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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Did I have the right estradiol test?
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<blockquote data-quote="Cataceous" data-source="post: 242666" data-attributes="member: 38109"><p>However, biotin can interfere with immunoassays. Therefore you should either stop taking it a few days before the test or else request an estradiol test based on liquid chromatography and mass spectrometry (LC/MS).</p><p></p><p style="margin-left: 20px"><em>Unfortunately, susceptibility to biotin interference is variable in magnitude and can skew results to be either falsely high or falsely low depending on the assay design and conditions. The ramifications for patients and caregivers are potentially grave. In typical competitive immunoassays for small molecules such as free thyroxine (fT4), free triiodothyronine (fT3), testosterone, estradiol, and cortisol, biotin interference blocks assay signal. Because signal is inversely proportional to analyte concentration in competitive assays, biotin can cause falsely high results. In the 2-site “sandwich” immunoassay format [typical for larger protein analytes such as thyroid-stimulating hormone (TSH), thyroglobulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, and for autoantibodies], excess biotin competes with the biotinylated complex causing a reduction in signal and a falsely lower result. This combination of 2 types of biotin interference can create the perfect factitious biochemical evidence of Graves thyrotoxicosis with highly increased fT4 and fT3, positive TSH receptor antibodies and suppressed TSH. Similar scenarios of biotin interference can be imagined for extremely high steroid hormone concentrations with suppressed LH or FSH, which would be suggestive of tumors.</em></p> <p style="margin-left: 20px">[<a href="https://academic.oup.com/clinchem/article/63/2/619/5612873" target="_blank">R</a>]</p> <p style="margin-left: 20px"></p> <p style="margin-left: 20px"><em>Usually interference is observed with a biotin dose of 5 mg </em>[5,000 mcg] <em>or higher depending on individual assay but a serum biotin level >500 ng/mL is known to interfere with all biotin-based assays. However, such high biotin concentration is only observed in people taking 100–300 mg biotin/per day.</em></p> <p style="margin-left: 20px">[<a href="https://www.sciencedirect.com/book/9780128164297/biotin-and-other-interferences-in-immunoassays" target="_blank">R</a>]</p></blockquote><p></p>
[QUOTE="Cataceous, post: 242666, member: 38109"] However, biotin can interfere with immunoassays. Therefore you should either stop taking it a few days before the test or else request an estradiol test based on liquid chromatography and mass spectrometry (LC/MS). [INDENT][I]Unfortunately, susceptibility to biotin interference is variable in magnitude and can skew results to be either falsely high or falsely low depending on the assay design and conditions. The ramifications for patients and caregivers are potentially grave. In typical competitive immunoassays for small molecules such as free thyroxine (fT4), free triiodothyronine (fT3), testosterone, estradiol, and cortisol, biotin interference blocks assay signal. Because signal is inversely proportional to analyte concentration in competitive assays, biotin can cause falsely high results. In the 2-site “sandwich” immunoassay format [typical for larger protein analytes such as thyroid-stimulating hormone (TSH), thyroglobulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, and for autoantibodies], excess biotin competes with the biotinylated complex causing a reduction in signal and a falsely lower result. This combination of 2 types of biotin interference can create the perfect factitious biochemical evidence of Graves thyrotoxicosis with highly increased fT4 and fT3, positive TSH receptor antibodies and suppressed TSH. Similar scenarios of biotin interference can be imagined for extremely high steroid hormone concentrations with suppressed LH or FSH, which would be suggestive of tumors.[/I][/INDENT] [INDENT][[URL='https://academic.oup.com/clinchem/article/63/2/619/5612873']R[/URL]][/INDENT] [INDENT][/INDENT] [INDENT][I]Usually interference is observed with a biotin dose of 5 mg [/I][5,000 mcg] [I]or higher depending on individual assay but a serum biotin level >500 ng/mL is known to interfere with all biotin-based assays. However, such high biotin concentration is only observed in people taking 100–300 mg biotin/per day.[/I][/INDENT] [INDENT][[URL='https://www.sciencedirect.com/book/9780128164297/biotin-and-other-interferences-in-immunoassays']R[/URL]][/INDENT] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Did I have the right estradiol test?
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