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Significant Interference of Biotin in Thyroid Function Tests Using Beckman Analyzer: How to Identify such

Melissa McBride1, Amitava Dasgupta2

  • 1Department of Clinical Laboratory Sciences, University of Kansas Medical Center, Kansas City, KS, USA.

Annals of Clinical and Laboratory Science
|March 8, 2023
PubMed
Summary

High biotin levels can interfere with thyroid function tests, particularly FT4, FT3, and total T3 assays. Non-biotin assays like TSH and total T4 are unaffected, suggesting biotin interference in specific thyroid tests.

Keywords:
BiotinInterferenceTSHThyroglobulinThyroid function test

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Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Biotin is crucial for various metabolic processes.
  • Elevated biotin levels can interfere with biotin-dependent immunoassays.
  • Thyroid function tests are commonly performed using immunoassays.

Purpose of the Study:

  • To investigate the impact of biotin interference on various thyroid function tests.
  • To differentiate between biotin-based and non-biotin-based thyroid assays.
  • To assess biotin interference both in vitro and in vivo.

Main Methods:

  • Serum pools were supplemented with varying biotin concentrations.
  • Thyroid function tests (TSH, FT4, FT3, total T4, total T3, thyroglobulin) were measured.
  • Volunteers ingested biotin supplements, with thyroid function tests performed before and after.

Main Results:

  • Biotin caused significant interference in biotin-based assays: positive for FT4, FT3, and total T3; negative for thyroglobulin.
  • Non-biotin-based assays (TSH, total T4) were not affected by biotin.
  • In vivo studies confirmed in vitro findings, showing biotin interference in individuals taking supplements.

Conclusions:

  • Elevated FT3 and FT4 with normal TSH may indicate biotin interference, necessitating further total T3 and T4 testing.
  • Discrepancies between total T3 (potentially falsely elevated) and total T4 (unaffected) can signal biotin interference.
  • Clinical laboratories should be aware of biotin interference in biotin-based thyroid function tests.