As the popularity of biotin has grown, so has the incidence of this vitamin interfering with critical medical tests, and now a review in The Journal of Applied Laboratory Medicine provides expert recommendations on how to reduce biotin interference with test results.

Biotin is also a key ingredient in the immunoassay that labs use to detect a broad range of conditions, from heart attacks and prostate cancer to thyroid disease and pregnancy. If a patient takes biotin supplements, the biotin in his or her blood sample competes with the biotin used in immunoassays and can falsely increase or decrease the results of these tests. This in turn can lead to inappropriate treatment and subsequent patient harm, and it has already caused one reported death. 

In this review, clinical laboratory experts Dina N. Greene, PhD, and Paula Jenkins Colon, MD, of the University of Washington in Seattle outline major steps clinicians and labs should take to minimize the impact of biotin interference on patient care.

Ideally, all healthcare providers should ask patients if they are taking biotin supplements and report this to the lab when ordering tests.  Patients might not be aware of the presence or dosage of biotin in multivitamins, however, so Greene and Colon also recommend that labs use streptavidin-coated microparticles to remove biotin from patient samples before immunoassay testing. 

In addition, Greene and Colon emphasize that biotin interference impacts some immunoassay technologies far more than others. Therefore, labs need to routinely conduct method validation studies to determine which of their immunoassays are affected by biotin. Greene and Colon further advise clinicians to be aware of what technology their lab uses and to incorporate this information into their test ordering practices accordingly.