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Findings on Biotin Use in Outpatient setting and Biotin Concentrations in Emergency Room Patients

Laboratorians from the Mayo Clinic in Rochester recently investigated the prevalence of self-reported biotin supplement use in the outpatient setting, and biotin concentrations in patients presenting to the emergency department. Results of their investigation indicate:

  • Self-reported biotin use is common (7.7%) 
  • Almost one third did not know their dose
  • 7.4% of plasma samples tested in the ED had biotin concentrations at or above 10 ng/ml
  • Nearly 50% of samples had a detectable concentration of biotin (≥ 5 ng/mL)
  • Measured concentrations ranged widely

Key takeaways:

  • Biotin use is common
  • Patients may often be unaware they are taking biotin-containing supplements
  • ED patients are a population at risk for potential harm due to biotin interference, particularly in critical assays such as troponin

Source: Katzman et al. Prevalence of biotin supplement usage in outpatients and plasma biotin concentrations in patients presenting to the emergency department. Clinical Biochemistry. 2018 https://www.sciencedirect.com/science/article/pii/S0009912018303151?via%3Dihub

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What are some common tests affected by biotin interference?

Biotin can affect a wide variety of laboratory tests. Examples include tests for:

  • Troponin
  • Thyroid hormone tests, such as thyroid stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3) tests
  • Other hormones, such as parathyroid hormone (PTH), cortisol, follicle -stimulating hormone (FSH) and luteinizing hormone (LH)
  • Vitamin D levels

Some laboratory platforms use methods that do not experience interference from biotin, even for the examples listed above. Tests that employ methods free from biotin interference can sometimes be used for re-testing samples from patients in whom biotin interference is suspected, similar to what is seen in the video, Biotin: Friend and Foe, found below in the Related Video section. Abbott Laboratories is one example of a diagnostic company that manufactures immunoassays that are not susceptible to biotin interference. Alternatively, re-testing may be done at a later time, after the patient has refrained from taking biotin.

How can a Health Care Practitioner prepare a patient for tests?

The FDA advises healthcare  practitioners to ask their patients if they are taking any biotin supplements and inform the testing laboratory if interference from biotin is a possibility. They should also consider biotin interference as a potential reason for lab results not matching with a patient's signs and symptoms and/or suspected health condition.

Get more answers to common biotin interference related questions

Educate Your Patients on Biotin Test Interference

In late November 2017, the Food and Drug Administration (FDA) published a safety alert to make the public and healthcare practitioners more aware that biotin can "significantly interfere with certain lab tests and cause incorrect test results…" According to the safety alert, there has been "an increase in the number of reported adverse events, including one death, related to biotin interference with lab tests." The one death occurred when a patient taking high doses of biotin had falsely low troponin results from a troponin test known to have interference from biotin.

Related Articles 

From AACC: Preventing a Widespread Beauty Fad From Interfering With Medical Tests 

Related Educational Offerings 

Biotin and Laboratory Testing: Recognizing Interferences and Preventing Misdiagnosis (FREE) 

On this Site

Tests: B Vitamins | Feature Articles:  Test Preparation: Your Role | In the News: FDA Warns that Biotin May Affect Some Lab Test Results


 

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