Morning Report

Patient Taking Biotin? Be Sure to Ask if Ordering Tests

Arefa Cassoobhoy, MD, MPH


January 04, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

In a recent safety report, the US Food and Drug Administration (FDA) warned that vitamin B7, also known as biotin, can interfere with common lab tests. This warning comes following an increase in reported adverse events.

In one case, a patient taking high levels of biotin died after a falsely low troponin level missed a heart attack. Biotin technology is used in many lab tests because biotin can bond with specific proteins used to measure various health conditions. This includes cardiac markers and hormone tests like thyroid levels.

The FDA recommends that clinicians ask patients what supplements they're taking. Biotin is found in multivitamins, including prenatal vitamins. And be aware that supplements marketed for hair, skin, or nail growth can contain high levels of biotin—up to 650 times the recommended daily intake.

If your patient is taking biotin, notify the lab when ordering tests. And if a lab result doesn't match the patient's clinical presentation, consider the possibility of biotin interference.

Follow Dr Cassoobhoy on Twitter at @ArefaMD


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