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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.
Comment
LINK(S):
FDA MedWatch safety alert (Free)
Background: NEJM Journal Watch Neurology coverage of biotin for multiple sclerosis (Your NEJM Journal Watch registration required)
Background: Physician's First Watch coverage of children's supplements containing high levels of biotin and other vitamins (Free)