Beware: Biotin Supplements Could Alter Your Thyroid Function Test
Biotin (vitamin B7) - an essential water-soluble micronutrient - is a member of the B-complex vitamins.1 Other names that are sometimes used for biotin are vitamin H, coenzyme R and d-biotin.2
Biotin represents a role in the production of energy and, since the body does not synthesize biotin, it is necessary to obtain it from food. It is commonly used to remedy neurological problems, hair loss (alopecia) and skin problems (such as acne and eczema) related to the lack of certain enzymes.
The level of adequate consumption established is 5 micrograms (mcg) per day for children and 30 mcg for adults, 3 and since this amount is easily obtained from food, it is believed that the deficiency is not very common.
For example, 50 grams (gr) of butter (about 3.5 tablespoons) or 50 grams of sunflower seeds contain 47 mcg and 33 mcg of biotin respectively. Even so, some people take high-dose biotin supplements to improve their hair, skin or nails, and it is important to keep in mind that this can distort the results of thyroid hormone tests.
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Common Signs and Symptoms of Biotin Lack
While it is rarer than other nutrient deficiencies, the lack or deficiency of biotin can certainly occur. Since biotin is soluble in water, the body does not store it. Therefore, its consumption must be constant.
Pregnant women are also at increased risk of lack or deficiency, which could have adverse effects on developing fetuses.
Hair loss and red and scaly rash (especially on the face) are common signs that you may need more biotin. Other signs and symptoms of biotin deficiency are:
- Depression
- Loss of appetite
- Sickness
- Muscle pain
- Paresthesia
In the body, biotin plays an important role in:
Biotin May Benefit Patients with Multiple Sclerosis
Interestingly, recent research suggests that biotin may be useful in conjunction with treatment for multiple sclerosis (MS) .7 Authority Nutrition reported: 8
"In MS, the protective coating of nerve fibers in the brain, spinal cord and eyes is damaged. This protective coating is called myelin and it is believed that biotin is an important factor in producing it. A pilot study9 conducted with 23 people with progressive MS analyzed the use of high doses of biotin.
More than 90% of the participants had some degree of clinical improvement ... [T] he randomized controlled trials were carried out with people with progressive MS.10,11,12 The final results have not been published, but the preliminary results are promising. "
As Multiple Sclerosis News Today explained: 13
"[Biotin] acts in MS by increasing a cell energy production pathway, which protects against the breakdown of the axons of nerve cells. It also activates enzymes that set the pace of myelin repair by getting involved in the production of myelin components. "
In one of these tests, about 13% of patients diagnosed with progressive MS reported improvement after taking high doses of pharmaceutical grade biotin (known as MD1003) for 9 months.
None of the patients who took a placebo reported improvement. After two years, 15.% of the group under treatment showed less disability.
According to Professor Ayman Tourbah: 14
"The full results of the MS-SPI study are especially remarkable. This is the first time that a drug reversed the progress of a disease in a statistically significant proportion of patients.
In addition, if we look at the Disability Status Expanded Scale (EDSS), the information compares very favorably with previous tests that observed the same endpoint. There was almost no progress in patients treated with MD1003 for 24 months and this had never been observed ...
The results ... show that focusing on the metabolism of neurons and oligodendrocytes represents a novel and promising strategy in disease-modifying therapy for progressive MS, particularly in patients with progressive non-active disease. "
In addition to all the benefits, biotin supplements have some disadvantages that you should really take into account. As shown, taking a biotin supplement could destabilize your thyroid function test results by producing erroneous high or low values. As reported by Endocrine News: 15
"For some time, the doctor had successfully treated his patient's hypothyroidism with levothyroxine when, suddenly, his free T4 levels peaked despite his normal level of thyroid-stimulating hormone (TSH). English).
The doctor referred the patient to Dr. Cary N. Mariash, professor of clinical medicine at Indiana University in Indianapolis, where additional laboratory tests had inconsistent results: his free T4 and total T3 were elevated, but his total T4, index of T4 and TSH were normal.
Fortunately, Mariash managed to clear up the confusion by asking the patient a simple question: 'Are you taking biotin?' Yes, she answered, she had recently started taking 10 mg a day in hopes of improving her hair and nails.
