Biotin. Vitamin B7. Vitamin H. This essential vitamin goes by many names and can be found in many sources. Food products such as eggs, meat, vegetables, and seeds contain biotin, and it is commonly found in prenatal and multivitamins. Biotin is also found in over-the-counter supplements marketed to improve hair, skin, and nails—often at concentrations several fold higher than the recommended daily intake. High doses of biotin also may be prescribed for therapeutic reasons.
As most clinical laboratorians now know, the high doses of biotin some patients take have the potential to interfere with laboratory testing and results. Over the last several years reports of laboratory assay interference due to biotin have been published in the peer-reviewed scientific literature and professional publications, and eventually, mainstream media.
“While the potential for biotin interference has been known for years, changes in societal preferences have moved this problem into focus,” said Patrick Kyle, PhD, who on Wednesday moderated the session, “Beautiful Skin but Erroneous Lab Results: The AACC Academy’s Guidance Document on Biotin Interference.” The session not only provided background information on biotin interference but explained the new AACC best practice recommendations for laboratories to address the potential interference.
“The exclusive use of assays that do not exhibit biotin interference has been suggested, but this is not always possible or feasible,” Kyle noted. When suspicious of interference, laboratories can take a number of steps, he said. These are focused on determining the presence of biotin and mitigating its interference. “Another option might include the analysis of a second specimen at a later time point if available. Laboratories should work to educate patients and their clinical providers on the issue of biotin interference,” Kyle emphasized.
During the session Angela Ferguson, PhD, highlighted several case reports related to biotin interference in laboratory assays, and the impact that had on patient follow-up and additional testing. Ferguson also reviewed published literature evaluating the degree of biotin interference in different assays across many manufacturers.
The AACC Academy is comprised of doctoral level professional members and provides scientific leadership for the field of laboratory medicine. The AACC Academy has recently developed a process to publish expert opinion guidance documents related to emerging areas of interest to the laboratory community. Topics and authors are selected by the AACC Academy Council, and all guidance documents undergo peer review and a public comment period prior to acceptance and publication. In addition to guidance documents, the AACC Academy also publishes scientific shorts and laboratory medicine practice guidelines.