Biotin Interferes with Lab Assays

[Dr Justin Saya MD]

Not sure if this has been covered already, but if folks ever encounter lab results that just don't make sense...biotin supplementation may be the culprit (see pages 4-7 for list of assays that may be impacted):

http://www.pages03.net/assetdownloa...ID=1182658835&spReportId=MTE4MjY1ODgzNQS2&b=0

 

[FeelingLost]

For a more accurate blood test would it be best to stop taking all OTC supplements 3-4 days before a blood draw?

 

[ratbag]

Thanks for that Dr. Saya. After my phone appointment with you I rec'd my Spectracell Micronutrient Labs and they stated I was deficient in Biotin and suggested that I take 1000mcg daily for 6 months in order to replenish my biotin. I'm glad you posted this as it appears all I have to do is stop taking it 72 hrs before labs. I hope this is enough time.

 

[Dr Justin Saya MD]

Ratbag - 72hrs is indeed the recommended interval.

 

[Dr Justin Saya MD]

For a more accurate blood test would it be best to stop taking all OTC supplements 3-4 days before a blood draw?

That's tough to answer. The answer in the case of something that would interfere with a lab assay (such as biotin) is clearly yes. The answer would also clearly be yes for any supplement that has shown a propensity to increase liver enzymes. However, it is probably not *necessary* to stop all OTC supplements 3-4 days prior to every lab draw, although another complication in the assessment is that there may be additional lab interfering compounds yet to be discovered.

 

[Dr Justin Saya MD]

It's also important to note that biotin can be included in many (?most) oral skin/hair/nail supplements and is even included in some of the more comprehensive daily multivitamins.

 

[MarkLA]

That's tough to answer. The answer in the case of something that would interfere with a lab assay (such as biotin) is clearly yes. The answer would also clearly be yes for any supplement that has shown a propensity to increase liver enzymes. However, it is probably not *necessary* to stop all OTC supplements 3-4 days prior to every lab draw, although another complication in the assessment is that there may be additional lab interfering compounds yet to be discovered.

Dr. Saya, if you had a list of supplements that you see elevating liver enzymes, it would be a useful thing to post.

Thanks you,
Mark

 

[Dr Justin Saya MD]

Dr. Saya, if you had a list of supplements that you see elevating liver enzymes, it would be a useful thing to post.

Thanks you,
Mark

Fortunately, or perhaps unfortunately depending on how you look at it, everyone's liver responds uniquely to anything taken orally and metabolized through the liver via first pass effect. Now there are some absolutes, such as C17 alpha-alkylated AAS, that will almost always cause liver enzyme elevation, but as far as supplements go there is not such a degree of predictability. I've seen different patient's livers respond like night and day to the exact same supplements...many times. In my opinion, for the most part the biggest risk is not with the actual type of supplement, per se, but rather the risk of contamination with unwanted/unknown (and perhaps liver toxic) substances. For this reason choosing a quality manufacturer (Life Extension Foundation, Jarrow, Pure Encapsulations...to name a few) is of the most importance, though the risk will always remain to some degree.

 

[Tommy Wall]

I have some multivitamines and they all have Biotin. Thx for your post! I´m sure people can live without it for 72h prior to labs.

 

[Dr Justin Saya MD]

I have some multivitamines and they all have Biotin. Thx for your post! I´m sure people can live without it for 72h prior to labs.

You're very welcome.

Everyone let your wives/significant others know as well. Very common for females to take supplements containing biotin (sometimes very high dosages as well).

 

[Dr. John Crisler]

GREAT post.

At first, I was wondering if this is true only for the (invalid for hormones) old immunoassay laboratory methodology. But then I remember the lab director of a urinalysis company telling me to hold B vitamins the day before collection, and he uses GC/MS.