018.
Over a lifetime, SkinStore says, this turns out to be over $200,000 or about ten percent of the average woman’s lifetime income. DermLetter adds, “It’s clear that women are willing to back up their skin with their wallet.”
Before we discuss natural medicines for preventing or treating aging skin and wrinkles, I’ve adapted these commonsense tips from Mayo Clinic for protecting your skin and minimizing premature skin aging or the appearance of wrinkles:
- Protect your skin from the sun. Use sunscreen year-round when outdoors.
- Choose skin-care products with a built-in sun protection factor (SPF) of at least 15. The American Academy of Dermatology (AAD) recommends using a broad-spectrum sunscreen with an SPF of 30 or more. When selecting UV blocking products, choose those with a broad-spectrum sunscreen—meaning they block both UVA and UVB rays. Always apply generously.
- Moisturize. Dry skin shrivels plump skin cells, which can lead to premature fine lines and wrinkles. Moisturizing traps water in your skin, which helps mask tiny lines and creases. It may take a few weeks of regular use of the product before you notice any improvement in your skin. Dr. Griffith shares, “Practically, patients who apply moisturizers over slightly damp extremities after bathing find it easier to form the habit. Most moisturizers marketed for the face also contain sunscreens, which definitely slows the changes of photoaging.”
- Don’t smoke. Even if you’ve smoked for years or smoke heavily, you can still improve your skin tone and texture and prevent wrinkles by quitting smoking.
- Eat a healthy diet. There is some evidence that certain vitamins in your diet (in foods and not in supplements) help protect your skin. More study is needed on the role of nutrition, but it’s good to eat plenty of fruits and vegetables.
What about Sunscreens?
One recent concern about sunscreens is the research suggesting that some of the chemicals in sunscreens absorb into your bloodstream after “maximal use.” There’s no indication so far of any clinical problems with this. As AAD points out, “Just because an ingredient is absorbed into the bloodstream does not mean that it is harmful or unsafe. Most importantly, the study authors and the FDA conclude that consumers should continue to use sunscreen to protect themselves from the sun.”
AAD recommends “that everyone seek shade, wear protective clothing— including a lightweight and long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses—and apply a broad-spectrum sunscreen to all exposed skin. These recommendations are based on current scientific evidence—which shows a sunscreen is an effective way to reduce skin cancer risk.”
AAD adds, “In addition to chemical sunscreens, people can use physical sunscreens, also known as mineral sunscreens, which act like a shield. They sit on the surface of the skin, primarily deflecting the sun’s rays. They include the active ingredients titanium dioxide or zinc oxide and are also recommended for people with sensitive skin.”
The medical experts at Up-To-Date advise, “Pending further data, we continue to advise that patients use sunscreen along with other sun-protection measures.”
The Skin Cancer Foundation writes, “Wrinkles, fine lines and pigmentation are inevitable skin woes that often appear as we age. While we like to place blame on getting another year older, the main culprit is photoaging—damage to the skin caused by exposure to sunlight and ultraviolet (UV) light. Responsible for 90 percent of visible changes to the skin, photoaging is a direct result of cumulative sun damage you’ve been exposed to throughout your life.”
And, “Photoaging from sunlight also can result in reduced skin elasticity, the degradation of skin texture, and many other signs of skin aging. This has been shown repeatedly, in different parts of the world, over many years, and in many different clinical studies.”
Natural Medicines says, “Skin that gets more sun exposure shows far more signs of aging than the less exposed skin. Compare the skin on the outside of the arm with the skin on the underside. Which side looks younger?” They add, “Excessive sun exposure can also lead to more serious conditions including premalignant lesions such as actinic keratoses and malignant lesions such as squamous cell carcinoma, basal cell carcinoma, and malignant melanoma.”
Also, “The best offense against aging skin is a good defense against sun damage,” and “sunscreen is the most effective skin defense on the market.”
