ARUP’s Commitment

On November 28, 2017, the FDA issued a Safety Communication warning that “Biotin May Interfere with Lab Tests.”

ARUP sent an announcement to clients regarding the original FDA Safety Communication warning on December 6, 2017. ARUP has also identified the tests that can potentially be affected by high levels of biotin.

On November 5, 2019, the FDA issued an updated Safety Communication “Update: The FDA Warns that Biotin May Interfere with Lab Tests: FDA Safety Communication.” Read more here.

Please be assured that ARUP responds to FDA notifications in a manner that is consistent with our commitment to quality and patient care.  ARUP continues to encourage health care providers to interpret associated clinical results for patients that are taking high levels of biotin with caution.

For additional questions, please contact ARUP Client Services, (800) 522-2787, and refer to the key word: Biotin Interference.

About Biotin

Biotin (vitamin B7) is a water-soluble B vitamin that helps turn carbs, fats, and proteins into energy. The recommended daily intake (RDI) varies based on age (adults: 30 µg/day). Biotin can be found in various foods, as well as multivitamins, prenatal vitamins, and dietary supplements.2 However, dietary supplements marketed for hair, skin, and nail growth may contain biotin concentrations up to 650 times (5–10 mg) the RDI. High dose supplementation of biotin (>10 mg/day) may be recommended for patients with certain inherited metabolic deficiencies/diseases or conditions such as multiple sclerosis (MS).3

Potential Effect(s) on Testing

While standard intake levels of biotin do not typically cause interference, higher levels may cause significant interference with certain immunoassays that use biotin-streptavidin technology and affect corresponding test results.1,3 This interference can cause false highs and false lows, potentially leading to misdiagnosis.

Patients may be unaware they are taking higher-than-recommended levels of biotin, so it is important for physicians to be diligent in obtaining a full list of supplements for testing accuracy. This information should then be communicated with the lab(s) conducting the test(s). For suspicious or inconsistent patient results, biotin interference may be considered. Consult with testing laboratory to discuss potential impact.

Additional Resources

References

  1. FDA in Brief: FDA reminder about the potential for biotin interference 2019.
  2. National Institutes of Health. Biotin fact sheet for consumers.
  3. Roche Diagnostics. Biotin facts.

