In January 2017, the B vitamin biotin was in the news as a possible breakthrough treatment for multiple sclerosis. This positive news was dampened a bit when the U.S. Food and Drug Administration (FDA) released a warning regarding the safety of biotin on November 28, 2017. The headlines from the warning are a bit misleading as biotin is certainly safe, even at the massive doses being used in multiple sclerosis. The safety concern is actually that high dosages of biotin can significantly interfere with certain laboratory tests. This interference can lead to dangerously incorrect conclusions. 

The FDA is warning that high doses of vitamin B7, or biotin, in dietary supplements can interfere with hundreds of common lab tests, including some that emergency room doctors rely on to diagnose a heart attack. The problem has led to at least one death. A protein called troponin, which rises after heart muscle has been damaged, is checked in the emergency room to determine whether a patient’s chest pain is from heartburn or a heart attack. The FDA says a patient who was taking high levels of biotin died when a troponin test failed to show he was having a heart attack. 

Several lab tests utilize biotin to bind to specific proteins in the blood sample that can then be measured to determine the diagnosis of cancer, heart disease, thyroid disorders, iron anemia, hormones, and even pregnancy. With high dosages, the presence of biotin in the blood can interfere with the test results causing either falsely low or high results. That can be a problem. 

Too much biotin in lab tests for thyroid hormones has led doctors to diagnose Graves’ disease in children and adults, with falsely elevated thyroid levels. Graves’ is an autoimmune disease that causes too much thyroid hormone in children and adults. 

High levels of Biotin may result in a falsely low TSH and elevated Free T3, resulting in a false diagnosis of hyperthyroidism. When they are unresponsive to antithyroid medications, patients are referred for either radioactive iodine ablation or surgery to definitively treat the “hyperthyroidism.” 

Consuming extra biotin can falsely elevate progesterone, estradiol, and testosterone levels, which can raise concern that a patient has cancer or their hormone replacement dose is wrong.

Tell your physician if you are taking biotin, especially if you are being treated for angina or thyroid disease. Even a 3 mg daily supplement may interfere with laboratory tests. If you have had a lab test done, and are concerned about the results, talk to your health care provider about the possibility of biotin interference.

Biotin is found in liver, eggs, fish, meat, nuts, seeds, and some vegetables, but in small amounts, verses all processed foods, rice, bread, pasta, and frozen food are fortified with vitamins, including biotin. You need to know how much biotin you are getting from these foods before you take extra. Read the labels!!

Bottom Line stop all biotin containing supplements & processed food 72 hrs. before Labs