Taking Biotin supplement? A very important warning...

Biotin Supplements Can Interfere With Cardiac Troponin Tests:

One person died after excessive levels of biotin, also known as vitamin B7, skewed their troponin test results, according to the FDA.

The US Food and Drug Administration (FDA) is warning physicians and other healthcare professionals that megadoses of supplementary biotin can result in skewed laboratory test results, including incorrect cardiac troponin measurements.

https://www.tctmd.com/news/biotin-supplements-can-interfere-cardiac-troponin-tests-fda

http://www.pharmacytimes.com/news/fda-warns-about-potential-vitamin-interference-with-lab-tests

 

This is a useful link on which tests have been shown to be unreliable if the patient takes biotin and the testing equipment uses biotin in the assay process :

http://www.ddtjournal.com/action/downloaddoc.php?docid=1212

I imagine the list may be rather longer now.

 

There is an article in Physician's Health Watch about it now:

Biotin (Vitamin B7) Supplementation Could Affect Lab Results
By Kelly Young
Edited by
- David G. Fairchild, MD, MPH, and
- Lorenzo Di Francesco, MD, FACP, FHM

The FDA is reporting an increase in adverse events and one death tied to inaccurate lab results due to interference of the supplement biotin (vitamin B7).

In addition to its role as a dietary supplement, biotin is used in lab tests because it binds to certain proteins. Accordingly, ingestion of high levels of biotin can lead to falsely high or low lab test results. The reported fatality occurred in a patient taking high levels of biotin who had a falsely low troponin test.

Clinicians may be recommending high-dose biotin for patients with multiple sclerosis. Biotin is also found in multivitamins and prenatal vitamins. In addition, dietary supplements touting biotin's benefits for hair, skin, and nail growth may contain up to 650 times the recommended daily intake (0.03 mg).

Clinicians should ask whether patients are taking biotin supplements, and this information should be conveyed to the laboratory. If test results do not match a patient's clinical presentation, providers should consider whether biotin may be interfering.

Link(s):
FDA MedWatch safety alert (Free) http://response.jwatch.org/t?ctl=25E8E:5FF9B588B7CB016C79269638EFA1DB69&
Background: NEJM Journal Watch Neurology coverage of biotin for multiple sclerosis (Your NEJM Journal Watch registration required) http://response.jwatch.org/t?ctl=25E8F:5FF9B588B7CB016C79269638EFA1DB69&
Background: Physician's First Watch coverage of children's supplements containing high levels of biotin and other vitamins (Free) http://response.jwatch.org/t?ctl=25E90:5FF9B588B7CB016C79269638EFA1DB69&

 

What I don't understand with regard to the death case - apart from the lab result, weren't there some symptoms?

 

I was reading between the lines on the death case too - the amount of info was a bit limited. I just assumed the person was suffering from symptoms of a heart attack, ended up in hospital, had a troponin test which came back negative and so the full list of heart attack checks wasn't carried out and he either died in hospital or was discharged early and died later from the untreated heart attack.

But then it makes you wonder if doctors think the troponin test is infallible and ignore the patient's symptoms if they don't match the test result. I'm sure doctors would believe blood tests over a patient any day of the week, to be honest, even in cases where symptoms were very serious.

 

That was what I was thinking. Heart stroke symptoms are clear, most often, especially in men. Maybe they thought he had a psychological issue after the normal troponin test.

In case of TSH, ft3 anf ft4 results it might be much more difficult with clinical symptoms, but in the article above the values were very high, suggesting strong hyperthyroidsm which should show clinical symptoms. Somehow strange...at least here more tests were performed.

Very interesting, that topic!

 

Whether or not biotin interferes with pathology tests entirely depends upon the use of the biotin-streptavidin capture system in immunoassays.

Immunoassays don't necessarily use this system.

You can only know if biotin is likely to be a problem by asking the path lab specifically which if any of their assays use biotin-streptavidin.

 

https://medicalxpress.com/news/2020-08-high-doses-popular-biotin-supplement.html