WASHINGTON – As the popularity of the beauty supplement biotin has grown, so has the incidence of this vitamin interfering with critical medical tests. A review published today in AACC’s The Journal of Applied Laboratory Medicine gives expert recommendations to healthcare providers on how to reduce biotin interference with test results to ensure that the many patients taking this supplement receive accurate diagnoses and treatment.
Approximately 20% of Americans consumed biotin-containing supplements in 1998, and market analysts estimate that figure has risen sharply since then. In the past several years, biotin has been heavily marketed for its supposed hair- and nail-enhancing effects. More significantly, biotin therapy has shown promise as a treatment for secondary progressive multiple sclerosis. However, biotin is also a key ingredient in a clinical testing method known as 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.
“Theoretically, all assays that utilize [biotin] can be affected by any amount of exogenous biotin, but distinguishing those assays that are significantly affected and recognizing potential for erroneous results is often problematic,” said Greene and Colon. “Strategies for preventing, detecting, and overcoming this interference will require participation and partnership among the assay manufacturers, laboratorians, and clinicians.”
Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.aacc.org.
Launched by AACC in 2016, The Journal of Applied Laboratory Medicine is an international, peer-reviewed publication that showcases the applied research in clinical laboratory science that is driving innovation forward in healthcare.