The use of a broad-spectrum sunscreen dramatically reduces skin damage and aging. Even more importantly, these sunscreens can help prevent melanoma and other types of skin cancer. I usually recommend to ALL of my patients that they apply a sunscreen with an SPF of at least 20 no less than twenty minutes before sun exposure (I call it Dr. Walt’s 20-20 rule).
If you’re going to be in the sun, reapply it every two hours after that. Also, protective clothing and a wide-brimmed hat of at least four inches can help. Try to avoid the sun when the rays are most intense, usually between 10:00 a.m. and 4:00 p.m. The bottom line is that you can best prevent premature aging of your skin by staying out of the sun when you can and by using sunscreen when you can’t.
Dr. Griffith adds, “The most common query I get in the office is, ‘What is the best sunscreen?’ My answer: ‘The one you will put on. The best sunscreen in the world is not useful if it stays inside the bottle,’” adding, “I recommend a broad-spectrum, water-resistant brand of SPF 30 or higher. In the south, the beach, sweat, and sun are routinely mixed, so water resistance is important.
Also, UV protective clothing is easiest for the trunk, especially when swimming.” Most experts now say that concern about vitamin D levels is not a good reason to avoid wearing sunscreen. Natural Medicines counsels, “While sunscreens do limit the amount of vitamin D produced by the body, the reduction is rarely enough to cause vitamin D deficiency.”
Avoid tanning booths at all costs. According to the American Society for Dermatologic Surgery (ASDS), “Exposure to the ultraviolet light from tanning beds can impact the skin in a variety of ways—including wrinkles, sunspots or freckles. And for one in every five Americans, this exposure can lead to skin cancer. The use of tanning beds and sun lamps is hazardous because the UV radiation they deliver can damage your skin. Dermatologists highly recommend not using tanning beds and sun lamps. There is growing evidence they may increase your risk of developing melanoma.”
AAD points out that tanning beds are not safer than the sun, make your skin age more quickly, can cause eye injuries, cannot prevent sunburn, and can make stretch marks more visible.
The AAD adds this disturbing information: “Growing evidence indicates that tanning can be addictive. About 20 percent of 18- to 30-year-old white women who use indoor tanning show signs of addiction. They find it hard to stop tanning. When they don’t get a steady dose of UV rays, they feel fidgety or depressed.”
Supplements for Aging Skin and Wrinkles
Collagen, mainly type I collagen, is a major structural protein of the skin that declines during aging. This leads to your skin thinning and becoming fragile, which increases wrinkling, the risk of bruising, and wound healing disorders.
Several topical treatments may restore collagen production in the skin and could hold promise to improve skin health. As a result, as Natural Medicines writes, “Aging Baby Boomers have created a huge market for skincare products that they hope will ‘turn back time.’”
Natural Medicines adds, “There continues to be growth in anti-aging products on the market to address these needs. These products are often called cosmeceuticals. They’re promoted as being more powerful than regular cosmetics, but not so powerful that they’re regulated like drugs. Many come in the form of facial creams or lotions, beefed up with antioxidants and other interesting and sometimes questionable ingredients. Some cosmeceuticals are even taken by mouth. Although many cosmeceuticals are marketed using claims that may sound medical in nature, they are typically regulated as cosmetics or dietary supplements rather than as prescription or over-the-counter drugs.”
Natural Medicines points out that “cosmeceuticals….do not have the same pre-market approval process as drugs. There are no rigorous safety or effectiveness standards required in order to market a cosmeceutical. Therefore, cosmeceuticals often enter the market without testing or evidence to support safety or to support the claims that are made.” Nevertheless, there are some worthy of your consideration.
Topical Retinoids, Adapalene, and Retinols
Currently, prescription products approved for treating aged skin include tretinoin (Renova®, Retin-A®) and tazarotene (Avage®). These prescriptions are “considered the gold-standard treatments for existing wrinkles,” says Natural Medicines.
Some dermatologists are recommending the off-label use of a less expensive retinoid by using adapalene (Differin® Gel) 0.1% daily. The product is marketed and approved OTC only for acne. Its use for skin photoaging is not FDA approved. However, a prescription concentration of 0.3 percent has been shown to be similar in efficacy to Retin-A® for photoaging of skin.16 Differin®
Gel is about $13 to $16 for a month’s supply that will cover the entire face with daily use.
