Biotin (Vitamin B7) safety communication by the FDA – follow up
This communication represents a follow-up from our Scientific Update #277, published on 13-Dec-2017, in which ICON Laboratory Services (ILS) highlighted to our sponsors a safety communication released by the FDA on 28-Nov-17. As per the FDA notification: “The FDA is alerting the public, health care providers, lab personnel, and lab test developers that biotin can significantly interfere with certain lab tests and cause incorrect test results which may go undetected. Biotin levels higher than the recommended daily allowance may cause interference with lab tests.”1
Please be assured that ILS is addressing the FDA notification in a manner that is consistent with our commitment to results quality. At this time, ILS encourages healthcare providers to interpret associated clinical results for patients that are taking high levels of biotin with caution.
The ICON Laboratory Operations, Scientific and Medical groups are in receipt of further information from our vendors. The table below shows the current list of assays confirmed to contain biotin by the manufacturers.
As you would expect, the extent of biotin interference varies per assay and per subject depending on dosage level and frequency of ingestion. Ultimately the most appropriate action is to have subjects, whose specimens will be tested via at risk assays, abstain from ingesting biotin until it has had a chance to wash out of the system. The following publication suggests a wash out period of 8-73 hours depending on assay and dosage https://www.future-science.com/doi/pdf/10.4155/ipk-2017-00132.
The extent of biotin interference varies per testing platform. ILS is committed to address this potential interference, where possible, via use of alternate assays which have proven no interference.
Please contact your Project Manager to address further questions that you may have.
Immunoassay Tests with Potential Interference by Biotin Supplementation
Note: This list depends on assay method/platform. Assays marked with * exhibit ≤10% interference at a Biotin concentration of 1500 ng/mL. Tests codes marked with ** have already been replaced with an alternate solution that is not subject to interference from biotin, most of these have been utilised as standard by ICON since approximately 2015.
Assay |
ILS Test Code |
Assay |
ILS Test Code |
Adrenocorticotropic hormone (ACTH)* |
ACTH |
Human Chorionic Gonadotropin (beta-hCG)* |
HCGQN** |
---|---|---|---|
Alpha-Fetoprotein* |
AFP** |
IFN-Gamma |
IFNGAMMAMP |
CA19-9 |
CA199 |
Insulin* |
INS** |
Calcitonin* |
CALCITONIN |
Interleukin-1 Beta |
IL1BETAMP |
Cortisol* |
CORTAM, CORTPM** |
Interleukin-10 |
IL10MP |
Cotinine, Serum |
SCOT |
Interleukin-13 |
IL13MP |
Cotinine, Ur., Quant. |
UCOTQNT |
Interleukin-2 |
IL2MP |
EBV VCA IgG |
EBVIGG |
Interleukin-5 |
IL5MP |
EBV VCA IgM |
EBVIGM |
Interleukin-6 |
IL6MP |
Estradiol* |
E2** |
Interleukin-8 |
IL8MP |
Ferritin* |
FERR** |
Luteinizing Hormone (LH)* |
LH** |
Folate |
FOLATE** |
Macrophage Inflammatory Protein - 1 beta |
MIP1BETAMP |
Follicle-stimulating hormone (FSH)* |
FSH** |
N Terminal ProBNP (NT proBNP) |
PROBNP |
Free T3* |
FT3** |
Amino-terminal propeptide of type III procollagen (PIIINP) for ELF score |
PIIINPELF |
Free T4* |
FT4** |
Prolactin* |
PROL** |
GM-CSF |
GMCSFMP |
Thyroid Stimulating Hormone (TSH)* |
TSH** |
Hepatitis A antibody Total (HAVT) |
HAVT** |
Thyroxine (T4)* |
THYROXT4** |
Hepatitis A IgM Antibody (HAV IgM) |
HAVIGM** |
TNF- alpha |
TNFALPHAMP |
Hepatitis B Core IgM Antibody (HBc IgM Ab) |
HBCOREABM** |
Total T3* |
T3** |
Hepatitis Be Antibody |
HEPBEAB |
Troponin I |
TROPIECLIA |
Hepatitis Be Antigen |
HEPBEAB |
Troponin T |
TROPT |
Hepcidin | HEPCIDIN | Vitamin B12 | B12** |
Homocysteine* |
HOMOCYS** |
|
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Scientific Update Revision History
Version # | Publication Date | Comments |
1 | 04-May-2018 | Original Document |
---|---|---|
2 | 05-Jun-2018 | Reference 4 added |
3 | 08-Oct-2018 | Updates made |