Test List

Last updated: February 2024

MnemonicTest NumberTest Name
ACTH IHC2003427ACTH by Immunohistochemistry
ADENOV IHC2003430Adenovirus by Immunohistochemistry
ACTH0070010Adrenocorticotropic Hormone
ALKD5F3 IP2007324ALK (D5F3) with Interpretation by Immunohistochemistry
A1 AT IHC2003424Alpha-1-Antitrypsin (AAT) by Immunohistochemistry
AFP IHC2003436Alpha-1-Fetoprotein (AFP) by Immunohistochemistry
ASYN IHC2003419Alpha-Synuclein by Immunohistochemistry
ALK1 IHC2003439Anaplastic Lymphoma Kinase 1 (ALK-1) by Immunohistochemistry
AR IHC3002791Androgen Receptor by Immunohistochemistry
BEREP4 IHC2003463Anti-Human Epithelial Antigen, Ber-EP4 by Immunohistochemistry
AQP42003036Aquaporin-4 Receptor Antibody
AQP4 R2013327Aquaporin-4 Receptor Antibody by ELISA with Reflex to Aquaporin-4 Receptor Antibody, IgG by IFA
ARG1 IHC2011890Arginase 1 by Immunohistochemistry
ATRX IHC2014499ATRX by Immunohistochemistry
BOB1 IHC2003442B Cell Specific Octamer Binding Protein-1 (BOB-1) by Immunohistochemistry
BAP1 IHC3004244BAP1 by Immunohistochemistry
BCL10 IHC3003393BCL-10 by Immunohistochemistry
BCL2 IHC2004513BCL-2 by Immunohistochemistry
BCL6 IHC2003457BCL-6 by Immunohistochemistry
BCAT1 IHC2003454Beta-Catenin-1 by Immunohistochemistry
BHCG TM0070029Beta-hCG, Quantitative (Tumor Marker)
BHCG CSF0020730Beta-hCG, Quantitative (Tumor Marker), CSF
BF1 IHC2003466BF-1 by Immunohistochemistry
BRACHY IHC3003824Brachyury by Immunohistochemistry
C1 INH PAN0050139C-1-Esterase Inhibitor Panel
CMYCIHC2008317C-MYC by Immunohistochemistry
CTX0070416C-Telopeptide, Beta-Cross-Linked, Serum
C1 INH F0050141C1-Esterase Inhibitor Functional
C4D IHC2003475C4D by Immunohistochemistry
CALCIT IHC2003481Calcitonin by Immunohistochemistry
CALDES IHC2003484Caldesmon by Immunohistochemistry
CALPON IHC2003487Calponin by Immunohistochemistry
CALRET IHC2003490Calretinin by Immunohistochemistry
CA1250080462Cancer Antigen 125
CA-BREAST0080464Cancer Antigen-Breast (CA 15-3)
CA-GI0080461Cancer Antigen-GI (CA 19-9)
CA-GI FL0020746Cancer Antigen-GI (CA 19-9), Body Fluid
CAIX IHC3001697Carbonic Anhydrase IX by IHC
CEA0080080Carcinoembryonic Antigen
CEA FL0020742Carcinoembryonic Antigen, Fluid
CEA M IHC2003824Carcinoembryonic Antigen, Monoclonal (CEA M) by Immunohistochemistry
CD10 IHC2003523CD10 (CALLA) by Immunohistochemistry
CD117 IHC2003806CD117 (c-Kit) by Immunohistochemistry
CD123 IHC2003809CD123 by Immunohistochemistry
CD138 IHC2003812CD138 (Syndecan-1) by Immunohistochemistry
CD15 IHC2003529CD15, Leu M1 by Immunohistochemistry
CD163 IHC2003815CD163 by Immunohistochemistry
CD19 IHC2005114CD19 by Immunohistochemistry
CD1A IHC2003502CD1a by Immunohistochemistry
CD2 IHC2003505CD2 by Immunohistochemistry
CD20 IHC2003532CD20, L26 by Immunohistochemistry
CD200 IHC2012844CD200 by Immunohistochemistry
CD21 IHC2003535CD21 (Dendritic Cell) by Immunohistochemistry
CD23 IHC2003541CD23 by Immunohistochemistry
CD25 IHC2003544CD25 by Immunohistochemistry
CD3 IHC2003508CD3 by Immunohistochemistry
CD30 IHC2003547CD30 (Ki-1) by Immunohistochemistry
CD31 IHC2003550CD31 by Immunohistochemistry
CD33 IHC2003553CD33 by Immunohistochemistry
CD34 IHC2003556CD34, QBEnd/10 by Immunohistochemistry
CD35 IHC2003559CD35 by Immunohistochemistry
CD4 IHC2003511CD4 by Immunohistochemistry
CD43 IHC2003568CD43, L60 (Leu 22) by Immunohistochemistry
CD45 IHC2003574CD45 by Immunohistochemistry
CD52 IHC2003586CD52 (CAMPATH-1) by Immunohistochemistry
CD56 IHC2003589CD56 (NCAM) by Immunohistochemistry
CD61 IHC2003595CD61 (Platelet Glycoprotein IIIA) by Immunohistochemistry
CD68 IHC2003598CD68, KP1 by Immunohistochemistry
CD7 IHC2003517CD7 by Immunohistochemistry
CD71 IHC3003704CD71 by Immunohistochemistry
