PMID 28879195 A Review of the Use of Biotin for Hair Loss Systematic review · Skin Appendage Disord, 2017 All 18 cases had an underlying condition where biotin helped - evidence for supplementation in healthy people is lacking.
Key summary
A systematic review of biotin's efficacy for hair and nail growth using PubMed case reports and randomized trials. It found 18 cases of improvement with biotin, and in every one there was an underlying pathology (such as a deficiency) behind the poor hair or nail growth. The authors concluded that while supplementation may help in inherited or acquired biotin deficiency and pathologies such as brittle nail syndrome or uncombable hair, these are uncommon and there is not enough evidence to support supplementation in healthy individuals. It directly targets the belief in cosmetic biotin use for people who are not deficient.
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BACKGROUND: Biotin has gained commercial popularity for its claimed benefits on healthy hair and nail growth. Despite its reputation, there is limited research to support the utility of biotin in healthy individuals. OBJECTIVE: To systematically review the literature on biotin efficacy in hair and nail growth. METHODS: We conducted a PubMed search of all case reports and randomized clinical trials (RCTs) using the following terms: (biotin and hair); (biotin and supplementation and hair); (biotin supplementation); (biotin and alopecia); (biotin and nails); (biotin and dermatology), and (biotin recommendations). RESULTS: We found 18 reported cases of biotin use for hair and nail changes. In all cases, patients receiving biotin supplementation had an underlying pathology for poor hair or nail growth. All cases showed evidence of clinical improvement after receiving biotin. CONCLUSIONS: Though its use as a hair and nail growth supplement is prevalent, research demonstrating the efficacy of biotin is limited. In cases of acquired and inherited causes of biotin deficiency as well as pathologies, such as brittle nail syndrome or uncombable hair, biotin supplementation may be of benefit. However, we propose these cases are uncommon and that there is lack of sufficient evidence for supplementation in healthy individuals. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 31613531 Biotin Deficiency Review · StatPearls, 2025 Biotin is an essential carboxylase cofactor - deficiency is rare and limited to specific at-risk groups. High doses can distort thyroid and troponin tests and cause misdiagnosis.
Key summary
A review of biotin (vitamin B7) physiology, deficiency, and clinical implications. Biotin is an essential cofactor for several carboxylase enzymes in fatty-acid, amino-acid, and glucose metabolism. Thanks to dietary sources (eggs, nuts, legumes) and synthesis by gut bacteria, deficiency is rare in the general population and arises only in specific at-risk groups such as long-term antibiotic or anticonvulsant users and those on parenteral nutrition without biotin. Deficiency starts gradually with nonspecific symptoms like fatigue, hair thinning, and eczematous rash and can progress to neurological signs if untreated. The review notes that although biotin is widely marketed for hair, skin, and nails, evidence in people without a documented deficiency is limited, and warns that high-dose supplementation can interfere with thyroid hormone and cardiac biomarker (troponin) immunoassays, causing false-positive or false-negative results and inappropriate decisions.
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Biotin (vitamin B7) is a water-soluble B-complex vitamin that plays a vital role in cellular metabolism. This vitamin is an essential cofactor for several carboxylase enzymes involved in the metabolism of fatty acids, amino acids, and glucose. These include acetyl-coenzyme A (CoA) carboxylase, propionyl-CoA carboxylase, β-methylcrotonyl-CoA carboxylase, and pyruvate carboxylase, each of which catalyzes reactions necessary for maintaining metabolic homeostasis. Biotin deficiency is rare in the general population due to its presence in various dietary sources, including eggs, nuts, legumes, and certain vegetables, and its endogenous synthesis by intestinal microbiota. However, deficiency may occur in specific at-risk groups, including individuals receiving long-term antibiotic therapy (which disrupts intestinal flora), chronic anticonvulsant therapy (which alters biotin metabolism), or total parenteral nutrition without adequate supplementation. Clinically, biotin deficiency develops gradually and initially presents with nonspecific symptoms such as fatigue, hair thinning or alopecia, and eczematous skin rashes. If left untreated, the deficiency may progress to neurologic manifestations, including paresthesias, peripheral neuropathy, myalgias, and, in severe cases, cognitive impairment or seizures. Due to these findings' subtle and variable nature, diagnosis is often delayed or overlooked. While biotin supplements are widely marketed for hair, skin, and nail health, limited clinical evidence supports their use in individuals without a documented deficiency. Moreover, high-dose biotin supplementation has been shown to interfere with immunoassays, particularly those measuring thyroid hormones and cardiac biomarkers (eg, troponins), which may result in false-positive or false-negative results and lead to inappropriate diagnostic or therapeutic decisions. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 35953126 Immunoassay design and biotin interference Review · Adv Clin Chem, 2022 Normal people get no benefit. High doses cause positive interference (competitive) and negative interference (sandwich) - thyroid error (FT3/FT4 high, TSH low) is the classic case.