Natural Medicines writes, “Some people think that because tretinoin is a vitamin A derivative, that vitamin A itself might also work. There is no evidence that taking vitamin A supplements orally improves aging skin. However, there is some evidence that applying vitamin A (as retinol) to the skin might be beneficial.”
Natural Medicines also points out, “Retinol preparations are less effective than tretinoin at improving signs of photodamage, so higher concentrations may be needed to achieve comparable effects. One clinical study showed that products containing retinol 1.0% are needed to reduce wrinkles similarly to formulations containing tretinoin 0.1%. Many over-the-counter retinol products contain retinol in lower amounts or do not specify the amount of retinol.”
Of note, one of the primary mechanisms for the photoaging treatment by topical retinoids is the production of collagen in collagen-depleted skin.17 Sun protection will extend the life of natural collagen; however, topical retinoids are known to increase its growth. University of Michigan researchers found that 0.4 percent topical retinol treatment increased the level of type I collagen “in photoaged forearms to levels similar to that of young forearms within four weeks….[and] proved the concept that reduced [type I collagen] production in aged skin can be readily restored.”
The use of retinoids, adapalene, and retinols can cause mild-to-severe skin reactions in some people and can also increase sensitivity to the sun and ultraviolet (UV) light. Always try a small amount initially.
Topical alpha hydroxy acids (AHAs)
As for natural medicines, topical alpha hydroxy acids are very commonly used and are moderately effective. Natural Medicines rates them “Likely Safe” and “Likely Effective” for aging skin, advising, “Applying alpha hydroxy acids in a lotion, cream, or solution daily can decrease wrinkles and other signs of aging or photodamage.”
AHAs were initially sourced from natural products, such as glycolic acid (from sugar cane), lactic acid (from sour milk), malic acid (from apples), citric acid (from citrus), and tartaric acid (from grapes). However, now the source of the AHAs in most cosmetics is predominantly synthetic.
They are a common ingredient in scrubs, lotions, and creams used for wrinkles. Dr. Griffith notes, “Most moisturizers without AHA gently trap water in the outermost layer of the skin, the stratum corneum, and hydrate those cells. However, moisturizers with added AHA can modify that layer of the skin making it exfoliate and more flexible. It may sting on application, and in conditions of high humidity, it may yield a sticky feel. Many of my patients prefer glycolic acid over lactic acid.”
They are also used in higher concentration, short-contact preparations as skin peels, which can help reduce fine wrinkles. Natural Medicines rates these products as “moderately effective for improving the signs of aging skin, including reducing wrinkles. They are generally safe and well-tolerated when used short-term and appropriately.”
However, the use of topical AHAs can cause mild-to-severe skin reactions in some people and can also increase sensitivity to the sun and ultraviolet (UV) light. Always try a small amount initially. I think of these AHAs based on their concentration:
- High concentrations of 50 to 70 percent are legally used only in physicians’ offices.
- Trained cosmetologists use medium concentrations of 20 to 30 percent for light skin peeling.
- Low concentrations of less than 10 to 14 percent are available to the consumer in a variety of products.
Collagen, Vitamin C, Vitamin E, and Other Products
Collagen Type I
Adults lose about one percent of the collagen in their skin each year, which contributes to thinning and wrinkling in aging skin. This loss of collagen may be more evident at an earlier age in women, who have lower collagen density in their skin than men.
ConsumerLab writes, “Some studies in people suggest that collagen can provide a very modest benefit (10–20 percent improvement) in improving wrinkles by increasing skin volume and elasticity. There is less evidence of a benefit for improving skin hydration and reducing skin roughness.” They add, “There are many types of collagen, but the predominant ones in the body are types I, II, and III.”
