Use of high-dose biotin supplements ‘common’ among women in rural Michigan
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SAN DIEGO — About 20% of rural health clinic patients, primarily women, reported using biotin supplements, and about 30% of users reported excessive doses of at least 5 mg, according to survey results.
High doses of biotin, or vitamin B7, can interfere with immunoassay blood tests for hormone and troponin levels, for example, according to study background. Supplementation with most over-the-counter multivitamins, in doses of 1 mg or 2 mg, does not interfere with blood tests, but supplements marketed for health of hair, nails and skin, containing 5 mg or greater, can lead to misdiagnoses.
Mary Nguyen, MD, a family medicine resident at MSU/MyMichigan Family Medicine Residency-Alma, presented the study at the American Association of Clinical Endocrinology Annual Scientific and Clinical Conference in San Diego.
“Our idea was maybe rural people may not be aware of or in the market for cosmetic supplements, but it turns out that it is a common problem,” researcher Saleh Aldasouqi, MD, FACE, ECNU, professor of medicine and chief of the endocrinology division at Michigan State University College of Human Medicine in East Lansing, told Healio. “There is a large study from Mayo Clinic which found that about 7.5% of the population that attended the outpatient clinics at Mayo Clinic reported using biotin at a level that can interfere with labs. We wanted to test the prevalence of this in rural Michigan.”
Researchers surveyed 264 patients at a rural family medicine clinic in Alma, Michigan, (median age, 49 years; 66.3% women) between March 2021 and January 2022. Of the 249 surveys with complete data, biotin use was reported by 54 participants (20.4%; 95% CI, 15.8-25.8), the majority women (87.04%; P = .001 vs. men), and 31.5% of these reported taking more than 5 mg daily. The researchers found no association between biotin use and age.
“We expected the prevalence of biotin use to be lower due to the possibly lower resources in a rural area compared to that at a tertiary care center,” researcher Jenna Bernson, MD, a second year family medicine resident and chief resident at MSU/MyMichigan Family Medicine Residency-Alma, told Healio. “We were surprised to see that our prevalence actually mirrored that of the Mayo clinic study.”
Bernson said she does not advise against use of these supplements, she but cautions that beauty product labels may not be clear or accurate.
“Therefore, patients may not be able to report that to their physician, and physicians may be fooled by false lab results,” she said. “It is important that I am aware of all supplements my patients are taking as they may affect labs, interact with other medications, and have side effects I should be concerned about. We plan on expanding this research to show the true scope of the high-dose biotin use and related lab errors in our communities.”
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Bernson J, et al. Biotin-related lab interference: The prevalence of excessive biotin use in rural Michigan. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; May 12-14, 2022; San Diego.
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