Key summary
A review explaining how biotin interferes with immunoassays from an assay-design perspective. Biotin is a cofactor for five biotin-dependent carboxylases; deficiency from rare inborn errors of metabolism can be reversed with supplementation, but the review states that normal individuals get no benefit from taking biotin. Its use for hair and nails is nonetheless widespread, and in assays that use biotinylated antibodies, elevated serum biotin makes competitive-format assays read high (positive interference) and sandwich-format assays read low (negative interference). The classic error is in thyroid testing, where free T3 and free T4 read high (competitive) and TSH reads low (sandwich), which can produce a diagnostic error resembling hyperthyroidism.
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Biotin (vitamin B7 or vitamin H), a member of vitamin B complex, acts as a cofactor for five biotin-dependent carboxylases, thus playing critical roles in gluconeogenesis, fatty acid synthesis and amino acid catabolism. Although rare inborn errors of metabolism may cause biotin deficiency, these can be successfully treated with biotin supplementation. In general, normal individuals do not get any benefit from taking biotin supplement. Nevertheless, biotin use remains widespread for growing healthy hair and nail. Unfortunately, the use/overuse of supplemental biotin may interfere with immunoassays that incorporate biotinylated antibody in assay design. Biotin if present in elevated concentration in serum or plasma, may falsely increase analyte concentration using competitive immunoassay (positive interference). In contrast, biotin shows negative interference if sandwich immunoassay format is used. Such interferences may cause diagnostic error, most commonly in cases of hyperthyroidism due to (1) positive interference of biotin in free triiodothyronine (FT3) and free thyroxine (FT4) assays (competitive format) and (2) negative interference in thyroid stimulating hormone (TSH) assay (sandwich format). In this review, I explore the biochemistry of biotin and discuss its role as a potential interferent in immunoassay formats that are biotin based. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 33761581 Independent and combined effects of biotin and hemolysis on high-sensitivity cardiac troponin assays Laboratory study (assay comparison) · Clin Chem Lab Med, 2021 Nine hs-troponin assays compared - most safe at supplement doses, but some (certain Roche cTnT) show sharply reduced recovery at high biotin (falsely low).
Key summary
A laboratory study quantitatively comparing the independent and combined effects of biotin and hemolysisThe breaking apart of red blood cells. across nine high-sensitivity cardiac troponin (hs-cTn) assays. Most assays were not affected at biotin levels expected from over-the-counter supplementation, but some (notably two Roche Cobas Elecsys cTnT assays and the Siemens Dimension EXL) showed decreasing troponin recovery as biotin rose. At high concentrations (10-2000 ng/mL) recovery can fall severely, yielding falsely low troponin results that can matter clinically. A newer version of one Roche assay reduced biotin interference roughly 100-fold, showing the risk varies greatly by manufacturer and assay.
