Why are physicians and laboratories worried about Biotin?

Biotin can interfere with laboratory test results 

A 2016 CAP TODAY article highlighted a growing trend in biotin supplementation with increased dosages. These elevated levels of biotin are interfering with laboratory results using a biotin-streptavidin capture methodology. 

Recent published reports of patient misdiagnosis due to biotin interference include: 

  • New England Journal of Medicine: August 2016: Biotin Treatment Mimicking Graves’ Disease.
  • January 2016: Thyroid Month: Beware of Biotin, Endocrine News.

Biotin Supplement Growth

Biotin usage and dosage concentration have grown due to biotin supplements being utilized to aid healthy skin, hair and nails.1,2,3 

  • Over the past three years, biotin has seen a significant increase in retail sales.  
  • Millions of people are now taking biotin supplement.
  • Biotin doses of 10,000 mcg are the number #1 selling supplement.
Source: Nielsen FDM Data Ending 03/26/16
*Volume sold represents # of capsules sold in the market. 
  It equalizes different sizes/forms to make comparisons easier 
**Biotin Market includes any product that has Biotin as an ingredient

What should Physicians Know?

Know if your patients are taking biotin supplements:

  • Patients may be unaware of the presence of biotin in their supplements.

If your patient is taking biotin and test results could be impacted based on the method used in your laboratory:

  • Send your patient home with instructions to not take biotin within a specified time from blood draw and  reschedule the laboratory test. Contact your laboratory professional to determine the duration of time the patient needs to stop taking the biotin containing supplements before blood collection.
  • For urgent care situations, you need to understand the impact biotin has on test results if testing cannot be delayed.

Discuss biotin interference with your laboratory professional:

  • Not all laboratory tests are impacted by biotin interference. Biotin interferes with laboratory tests that use the biotin-streptavidin capture method. 
  • Your laboratory professional can help identify tests that are not impacted.
  • Request one of these tests and have confidence that your test results are accurate. 


Contact Your Laboratory Professional 

  1. Nielsen FDM Data Ending 03/26/16.
  2. https://www.amazon.com/s/ref=nb_sb_noss_1?url=search-alias%3Daps&field-keywords=biotin.
  3. Google analytics: September 2016.
  4. Zempleni J, Kuroishi T. Biotin. Adv Nutr. 2012;3:213-214. 
  5. Combs GF. Biotin. In: Combs, GF. The Vitamins: Fundamental Aspects in Nutrition and Health. San Diego, CA: Elsevier, Inc.; 2008: 331-3.
  6. Kummer, S. NEJM August 2016: Biotin Treatment Mimicking Graves’ Disease.
  7. Saint Paul LP, Debruyne D, Bernard D, Mock DM and Defer GL. Pharmacokinetics and pharmacodynamics of MD1003 (high-dose biotin) in the treatment of progressive multiple sclerosis, 2016; Expert Opinion on Drug.
  8. Fernandez-Mejia,  C. Journal of Nutritional Biochemistry 16 (2205) 424-427.
  9. Seaborg, E. January 2016: Thyroid Month: Beware of Biotin, Endocrine News, 2016. 
  10. Paxton A.  Beauty fad’s ugly downside: test interference.  CAP Today, September 20, 2016.

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