Collagen supplements for the skin typically (but not always) contain type I or type III collagen. ConsumerLab advises, “The best evidence supporting the use of collagen in aging skin is with Verisol® (Gelita AG), a collagen peptide made of hydrolyzed, porcine-derived (from pigs) type I collagen.” They add that Verisol® is “the only ingredient to have been tested in several placebo-controlled clinical trials….(showing) a modest improvement in wrinkles after eight weeks and a slight improvement in the appearance of cellulite after six months.”
Natural Medicines rates collagen peptides as “Possibly Safe” and “Possibly Effective” for improving skin hydration and elasticity in older patients and for possibly reducing wrinkles but lists no Verisol®-containing products with a NMBER rating higher than 5 out of 10.
ConsumerLab’s two “Top Picks” for collagen for skin are “Trunature® [Costco®] Healthy Skin Verisol® Collagen capsules and Besha Inc. Collagen Peptides powder. Both of these products contain collagen peptides (hydrolyzed collagen) from the branded ingredient Verisol®.” They add, “The products are also reasonably priced, with a daily serving of Trunature® (4 capsules) costing 30 cents and providing 2.5 grams of collagen peptides and Besha (2 teaspoons) costing 47 cents and providing 2.9 grams of collagen peptides. Trunature® is slightly less expensive per gram, but the real deciding factor between the two is whether you prefer to take 4 fairly large capsules daily or mix about 2 teaspoons of powder into your preferred beverage.”
ConsumerLab also advises, “Be aware that Verisol® is sourced from pigs.” If you have dietary restrictions and prefer other sources, ConsumerLab lists products from bovine (cow), chicken, fish, and eggshell products.
They add, “The collagen hydrolysates in the powders from Great Lakes® Gelatin Co.® and Vital Proteins®, for example, are both from bovine hide and are listed as kosher.” Labdoor has not rated collagen type I products.
A trendy approach to aging skin is to use topical antioxidants to prevent the oxidative damage caused by sun exposure and UV radiation.
Vitamin C is perhaps the most common antioxidant included in skincare products. It’s available in several active forms. Among them all, L-ascorbic acid is the most biologically active and well-studied.20 In addition to its antioxidant effects against UV-induced damage, vitamin C may play a role in collagen synthesis and tissue repair.
One recent review concluded, “Topical vitamin C has a wide range of clinical applications, from antiaging and antipigmentary to photoprotective. Currently, clinical studies on the efficacy of topical formulations of vitamin C remain limited, and the challenge lies in finding the most stable and permeable formulation in achieving the optimal results.”
Natural Medicines writes, “Vitamin C is water-soluble, and therefore, taking it orally might not produce high enough concentrations in the skin to be beneficial.” However, “Topical preparations containing 5 to 10 percent vitamin C seem to improve the appearance of wrinkled skin.” For example, “There is preliminary evidence showing a topical vitamin C formulation (Cellex-C High-Potency Serum®, which combines 10 percent vitamin C with tyrosine, zinc, and hyaluronic acid) might help. In three studies, this specific product seems to reduce fine lines, wrinkles, and roughness, and improve skin tone when applied for 12 weeks. In addition, preliminary evidence shows that a 3 percent vitamin C topical preparation applied for 12 weeks might also reduce facial wrinkles.”
Natural Medicines adds, “Lots of skin products contain vitamin C, but it might not be obvious after a first glance at the ingredient list. Some products list acerola or rose hip. These are plant materials that contain a high concentration of vitamin C, but there is no reliable evidence that these products are any better than regular vitamin C products.”
Vitamin E is also a prevalent antioxidant in skincare products. Natural Medicines advises that it is available “both orally and topically. It may improve skin moisture, softness, and smoothness while providing mild protection from ultraviolet sun damage. But so far, there is no reliable clinical evidence that oral or topical vitamin E is helpful for improving signs of aging skin.”
However, Natural Medicines says, “There is evidence that taking a combination of both vitamin C and vitamin E supplements orally might help in the prevention of photoaging. The most studied dosing is two grams (2000 mg) of vitamin C plus 1,000 IU of vitamin E orally.” But they warn that “these high doses might cause adverse effects, including nausea, vomiting, and diarrhea, in some people.” In addition, more than 400 IU/day of vitamin E has been linked to increased mortality.
