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Biotin is an important cofactor in several metabolic pathways in humans. Biotin deficiencies are quite uncommon and there is limited data to support recommending it to treat hair, skin, and nail conditions. A 2017 FDA safety alert warned that biotin can interfere with laboratory testing resulting in incorrect diagnoses and even death. Therefore, our study objectives were to assess biotin recommendation practices and survey physician knowledge of biotin interference in routine laboratory tests. In a national survey of 149 physicians, we found that 43.9% of physicians prescribe biotin, primarily for hair and nail disorders, and 39.5% recommended other biotin-containing supplements. Most physicians answered correctly that there are no randomized studies that biotin improves dermatological conditions, and that biotin interferes with thyroid and troponin testing. Few knew of interference with b-HCG, Hepatitis serology, HIV serology and Vitamin D levels, and 19.5% were unaware of any interference. Almost half of physicians did not ask patients to discontinue biotin prior to laboratory testing. Our study shows that physicians continue to prescribe biotin despite knowledge gaps about laboratory interference, and highlights the need for increasing physician awareness of risks and benefits of recommending biotin to treat skin, hair, and nail conditions.

A survey-based study of physician practices regarding biotin supplementation