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Biotin is also known as vitamin H and coenzyme R (Hexahydro-2-oxo-1H-thienal[3,4-d]- imidazole-4-pentatonic acid). It is found primarily in liver, kidney and muscle. Biotin functions as an essential cofactor for four carboxylases that catalyze the incorporation of cellular bicarbonate into the carbon backbone of organic compounds. Acetyl-CoA carboxylase (ACC) is located in the cytosol where it catalyzes the formation of malonyl-CoA which then serves as a substrate for fatty acid elongation. The other three enzymes are located in the mitochondria. Pyruvate carboxylase (PC) catalyzes the incorporation of bicarbonate into pyruvate to form oxaloacetate, an intermediate in the tricarboxylic acid cycle. In gluconeogenic tissues such as the liver and kidney, oxaloacetate can be converted to glucose. Methcrotonyl-CoA carboxylase (MCC) catalyzes the incorporation of bicarbonate into propionyl-CoA to form methylmalonyl-CoA which, in turn, is metabolized to other compounds that eventually enter the tricarboxylic acid cycle. Deficiencies: Severe deficiency causes 1) thinning of hair, loss of hair color, and eventually complete loss of hair; 2) a scaly, red rash distributed around the openings of the eyes, nose, mouth, and perineal area; and 3) central nervous system abnormalities such as depression, lethargy, hallucinations, and paresthesias. In infants, the neurologic findings include hypotonia, lethargy, and developmental delay, as well as a peculiar withdrawn behavior. In patients on total or near total intravenous feeding, an unusual distribution of facial fat coupled with the rash and hair loss produces a distinct appearance called "biotin deficiency facies."

Clinical uses: Biotin is routinely provided to individuals receiving total intravenous feeding and is incorporated into almost all nutritionally complete dietary supplements and infant formulas. In larger doses, biotin is also used to treat inborn errors of metabolism such as biotinidase deficiency, holocarboxylase synthetase deficiency, and the isolated deficiencies of PC, PCC, and MCC. Marginal states of biotin deficiency may develop during normal pregnancy, possibly due to accelerated biotin breakdown. Adequate intakes for pregnancy may need to be revised upward in the future; however, no untoward effects of marginal biotin status in pregnancy have been proven to date. Marginal status has also been detected in patients taking anticonvulsants; these anticonvulsants appear to accelerate the rate of biotin breakdown and interfere with biotin absorption.

Diet recommendations: The estimated safe and adequate dietary intake values for biotin for different age groups are as follows: 5, 6, 8, 12, 20, 25 and 30 ug/day for ages of 0-0.5, 0.5-1, 1-3, 4-8, 9-13, 14-18 and >19 years, respectively. The values for pregnacy and lactation were estimated to be 30 and 35 ug/day, respectively.

Food sources: Biotin is widely distributed in food stuffs, but the amounts are small relative to other vitamins. Biotin deficiency is rare in the absence of total intravenous feedings without added biotin or the chronic ingestion of raw egg white.

Toxicity: Oral and intravenous doses up to 200 mg have not produced frank toxicity in human subjects. In animal studies, even higher doses per kilogram body weight have not produced toxicity.

When a person receives good nutrition is critical since growth occurs almost exclusively in infancy and adolescence. Humans grow fastest during the first two to three years of life, then growing slows through childhood until about age 10 or 11.

At this point, says Leonard, girls accelerate in height to reach their maximum by age 17 while boys shoot up a little later, reaching their tallest by age 20. One of America's most famous tall people, Wilt Chamberlain, hit a major growth spurt at age 15, when he grew four inches in three months. By the time he started playing college basketball he had reached a towering 7 feet 1 inch.

Growth beyond the age of 20, says Leonard, is rare. But interestingly, late growth spurts are more likely to occur when poor nutrition has inhibited growth earlier in life.

In the malnourished communities in South America, for example, people continued growing throughout their 20s. But these people still remained shorter than most Americans, since they grew less during the more critical years of childhood.

Since tallness reflects a person's early health and nutrition, tallness, in turn, can be a good indicator of a person's longevity. A recent study by David Gunnell, an epidemiologist at England's University of Bristol, showed that at least in older times, good height meant a long life.

Height Linked to Longevity

Gunnell measured hundreds of human arm and leg bones exhumed from English graves from between the ninth and 19th centuries. His studies showed that the longer the bone length (bone length correlates to overall height), the more likely a person lived beyond the age of 30.

In modern times being tall can help a person be more successful — sexually and professionally. In the United States studies have shown taller presidential candidates are more likely to be elected (with the notable recent exception of George W. Bush) and anecdotal evidence suggests that taller people appear more attractive and so have an easier time finding sexual partners.

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