Although an “uncommon phenomena,” there are reports of “vitamin E- induced allergic contact dermatitis,” which included several hospitalizations.
Again, I recommend that any time you use a new topical product, you test it on a small area of skin for a few days.
ConsumerLab writes, “Other natural products such as topical alpha-lipoic acid [ALA], topical green tea, coenzyme Q10, lycopene, a chemical derivative of kinetin (furfuryl tetrahydropyranyladenin), and DMAE (dimethylaminoethanol or deanol) are showing promise in clinical research.
For example, hyaluronic acid has been evaluated as an oral supplement in combination with other natural medicines (GliSODin® Skin Nutrients Advanced Anti-Aging Formula, Isocell North America Inc.), including krill oil, sea buckthorn berry oil, and cacao bean extract.” They add, it “moderately decreases wrinkling and photodamage and improves skin moisture and elasticity.”
Natural Medicines concludes, “However, it is unclear if these effects are due to hyaluronic acid, other ingredients, or the combination.” As a result, they add, “it’s too soon to recommend these products as reliable preventive measures or treatments of aging skin.”
As to DMAE, ConsumerLab says, “It’s showing up in all kinds of facial moisturizers promoted to firm up sagging facial skin. An example is Reviva® Labs DMAE Firming Fluid, Skin Eternal® Cream, etc. A one-ounce bottle can cost upwards of $50.” I recommend people wait for evidence of safety and effectiveness before purchasing them.
The experts at Natural Medicines write, “Patients can spend a lot of extra money for products that boast natural ingredients with all sorts of exciting names and scientific-sounding benefits. For now, tell them to save their money until the effects of these ingredients are better understood. Also, explain that more expensive skincare products aren’t necessarily more effective. Many cheaper products contain the same ingredients as more expensive brand name products.”
An Atlantic article with the subtitle “Don’t Rub the Money Directly on Your Face,” correctly reports the most “natural way” to slow skin aging: “A diet of fresh foods, plenty of water, and eight hours of sleep every night [which affects] how your skin looks. Studies have demonstrated links between all three and physical appearance, and they’ll help most people achieve the modest goal of looking totally fine.”
This is good advice that will also have the rest of your body becoming healthier.
I must give you a warning though. Any of the products mentioned in this article can cause mild-to-severe skin reactions in some people and can also increase sensitivity to the sun and ultraviolet (UV) light. I tell my patients to always test topical products on a small area of skin for a day or two before applying it to a larger area.
I also warn people to use a sunscreen or wear protective clothing when first trying these products. This increased sensitivity typically resolves within one week of discontinuing treatment.
Brittle nails are said to affect approximately 20 percent of the population, and the incidence increases with age. The medical term onychoschizia includes splitting, brittle, soft, or thin nails. The American Osteopathic College of Dermatology says, “Other than aging, common causes include frequent wetting and drying, chemical exposure, underlying health or medical problems, stress or trauma, and hormone changes, particularly menopause.”
Dr. Griffith adds, “Limiting the frequency of fingernail polish removal is helpful. The simplest approach is moisturizers applied to the nails frequently, specifically products containing AHAs.”
The most common natural medication recommended for brittle nails is biotin (vitamin B7). ConsumerLab points out, “a small but controlled study among women with brittle nails found that a daily dose of 2.5 mg (2,500 mcg) of biotin for six to nine months increased nail thickness by 25 percent and reduced their tendency to split. Biotin does not, however, further strengthen healthy nails.”
Natural Medicines considers this “Insufficient Evidence” to recommend biotin for brittle nails.
Nevertheless, Marvin M. Lipman, MD, Consumer Reports’ chief medical adviser, says, “If there are no medical problems causing nail problems, and if nothing shows up after appropriate testing, because we don’t have a good blood test to detect biotin deficiency, it might be worthwhile to try a supplement for three months.”
