Biotin Can Distort Thyroid Lab Testing

Discussion in 'Blood Work, Labs' started by aguilaroja, Jul 29, 2017.

  1. aguilaroja

    aguilaroja Member

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    High dose biotin supplements can falsely elevate TSH or other thyroid lab tests.

    @Koveras discussed this in March, but maybe a separate post can emphasize the concern.
    Confusing Blood Tests - High FT3 And FT4 And High TSH

    This is ONLY a caution about interpreting thyroid LAB tests with recent high biotin intake. There is no evidence, on brief literature review, that boosting biotin intake damages real-world thyroid function.

    Supplementary biotin, and potential benefits, has been mentioned by @haidut, @paymanz and others. Dr. Peat has mentioned biotin in some essays:
    Lactate vs. CO2 in wounds, sickness, and aging; the other approach to cancer
    “Vitamins D, K, B6 and biotin are also closely involved with carbon dioxide metabolism. Biotin deficiency can cause aerobic glycolysis with increased fat synthesis (Marshall, et al., 1976).”
    Biotin is being used for multiple sclerosis relief, and for other matters.

    For those, and their doctors, using thyroid lab tests for decision making, it may be better to stop added biotin in the short term before testing.


    A Single 10 mg Oral Dose of Biotin Interferes with Thyroid Function Tests. - PubMed - NCBI

    Biotin Interference in Thyroid Panel Assays With Biotinylated Components. - PubMed - NCBI


    High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference. - PubMed - NCBI

    Biotin interferes with free thyroid hormone and thyroglobulin, but not TSH measurements using Beckman-Access immunoassays. - PubMed - NCBI

    Biotin treatment causing erroneous immunoassay results: A word of caution for clinicians. - PubMed - NCBI
    https://www.jstage.jst.go.jp/article/ddt/10/6/10_2016.01074/_pdf

    HIGH-DOSE BIOTIN TREATMENT FOR SECONDARY PROGRESSIVE MULTIPLE SCLEROSIS MAY INTERFERE WITH THYROID ASSAYS

    A caution regarding high-dose biotin therapy: misdiagnosis of hyperthyroidism in euthyroid patients

    Factitious Graves' Disease Due to Biotin Immunoassay Interference-A Case and Review of the Literature. - PubMed - NCBI

    Misdiagnosis of Graves' Disease with Apparent Severe Hyperthyroidism in a Patient Taking Biotin Megadoses. - PubMed - NCBI
     

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  2. haidut

    haidut Member

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    Oh wow, thanks! I had seen some of the studies on interference but those patients were using 200mg+ to mimic the MS study. One of your links says that even 10mg can cause interference with thyroid test results!
     
  3. schultz

    schultz Member

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    Isn't 10mg still quite a large dose?

    So does the biotin just interfere with the test results or is it actually lowering TSH and raising thyroid hormones?

    The first paper seems to say that it is actually lowering TSH and raising T3...

    ----

    "The mean level of TSH was 2.84 ± 1.27 mUI/L before biotin intake and decreased to 1.66 ± 0.6 mUI/L at 3 h after biotin ingestion (p < 0.005)."

    "One important aspect that should be considered is the failure in the diagnosis of subclinical hypothyroidism in the two subjects with slight elevation of basal TSH concentrations, which dropped, to normal values after biotin ingestion."

    "Regarding FT4 measurements, the mean level of FT4 was 0.8 ± 0.1 ng/dL before biotin ingestion and increased to 1.2 ± 0.2 ng/dL at 3 h after biotin ingestion (p < 0.0001); 10 out of 19 of these subjects (52%) showed concentrations above the upper reference limit. The mean level of T3 was 116 ± 10 ng/dL before biotin ingestion and increased to 154 ± 26 ng/dL at 3 h after biotin ingestion (p < 0.0001), but all the concentrations of all samples remained within the reference range."

    ----

    It goes on to say...

    "This is the first study to demonstrate that acute ingestion of biotin (10 mg) by healthy volunteers interferes with TSH, FT4 and T3 assays, and these effects disappear within 24 h."

    So does it just interfere with the assay, or is it actually having a pro thyroid action?
     
  4. haidut

    haidut Member

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    I think it just interferes with assay as the lab tests use an kits sensitive to biotin. I think it can also interfere with all steroids like progesterone, estroge, T, DHT, DHEA, etc.
     
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