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Effect of High-dose Biotin on Thyroid Function Tests: Case Report and Literature Review
- Source :
- Cureus
- Publication Year :
- 2018
- Publisher :
- Cureus, 2018.
-
Abstract
- Biotin is a readily available supplement that is part of the B-complex vitamins. It is an essential co-factor for five carboxylases involved in fatty acid synthesis and energy production. The recommended daily intake (RDI) of biotin ranges from 30 to 70 mcg per day. At high doses (10,000 times RDI), biotin improves clinical outcomes and quality of life in patients with progressive multiple sclerosis (MS). It has been reported to cause interference in immunoassays resulting in abnormal thyroid function tests. Hereby we are describing the case of a patient having MS who was on high-dose biotin, seen in the clinic for a follow-up visit with thyroid function tests suggestive of Graves' disease with no signs and symptoms of hyperthyroidism and completely normal physical examination. In the case we have described, the laboratory measurements suggestive of thyrotoxicosis were attributed to interference of the patient's high-dose biotin treatment with the biotin-streptavidin chemistry of the immunoassays. We observed normalization of the thyroid stimulating hormone (TSH) and free T4 measurements when the patient withheld biotin for a week. As our case illustrates, early consideration of biotin interference minimizes unnecessary repeat laboratory studies. As trials in MS are progressing, we expect to see more patients on high-dose biotin treatment with spurious laboratory measurements. Therefore, we advise careful history taking and close communication with the laboratory when the clinical picture does not match with the laboratory results.
- Subjects :
- Pediatrics
medicine.medical_specialty
biotin-streptavidin immunoassay
Graves' disease
Physical examination
multiple sclerosis
Reference Daily Intake
Thyroid function tests
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Thyroid-stimulating hormone
Biotin
medicine
Internal Medicine
hyperthyroidism
Medical history
medicine.diagnostic_test
business.industry
thyroid function tests
Multiple sclerosis
General Engineering
Endocrinology/Diabetes/Metabolism
medicine.disease
graves disease
chemistry
030220 oncology & carcinogenesis
business
high dose biotin
030217 neurology & neurosurgery
Family/General Practice
Subjects
Details
- Language :
- English
- ISSN :
- 21688184
- Volume :
- 10
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Cureus
- Accession number :
- edsair.doi.dedup.....61db2da9445eab234ee6cd6a01a7e8ca