Question: What to do if taking biotin and yet beta-hydroxyisovalerate is elevated.

Well in theory that's a marker of biotin deficiency, but you might have a defect in a biotin-dependent enzyme so you can try 5 milligrams, but if you still have high beta hydroxy isovaleric you need to start looking at a metabolic disorder, providing there are symptoms. You might have a 20% decrease in that enzyme activity.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

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Chris Masterjohn, PhD, is the Founder and Scientific Director of the mitochondria test Mitome.