Biotin-The Hair & Nail Supplement

By: Nicole Mezo, PA-C

Biotin (Vitamin B7) is a vitamin found in multivitamins, prenatal vitamins, and products promoting healthy hair, nails, and skin.  Some medical professionals even prescribe the vitamin as adjunct therapy for nerve pain and multiple sclerosis.  The recommended daily allowance for Biotin is 30 micrograms (mcg) per day.  However, some products contain much higher doses from 5,000-10,000 mcg.  What was once thought to be a fairly benign vitamin could actually interfere with some laboratory tests leading to incorrect medical diagnoses and treatment.

Biotin & Test Results

In November 2017, the Food and Drug Administration (FDA) published a safety alert to the public and health care professionals.  The alert stated that Biotin could “significantly interfere with certain lab tests and cause incorrect test results” leading to low or elevated results.  This in turn led to misdiagnoses and incorrect treatments.   Some people taking high doses of Biotin were misdiagnosed as having Grave’s disease (an autoimmune thyroid disease), and it was determined Biotin could affect tests for pregnancy, iron deficiency anemia, some cancers, and possibly “hundreds” of other tests.   Sadly, one patient taking high doses of Biotin died as a result of falsely low troponin levels due to “Biotin interference” (troponin is a heart protein that is typically elevated during a heart attack).  A study from the University of Minnesota Medical Center showed Biotin levels as low as 10mg (10,000 mcg) distorted approximately 40% of lab tests.

The mechanism for the interference occurs as blood tests (known as immunoassays), which use Biotin as part of the testing, is affected by the increased levels of Biotin in the patients’ blood.  Because some immunoassays use Biotin to adhere chemicals and other products in the blood to the collection tube to measure the levels, increased serum Biotin from supplementation can prevent binding and “the substance isn’t measured accurately.”

Hair & Nail Supplement

In regard to improving hair, nails, and skin, studies suggest that Biotin supplements are not very helpful and the evidence is “quite weak.”   Some literature even suggests that it may not be necessary to supplement with Biotin as it can be consumed in foods such as liver, egg yolks, fish, meat, seeds, nuts, and some vegetables like sweet potatoes.  As always, please check with your medical provider before starting or stopping any supplements.

Biotin Foods