One of my most popular blogs are my Hashimoto’s Hypothyroidism entries. Today I wanted to address an over the counter supplement that is widely used and loved in the nail community, Biotin. Particularly the 10,000 mcg dose. I have suffered from Hashimoto’s for about 6 yrs now and continue to learn new things about this chronic disease and how to manage it.

In the past I had not disclosed that I used the supplement, but in this visit my symptoms had spiraled and I blurted out that my nails kept breaking and my hair kept falling out even while on this high dose of Biotin, on my last visit to my Endocrinologist.

My Doctor promptly stopped me and said “We can’t do you your blood work today”, I said why? The explanation was brief, but essentially Biotin skews your result levels and so you must be off biotin for a week prior to blood work being done. So I followed instructions and spent a week off Biotin and then got my blood work. The absence of the biotin was felt by me in the sense of lack of energy, patchy skin and brittle nails.

In the meantime I set off on doing some research on this new information and I found out some interesting things, first if you are being treated for Graves’ (Hyperthryroid), Biotin has lead to many misdiagnosis. The journal I read showed someone who was diagnosed with Graves and their test results were completely off the charts while on Biotin, but with just 7 days of Biotin withdrawl their results came within normal ranges. (as seen in the table below)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103391/

Now for someone who has Hashimoto’s dealing with the other side of the spectrum, you may be feeling like utter crap, but your tests look mostly with in range and the result is an Endocrinologist side eyeing you! In order to demonstrate, I have my own results below.

Lab TestOn BiotinOff Biotin
1/31/183/12/19
TSH Thyroid Stim. Hormone 
Standard Range 0.50 – 4.50 u[IU]/mL
6.595.71
Free T4 (Thyroxine, Free)
Standard Range 0.8 – 1.8 ng/dL
1.41.4
T3 (Triiodothyronine)
Standard Range 0.80 – 2.00 ng/mL
0.930.85

Now in my results my TSH and T4 were the most affected, but this result justified a pretty big increase on my dose and honestly, I don’t think I’m done.

Now for the Science:
In the case of the patient with the Graves diagnosis, the complete revival of normal thyroid function tests just one week after the interruption of a megadose of biotin treatment suggests the cause is a biochemical abnormality produced by Streptavidin. Steptavidin – Biotin is a protein produced by Streptomyces avidinii, that binds biotin creating a continual dissociation. Excess biotin in the blood will result in a reduced binding of the immune complexes with the solid phase, and hence a falsely low TSH level.

So the conclusion is, make sure to talk to your endocrinologist about your Biotin intake and make sure to stop biotin intake 7 days prior to your blood work in order to get your correct dosage and or diagnosis. Biotin is beneficial for many things beyond just Hair and Nails, I know that personally I would not have long nails and keep growing hair with out the high dose. Biotin is a B7 vitamin and helps reduce your blood sugar, aids your metabolism, ensures proper cardiac muscle health and even aid in your Hypotyroid symptoms.

The more you know…

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Thanks for reading!

Sources for data research:

1. www.empoweryourhealth.org. http://www.empoweryourhealth.org http://www.empoweryourhealth.org. https://www.empoweryourhealth.org/magazine/vol9_issue1/thyroid_patients_be_aware_of_biotin
2. High doses of biotin in chronic progressive multiple sclerosis: a pilot study. Sedel F, Papeix C, Belanger A, et al.  Mult Scler Relat Disord . 2015;4:159–169. [PubMed] [Google Scholar]
3. High dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference. Piketty M, Prie D, Sedel Sedel, F F, et al.  Clin Chem Lab Med. 2017;55:817–825. [PubMed] [Google Scholar]
4. The biotin-(strept)avidin system: principles and applications in biotechnology. Diamandis EP, Christopoulos TK. http://clinchem.aaccjnls.org/content/37/5/625. Clinical Chemistry. 1991;37:625–636.[PubMed] [Google Scholar]
5. Minkovsky A, Lee MN, Dowlatshahg M, et al.  AACE Clin Case Rep. Vol. 2. Germany: Roche Cobas; 2016. High-dose biotin treatment for secondary progressive multiple sclerosis may interfere with thyroid assays; p. 0. [PMC free article] [PubMed] [Google Scholar]
6. Biotin interference on TSH and free thyroid hormone measurement. Kwok JS, Chan IH, Chan MH. Pathology. 2012;44:278–280. [PubMed] [Google Scholar]
7. Positive and negative interference in immunoassays following biotin ingestion: a pharmacokinetic study. Wijeratne NG, Doery JC, Lu ZX. Pathology. 2012;44:674–675. [PubMed] [Google Scholar]
8. Biotin interference on immunoassay methods: sporadic cases or hidden epidemic? Clerico A, Plebani M. Clin Chem Lab Med. 2017;55:777–779. [PubMed] [Google Scholar]
9. Biochemical hyperthyroidism in a newborn baby caused by assay interaction from biotin intake. Pedersen I, Laurberg P. Eur Thyroid J. 2016;5:212–215. [PMC free article] [PubMed] [Google Scholar]


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