The clinical significance of low dose biotin supplements (<300μg/day) in treatment of patients with hypothyroidism: crucial/ overestimated?

[helvella]

Very pleased to see this bit of research. The question is simple enough. Does low dose biotin affect thyroid blood tests?

The abstract pretty much says it all!

For myself, I think I'll continue with the same attitude I've long had - stop for a couple of days before a test. If that is not possible (e.g. a surprise test), then consider the possibility of a small impact and whether even that would change interpretation.

On higher doses, clearly more care and thought is required.

The clinical significance of low dose biotin supplements (<300μg/day) in the treatment of patients with hypothyroidism: crucial or overestimated?

Nicholas Angelopoulos, Rodis D. Paparodis, Ioannis Androulakis, Panagiotis Anagnostis, Anastasios Boniakos, Leonidas Duntas, Spyridon N. Karras & Sarantis Livadas

Thyroid Research volume 16, Article number: 18 (2023)

Abstract

Background

In the last decade, the combination of the widespread use of streptavidin–biotin technology and biotin–containing supplements (BCS) in the daily clinical practice, have led to numerous reports of erroneous hormone immunoassay results. However, there are no studies assessing the clinical and biochemical significance of that phenomenon, when treating patients with hypothyroidism. Therefore, a prospective study was designed to investigate the potential alterations in the measurement of thyroid hormone concentrations and clinical consequences in patients with hypothyroidism using low -dose BCS containing less than 300 μg/day.

Methods

Fifty-seven patients on thyroxine supplementation, as a result of hypothyroidism and concurrent use of BCS at a dose <300μg/day for 10 to 60 days were prospectively evaluated. Namely, TSH and free T4 (FT4) concentration measurements were performed, during BC supplementation and 10 days post BCS discontinuation and compared to 31 age-matched patients with supplemented hypothyroidism and without BCS.

Results

A statistically significant increase in TSH and decline in FT4 concentrations was observed after BCS discontinuation. However, on clinical grounds, these modifications were minor and led to medication dose adjustment in only 2/57 patients (3.51%) in whom TSH was notably decreased after supplement discontinuation.

Conclusion

Our study suggests that changes in thyroid hormones profiling, due to supplements containing low dose biotin, are of minimal clinical relevance and in most cases don’t occult the need to adjust the thyroxine replacement dose in patients with hypothyroidism. Larger, well-designed trials are required to further evaluate this phenomenon.

Full paper open access here:

thyroidresearchjournal.biom...

[HealthStarDust]

I remember this is exactly what brought me to this website in the first place with my first question in relation to the biotin in prenatal supplements.

Like you, I think I’d rather err on the the side of caution until more research is done on thia area.

[ERIC107]

Thank you helvella ! I really appreciate you posting scientific papers like this.

[Everywhere]

My body is a strange thing. It seems to defy all the rules.

Biotin doesn’t seem to affect my blood tests; neither do PPIs. Tests stubbornly remain the same provided that testing/time protocols have been followed.

It does make me wonder if these substances ever get absorbed in my case.

[helvella Administrator Thyroid UK in reply to Everywhere]

It is important to realise that biotin only interferes with some TSH and FT4 tests - some are not, and never have been, affected.

(Biotin can interfere with a range of other tests including FT3. It's just not sensible for us to imply we know about all tests.)