How Biotin In Supplements Can Alter Lab Results And Lead To Misdiagnoses

Otherwise referred to as vitamin B7 or vitamin H, biotin is an essential micronutrient that aids the body in hormone production and the conversion of food sources into energy (via Testing.com). While the average daily recommended intake for biotin is no more than 30 micrograms (mcg), some supplements contain levels of biotin that far exceed this recommendation. Purported to boost hair and nail growth, the U.S. Food and Drug Administration (FDA) notes that some biotin supplements, including multivitamins, contain upwards of 20 to 100 milligrams (mg) per dose — the equivalent of 20,000 to 100,000 micrograms (per Testing.com). In 2017, the FDA released a public safety warning stating how high levels of biotin supplementation could alter the results of certain blood tests, leading to potential misdiagnosis of patients and subsequent adverse outcomes.

According to Testing.com, high levels of biotin in the blood may interfere with certain lab exams, producing an inaccurately high or low test result. For example, the Therapeutic Research Center notes that, depending on the dosage, biotin can produce inaccurately low test results for levels of insulin, growth hormone, thyroid-stimulating hormone, follicle-stimulating hormone, and more. Conversely, excess biotin can also falsely increase levels of folate, testosterone, vitamin B12, and vitamin D in laboratory test results.

The FDA has voiced concerns about biotin's potential to produce an inaccurately low test result for levels of troponin in the body — used to help diagnose a heart attack. This was the case in one report received by the agency in which a patient experienced a heart attack, and died following a falsely low troponin test result. Among older adults, biotin supplementation is becoming increasingly more common, reports HealthDay News. This may put the age group at risk, as those over the age of 60 are more susceptible to cardiac events.

"This is a message that needs to get out," Dr. Lynn Burmeister, endocrinologist and associate professor of medicine at the University of Minnesota, told WebMD. However, the FDA notes that the recommended daily intake of 30 micrograms of biotin is not considered high enough to manipulate test results. Even so, the agency encourages patients to speak with their physician if they are currently taking biotin supplements. In some cases, your doctor may suggest stopping biotin usage for a few days prior to testing, reports the Therapeutic Research Center. For healthcare providers, the FDA advises that physicians inquire as to whether or not their patients are taking biotin supplements. Additionally, healthcare providers should compare test results to the clinical presentation of their patients. If they do not appear to be in alignment, the biotin supplementation may be influencing test results.