His analysis returned to normal when he stopped taking biotin. The problem had nothing to do with the patient's thyroid - biotin was interfering with the exams.
Mariash presented this case at the recent International Thyroid Congress, because lately she had found several patients whose abnormal thyroid test results were due to biotin and 'most endocrinologists do not know about this problem' ".
If the Results of the Thyroid Function Analysis do not coincide with the Clinical Observations, consider the Biotin Interference
The repercussions of this type of interference on the result could be serious. As Dr. Carol Greenlee, a Colorado-based endocrinologist, says, people could be treated for hyperthyroidism, Graves' disease, or even cancer, even though they do not really have a problem with the thyroid - they just take high doses of biotin, which unbalances the results of the analysis.
The reason for this discrepancy in the results is related to the fact that most immunoassays depend on the attraction between biotin and streptavidin and, when the blood sample contains enormous doses of biotin, it interferes with this process, and produces erroneously results high or low. According to Endocrine News:
"In the case of competitive immunoassays - generally used for substances of low molecular weight (such as T4, T3 and cortisol) - the interference of biotin causes a false high result. In immunometric analysis (sandwich), it gives a false low result.
Other characteristics of the analysis can also make a difference. For example, a longer incubation time increases the opportunity for interference. The different analyzes for different analytes, even from the same manufacturer, can, therefore, vary in the susceptibility to biotin interference ...
[The co-director of the endocrine laboratory at the Mayo Clinic, Dr. Stefan] Grebe states that the doctor requesting the analysis should have the responsibility to be on top of it:
'When the laboratory results do not make sense in relation to the clinical picture, or as regards the constellation of laboratory results that have been received, one must always think of an interference in the analysis - one of which is biotin - before to think about really exotic reasons why this result could have been obtained, like tumors in the pituitary that release the thyroid-stimulating hormone. '"
The remedy is simple. Since biotin is soluble in water, it leaves the body fairly quickly. Simply avoid taking any biotin supplement at least one or two days before your thyroid function analysis to ensure that your results are accurate. Biotin does not alter the thyroid hormone, it only affects the results, so, in general, it is not contraindicated for thyroid health.
Food Sources of Biotin
In addition, the concern that biotin alters the test results only takes into account high-dose supplements of biotin, not food, and, since biotin is easily found in many foods, these are your best option if think you need a greater amount. That said, biotin supplements are, by themselves, quite safe, even in the huge doses used in MS studies, which used more than 300 mg per day.
There are two types of biotin present in food: free biotin (found in plants) and biotin bound to protein (found in protein-based animal foods).
Your body can use any of these forms, although the free version is absorbed more easily and it is not necessary to convert it to its bioavailable form. Foods high in free biotin are: 16.17
- Sunflower seeds
- Peas and lentils
- Nuts and pecan
- Carrot, cauliflower and mushrooms
- Avocados
The biotin bound to the protein is found in:
Organic egg yolk, from free-range hens and fed with pasture
Organ meat, such as liver and kidneys
Dairy products, such as milk, butter and cheese (ideally organic raw milk from cows fed pasture)
Seafood (just make sure they are low in mercury and other contaminants and that they are wild, not farmed)
The egg yolk of free-range hens is one of the best sources of biotin, although many people warn against the egg, because the egg white contains avidin, a glycoprotein that binds to biotin. The idea is that consuming egg whites could cause biotin deficiency.
However, cooking egg white deactivates avidin, so this is not a problem. (Biotin, on the other hand, is not affected by the cooking process).
In addition, if you consume the whole egg (both yolk and white), there is more than enough biotin in the yolk to compensate for binding to avidin, which makes biotin deficiency a very unlikely result of egg consumption.
On the other hand, if you usually consume only egg whites (perhaps by eliminating the yolk for fear of cholesterol or fat), you are putting yourself at risk for biotin deficiency, unless you consume many other foods rich in biotin or take a supplement.
So, to be clear, I recommend consuming the whole egg. Not only will it give you enough biotin, but the yolk also contains fats, cholesterol and valuable proteins, which are necessary for optimal health.