This is the approach I have taken with patients in my practice, and, anecdotally, it seems to have been somewhat helpful for people with brittle nails and no discernible medical cause. Natural Medicines says it is “Possibly Safe” and has been “well-tolerated in clinical trials. Relatively high doses up to 300 mg daily for up to 30 months have been taken in some cases without adverse effects.”
In a 2020 review, ConsumerLab “Approved” four of five biotin products, advising, “If you want to take biotin for (brittle nails), our ‘Top Pick’ is NutraBlast® Hair Skin & Nails, as it provides 2,500 mcg of biotin per gummy (13 cents)—a bit more expensive than the other ‘Approved’ products, but the right dose. A less expensive option is Nature’s Life® Biotin 2,500 mcg Hair, Skin and Nails Formula, which we tested in 2017; each 10-cent capsule provided 2,500 mcg of biotin.” USP®-“Verified” Nature Made® Biotin Adult Gummies, which at 3,000 mcg (two 1,500 mcg gummies per day) are a slightly higher dose than you need but cost as little as 16 cents a day.
Natural Medicines lists over 110 USP®-“Verified” products containing biotin, with forty of them achieving NMBER ratings of 8 out of 10. Labdoor has “Certified” nine biotin products: four with an “A-plus” rating, four with an “A” rating, and one with an “A-minus” rating. Nature’s Bounty® Biotin rated “A-plus” and VitaFusion Biotin rated “A-minus.” Both have 1,000 mcg of biotin. The other seven contained 5,000 or 10,000 mcg of biotin,27 which may be excessive. There’s one last option to consider if the previous suggestions aren’t helpful.
A small study in women with brittle nails taking Verisol® (Gelita AG), 2.5 grams daily for six months, improved overall symptoms of brittle nails. Also, a 12 percent increase in nail growth rate and a 42 percent decrease in broken nail frequency compared to baseline was reported.
The study was limited by its small size and lack of a placebo group,28 so Natural Medicines lists it as having “Insufficient Evidence” for effectiveness. However, they do rate it as “Possibly Safe” and “Possibly Effective” for aging skin based upon studies using four to ten grams a day of Verisol® for up to twelve weeks. Therefore, it may be worth a try.
Biotin and Lab Tests
ConsumerLab advises, “High doses of biotin (5,000 mcg or more per day) may interfere with certain laboratory tests, so be sure to inform your physician before undergoing tests if you take high doses.” Dr. Worthington warns, “There is evidence that even doses as low as 300 mcg daily can interfere with many lab tests.”
An FDA Safety Bulletin in 2017 warned, “Patients and physicians may be unaware of biotin interference in laboratory assays.” The FDA added, “Be aware that many lab tests, including but not limited to cardiovascular diagnostic tests and hormone tests, that use biotin technology are potentially affected, and incorrect test results may be generated if there is biotin in the patient’s specimen.”
The American Association for Clinical Chemistry (AACC) Academy, formerly the National Academy of Clinical Biochemistry (NACB), writes, “Most of the published research on biotin interference covers hormone tests, such as parathyroid hormone (PTH), thyroid stimulating hormone (TSH), T4 and T3 tests, as well as tests for troponin (a test for heart damage). However, because biotin is used in so many immunoassays, scientists say it could interfere with many others.”
In a 2019 update, the FDA writes that it is “particularly concerned about biotin interference causing a falsely low result for troponin, a clinically important biomarker to aid in the diagnosis of heart attacks, which may lead to a missed diagnosis and potentially serious clinical implications. The FDA continues to receive adverse events reports indicating biotin interference caused falsely low troponin results.”
The FDA has reported one death that “occurred when a patient taking high doses of biotin had falsely low troponin results from a troponin test known to have interference from biotin. Troponin is a biomarker that helps diagnose heart attacks.”
Also, researchers have found that even a single dose of biotin can cause a false-positive result for hepatitis B and false-negative results for HIV and hepatitis C blood tests. The researchers advised that biotin from supplements should not be taken for forty-eight hours before blood tests for hepatitis B, hepatitis C, or HIV.