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The present article is devoted on the intake of biotin, i.e., vitamin B7 and its probable adverse impact on pathological test reports.

What is Biotin?

Biotin is actually vitamin B7 or H. It is a water-soluble B-Complex. It helps the body metabolise proteins, fats, carbohydrates and process glucose. In common practice it is also known as “beauty vitamin” as it is a safe and essential vitamin that supplements the overall health of individuals. It also plays a role in medicine and in the beauty sector. Proper intake of this vitamin improves hair, skin, and nails.

The problem

In 2015, a 55 year old man with multiple sclerosis was referred to a hospital’s thyroid unit because the screening thyroid function tests showed markedly elevated FT4 and FT3 results and low (apparently suppressed) levels of TSH. This pattern of results typically suggests a severe form of Graves’ disease. However, to justify the report, a thyroid scan with 123- Iodine test was done which showed a normal thyroid gland. The patient showed no symptoms of hyperthyroidism. The pathological results were not consistent with the patient’s clinical assessment. It emerged that the patient had taken very high doses of biotin (300 mg daily, roughly 3000 times the recommended daily intake). The discontinuation of biotin supplements resulted in the FT3, FT4, and TSH results returning to the normal range in a few days.

Initially only very high levels of biotin were considered a cause of “incorrect” laboratory results. However, further studies have demonstrated that even moderately elevated biotin concentrations, may influence pathological results.

The pathological test kits involve biotin-streptavidin capture. Your pathology tests may show variations if you are taking supplements that contain biotin, i.e., vitamin B7. The laboratory will not know if the specimens contain biotin, and physicians will prescribe medicine based on inaccurate lab results.

Some steps to help reduce lab errors caused by biotin

Biotin is the medicine of choice of some health parameters. It has no adverse effect on your health but can impact your pathological report.

The following steps should be widely circulated -

(a) Raise awareness about Biotin intake before doing pathological test to prevent incorrect diagnosis.

(b) Know your assays and the impact biotin can have on them

c) Educate your health care provider and patients.

Biotin interference test parameters

One must know that excess biotin intake may influence some pathologi- cal results. Biotin inter- ference test parameters are FT3, FT4 TSH, LH, FSH, PRO-LACTIN, HCG, CORTISOL, VITA-MIN D etc.In future, aptamers may be used as a parallel detection techno- logy. But this technology is still being researched.