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OBJECTIVES: This study compared the independent and combined effects of hemolysis and biotin on cardiac troponin measurements across nine high-sensitivity cardiac troponin (hs-cTn) assays. METHODS: Parallel cTn measurements were made in pooled lithium heparin plasma spiked with hemolysate and/or biotin using nine hs-cTn assays: Abbott Alinity, Abbott ARCHITECT i2000, Beckman Access 2, Ortho VITROS XT 7600, Siemens Atellica, Siemens Centaur, Siemens Dimension EXL cTnI, and two Roche Cobas e 411 Elecsys Troponin T-hs cTnT assays (outside US versions, with and without increased biotin tolerance). Absolute and percent cTn recovery relative to two baseline concentrations were determined in spiked samples and compared to manufacturer's claims. RESULTS: All assays except the Ortho VITROS XT 7600 showed hemolysis and biotin interference thresholds equivalent to or greater than manufacturer's claims. While imprecision confounded analysis of Ortho VITROS XT 7600 data, evidence of biotin interference was lacking. Increasing biotin concentration led to decreasing cTn recovery in three assays, specifically both Roche Cobas e 411 Elecsys Troponin T-hs assays and the Siemens Dimension EXL. While one of the Roche assays was the most susceptible to biotin among the nine studied, a new version showed reduced biotin interference by approximately 100-fold compared to its predecessor. Increasing hemolysis also generally led to decreasing cTn recovery for susceptible assays, specifically the Beckman Access 2, Ortho VITROS XT 7600, and both Roche Cobas e 411 Elecsys assays. Equivalent biotin and hemolysis interference thresholds were observed at the two cTn concentrations considered for all but two assays (Beckman Access 2 and Ortho VITROS XT 7600). When biotin and hemolysis were present in combination, biotin interference thresholds decreased with increasing hemolysis for two susceptible assays (Roche Cobas e 411 Elecsys and Siemens Dimension EXL). CONCLUSIONS: Both Roche Cobas e 411 Elecsys as well as Ortho VITROS XT assays were susceptible to interference from in vitro hemolysis at levels routinely encountered in clinical laboratory samples (0-3 g/L free hemoglobin), leading to falsely low cTn recovery up to 3 ng/L or 13%. While most assays are not susceptible to biotin at levels expected with over-the-counter supplementation, severely reduced cTn recovery is possible at biotin levels of 10-2000 ng/mL (41-8,180 nmol/L) for some assays. Due to potential additive effects, analytical interferences should not be considered in isolation. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 40324612 Cardiac troponin Review · Clin Chim Acta, 2025 Troponin immunoassays can be affected by autoantibodies, cross-reactivity, and biotin, lowering accuracy - mass spectrometry (LC-MS/MS) is an alternative that reduces interference.
Key summary
A review of cardiac troponin (cTn) testing technologies. Troponin testing is central to diagnosing acute coronary syndrome and acute myocardial infarctionA heart attack - death of heart muscle from blocked blood flow., but the review notes that conventional immunoassays can be subject to autoantibodies, cross-reactivity, and biotin-related effects that reduce diagnostic accuracy. It examines the prevalence of false-positive results across methods and describes liquid chromatography-tandem mass spectrometry (LC-MS/MS) as an alternative that reduces immunoassay interference and improves specificity, though clinical adoption is limited by technical complexity. It supports biotin being one factor that can affect the reliability of troponin immunoassays.
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Cardiac troponin (cTn) testing plays a crucial role in the diagnosis of cardiovascular diseases, particularly acute coronary syndrome (ACS), which includes acute myocardial infarction (AMI). However, conventional immunoassays may be subject to interference from autoantibodies, cross-reactivity, and biotin-related effects, compromising diagnostic accuracy. A thorough investigation of these interference mechanisms is necessary to improve assay methodologies, ensuring greater reliability and precision. In recent years, significant advancements in mass spectrometry (MS) technology have sparked increased interest in its application for cTn testing. For instance, liquid chromatography-tandem mass spectrometry (LC-MS/MS) employs multiple reaction monitoring (MRM) to accurately quantify cardiac troponin I (cTnI)-specific tryptic peptides along with their fragment ions. This technique effectively reduces immunoassay interference while improving analytical specificity. Compared to traditional immunoassays, MS-based approaches alleviate matrix effects and analytical interferences while achieving superior specificity. Nonetheless, clinical adoption remains constrained by technical complexity; thus clinicians can obtain more reliable diagnostic insights. This review summarizes the current landscape of cTn detection technologies by examining the prevalence of false-positive results across various methods. It further explores both the practical applications and challenges associated with MS-based techniques in cTn testing. Ultimately, this review aims to improve cTn testing reliability, enhance cardiovascular disease diagnosis, and guide personalized treatment strategies. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
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