Biotin supplements taken at common over-the-counter doses can interfere with the results of certain hormone assays, giving falsely high or low results that could lead to a misdiagnosis, researchers reported. Biotin supplements, at very large doses, 10-15mg (333-fold greater than the dietary recommendation), have become popular for the presumptive benefits of stimulating hair growth, diabetes, lipid disorders, and diabetic peripheral neuropathy. 

High doses of biotin may interfere with lab tests because biotin is a common component of many immunoassays in the form of biotinylated antibodies or analogs. If you are taking a biotin supplement, please stop it at least 4 days before getting your blood drawn. Biotin supplements taken at common over-the-counter doses can interfere with the results of certain hormone assays, giving falsely high or low results that could lead to a misdiagnosis. Biotin supplements, at very large doses, 10-15mg (333-fold greater than the dietary recommendation), have become popular for the presumptive benefits of stimulating hair growth, diabetes, lipid disorders, and diabetic peripheral neuropathy. High doses of biotin may interfere with lab tests because biotin is a common component of many immunoassays in the form of biotinylated antibodies. 

Biotin At A Glance

  • Many patients are taking megadoses of biotin that can cause falsely high and falsely low results in a variety of laboratory tests, including thyroid tests.

 

  • Patients are taking these supplements mainly to improve their hair, skin, and nails — and might not consider them medications to report on their list.

 

  • Biotin interference with lab tests could be causing misdiagnoses — and even mistreatment — in an unknown number of patients.



Need for More Assertive Interaction with Patients


Clinicians are cautioned to act decisively given the risk of inaccurate or missed diagnosis and in light of the urgency that prompted a Food and Drug Administration (FDA) Safety Communication on this very topic.

The FDA recommends1 that clinicians take the following precautions:

  • Talk to your patients about any biotin supplements they may be taking, including supplements marketed for hair, skin, and nail growth

  • 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

  • Communicate to the lab conducting the testing if your patient is taking biotin

  • If a lab test result doesn’t match the clinical presentation of your patient, consider biotin interference as a possible source of error

  • Know that biotin is found in multivitamins, including prenatal multivitamins, biotin supplements, and dietary supplements for hair, skin, and nail growth in levels that may interfere with lab tests

  • Report to the lab test manufacturer and the FDA if you become aware of a patient experiencing an adverse event following potentially incorrect laboratory test results due to biotin interference.

The FDA reports taking the following actions—working with stakeholders to better understand biotin interference with laboratory tests in order to develop recommendations for more accurate testing in patients who have taken high levels of biotin in advance of laboratory testing.

 

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