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General Health & Fitness
Nutrition and Supplements
Biotin interference with lab tests
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<blockquote data-quote="madman" data-source="post: 163032" data-attributes="member: 13851"><p><strong>Biotin interference </strong></p><p><span style="color: rgb(184, 49, 47)">Underrecognized patient safety risk in laboratory testing </span></p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)"><em>In Western populations, dietary biotin intake is estimated to be </em></span><em><span style="color: rgb(44, 130, 201)">35 to 70 µg daily,</span><span style="color: rgb(184, 49, 47)"> a level in line with the recommended dietary allowance.</span></em></strong><em> Most multivitamin pills contain about 30 µg of biotin. High-dose supplementation (doses greater than 1 mg/d) plays a role in therapy for several diseases, including biotinidase deficiency, mitochondrial metabolic disorders, and multiple sclerosis. <span style="color: rgb(184, 49, 47)"><strong>Doses up to </strong></span><span style="color: rgb(44, 130, 201)"><strong>10 mg a day </strong></span><span style="color: rgb(184, 49, 47)"><strong>are frequently encountered in nutritional supplements taken to improve hair, skin, and nail health. The problem is that many common blood tests employ a biotin-streptavidin reaction as part of the test procedure. While the amount of usual dietary biotin intake is not expected to be high enough to affect these tests,</strong></span></em><span style="color: rgb(44, 130, 201)"><strong><em> biotin supplementation at doses greater than 1 mg per day can cause either falsely low or falsely high test results, depending on the analyte and platform used for testing.</em></strong></span></p><p></p><p></p><p><span style="color: rgb(184, 49, 47)"><strong><em>A literature search revealed an increasing number of published cases, most describing the problem of biotin interference in thyroid function tests. High-dose biotin can produce a dangerous combination of positive and negative interference among the thyroid tests </em></strong></span><em><span style="color: rgb(44, 130, 201)"><strong>(free thyroxine, free triiodothyronine, thyroid-stimulating hormone, and thyroid-stimulating hormone receptor antibodies)</strong></span><span style="color: rgb(184, 49, 47)"><strong> and paint a picture of Graves disease in patients who have either no clinical symptoms or unrelated symptoms. </strong></span>Without good clinical observations, this could lead to unnecessary procedures and treatments. Interference of high-dose biotin with thyroid tests is particularly troubling for patients with multiple sclerosis, as large doses of this vitamin are emerging as a new treatment. </em><strong><span style="color: rgb(44, 130, 201)"><em>Interference with parathyroid hormone, follicle-stimulating hormone, luteinizing hormone, sex-hormone binding globulin, estradiol, progesterone, testosterone, cortisol, folate, vitamin B12, and ferritin testing has also been reported. </em></span></strong></p><p></p><p></p><p><span style="color: rgb(184, 49, 47)"><strong><em>The interference of high-dose biotin on immunoassays in the clinical laboratory is an emerging issue.</em></strong> </span><em>Many questions have not been addressed. What is the prevalence of high-dose biotin in a given patient population? What are the pharmacokinetics of high-dose biotin? How effective is the use of streptavidin-agarose beads to remove biotin interference? </em><strong><em><span style="color: rgb(184, 49, 47)">For many laboratories, the current solution is basic: It is recommended that patients abstain from taking biotin for </span><span style="color: rgb(44, 130, 201)">at least 48 hours</span><span style="color: rgb(184, 49, 47)"> before specimen collection. </span></em><span style="color: rgb(44, 130, 201)"><em>The most effective approach, however, is an extensive communication campaign to educate physicians and patients </em></span></strong></p></blockquote><p></p>
[QUOTE="madman, post: 163032, member: 13851"] [B]Biotin interference [/B] [COLOR=rgb(184, 49, 47)]Underrecognized patient safety risk in laboratory testing [/COLOR] [B][COLOR=rgb(184, 49, 47)][I]In Western populations, dietary biotin intake is estimated to be [/I][/COLOR][I][COLOR=rgb(44, 130, 201)]35 to 70 µg daily,[/COLOR][COLOR=rgb(184, 49, 47)] a level in line with the recommended dietary allowance.[/COLOR][/I][/B][I] Most multivitamin pills contain about 30 µg of biotin. High-dose supplementation (doses greater than 1 mg/d) plays a role in therapy for several diseases, including biotinidase deficiency, mitochondrial metabolic disorders, and multiple sclerosis. [COLOR=rgb(184, 49, 47)][B]Doses up to [/B][/COLOR][COLOR=rgb(44, 130, 201)][B]10 mg a day [/B][/COLOR][COLOR=rgb(184, 49, 47)][B]are frequently encountered in nutritional supplements taken to improve hair, skin, and nail health. The problem is that many common blood tests employ a biotin-streptavidin reaction as part of the test procedure. While the amount of usual dietary biotin intake is not expected to be high enough to affect these tests,[/B][/COLOR][/I][COLOR=rgb(44, 130, 201)][B][I] biotin supplementation at doses greater than 1 mg per day can cause either falsely low or falsely high test results, depending on the analyte and platform used for testing.[/I][/B][/COLOR] [COLOR=rgb(184, 49, 47)][B][I]A literature search revealed an increasing number of published cases, most describing the problem of biotin interference in thyroid function tests. High-dose biotin can produce a dangerous combination of positive and negative interference among the thyroid tests [/I][/B][/COLOR][I][COLOR=rgb(44, 130, 201)][B](free thyroxine, free triiodothyronine, thyroid-stimulating hormone, and thyroid-stimulating hormone receptor antibodies)[/B][/COLOR][COLOR=rgb(184, 49, 47)][B] and paint a picture of Graves disease in patients who have either no clinical symptoms or unrelated symptoms. [/B][/COLOR]Without good clinical observations, this could lead to unnecessary procedures and treatments. Interference of high-dose biotin with thyroid tests is particularly troubling for patients with multiple sclerosis, as large doses of this vitamin are emerging as a new treatment. [/I][B][COLOR=rgb(44, 130, 201)][I]Interference with parathyroid hormone, follicle-stimulating hormone, luteinizing hormone, sex-hormone binding globulin, estradiol, progesterone, testosterone, cortisol, folate, vitamin B12, and ferritin testing has also been reported. [/I][/COLOR][/B] [COLOR=rgb(184, 49, 47)][B][I]The interference of high-dose biotin on immunoassays in the clinical laboratory is an emerging issue.[/I][/B][I] [/I][/COLOR][I]Many questions have not been addressed. What is the prevalence of high-dose biotin in a given patient population? What are the pharmacokinetics of high-dose biotin? How effective is the use of streptavidin-agarose beads to remove biotin interference? [/I][B][I][COLOR=rgb(184, 49, 47)]For many laboratories, the current solution is basic: It is recommended that patients abstain from taking biotin for [/COLOR][COLOR=rgb(44, 130, 201)]at least 48 hours[/COLOR][COLOR=rgb(184, 49, 47)] before specimen collection. [/COLOR][/I][COLOR=rgb(44, 130, 201)][I]The most effective approach, however, is an extensive communication campaign to educate physicians and patients [/I][/COLOR][/B] [/QUOTE]
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Biotin interference with lab tests
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