CD79A IHC2003800CD79A by Immunohistochemistry
CD8 IHC2003520CD8 by Immunohistochemistry
CDK4 IHC2005534CDK4 by Immunohistochemistry
CDX2 IHC2003821CDX2 by Immunohistochemistry
CHROMO IHC2003830Chromogranin A by Immunohistochemistry
CHYMO IHC3003423Chymotrypsin by Immunohistochemistry
COTININE2007081Cotinine Screen, Urine
COV19G SQ3003648COVID-19 IgG (Spike), Semi-Quantitative by CIA
CXCL13 IHC2008622CXCL13 by Immunohistochemistry
CYCSP4 IHC2003842Cyclin D1, SP4 by Immunohistochemistry
CYFRA0081344CYFRA 21-1 (Cytokeratin 19 Fragment), Serum
CYTO20 IHC2003848Cytokeratin 20 (CK 20) by Immunohistochemistry
CYTO56 IHC2003851Cytokeratin 5,6 (CK 5,6) by Immunohistochemistry
CYTO 7 IHC2003854Cytokeratin 7 (CK 7) by Immunohistochemistry
CAM5.2 IHC2003493Cytokeratin 8,18 Low Molecular Weight (CAM 5.2) by Immunohistochemistry
CYT13 CSF3003259Cytokine Panel 13, CSF
CYT13 PLA3002601Cytokine Panel 13, Plasma
CYT 12 SE0051394Cytokine Panel 13, Serum
CYT MON P3002616Cytokine Panel, Monokines, Plasma
CYT MON SE0051524Cytokine Panel, Monokines, Serum
CYT TH1 P3002617Cytokine Panel, TH1, Plasma
CYT TH1 SE0051408Cytokine Panel, TH1, Serum
CYT TH2 P3002627Cytokine Panel, TH2, Plasma
CYT TH2 SE0051518Cytokine Panel, TH2, Serum
CMV IHC2003833Cytomegalovirus (CMV) by Immunohistochemistry
D240 IHC2003857D2-40 by Immunohistochemistry
DHEAS0070040Dehydroepiandrosterone Sulfate, Serum
DESMIN IHC2003863Desmin by Immunohistochemistry
DOG1 IHC2010168DOG1 by Immunohistochemistry
ECADH IHC2003869E-Cadherin by Immunohistochemistry
EMA IHC2003872Epithelial Membrane Antigen (EMA) by Immunohistochemistry
ERA IHC2003875Epithelial-Related Antigen, MOC-31 by Immunohistochemistry
HERCEP IHC2007332ERBB2 (HER2) (HercepTest) by Immunohistochemistry
ERG IHC2012555ERG by Immunohistochemistry
ER IHC2004516Estrogen Receptor (ER) by Immunohistochemistry
O13 IHC2004055Ewing Sarcoma (O13) by Immunohistochemistry
FAC 13 IHC2003878Factor XIIIa by Immunohistochemistry
FSH0070055Follicle Stimulating Hormone, Serum
FUMHYD IHC3001416Fumarate Hydratase by Immunohistochemistry
GAST0070075Gastrin
GASTRI IHC2003896Gastrin by Immunohistochemistry
GAST 12012636Gastrin, 1 Minute
GAST 102012734Gastrin, 10 Minute
GAST 22012638Gastrin, 2 Minute
GAST 302012736Gastrin, 30 Minute
GAST 52012732Gastrin, 5 Minute
GAST BASE2012738Gastrin, Baseline
GFAP IHC2003899Glial Fibrillary Acidic Protein (GFAP) by Immunohistochemistry
GLUT1 IHC2003905Glucose Transporter-1 (GLUT-1) by Immunohistochemistry
GLYC A IHC2003908Glycophorin A by Immunohistochemistry
GLYP3 IHC2011925Glypican 3 by Immunohistochemistry
GRANZB IHC2007173Granzyme B by Immunohistochemistry
HGH IHC2003929Growth Hormone by Immunohistochemistry
H3K27M IHC3004370H3K27M by Immunohistochemistry
H3K27M3IHC3004364H3K27me3 by Immunohistochemistry
HPYLOR IHC2003941Helicobacter pylori by Immunohistochemistry
HAVAB0020591Hepatitis A Virus Antibodies (Total)
HAVABM0020093Hepatitis A Virus Antibody, IgM
HEP A PAN0020597Hepatitis A Virus Panel
HBV PAN PN2014285Hepatitis B Virus (HBV) Perinatal Exposure Follow-up by CIA, Panel
HEPCHRONIC0020454Hepatitis B Virus Panel, Chronic with Reflex to HBsAg Confirmation
HBSAB0020090Hepatitis B Virus Surface Antibody
HBSAG0020089Hepatitis B Virus Surface Antigen with Reflex to Confirmation
HBSAG PN2007573Hepatitis B Virus Surface Antigen with Reflex to Confirmation, Prenatal
HEP SA IHC2003923Hepatocyte Specific Antigen (HSA) by Immunohistochemistry
HSV IHC3000101Herpes Simplex Virus (HSV) Types I/II by Immunohistochemistry
HHV8 IHC2003932Herpes Virus 8 by Immunohistochemistry
HGAL IHC3004201HGAL by Immunohistochemistry
HNF1B IHC3001791HNF-1B by Immunohistochemistry
HCG IHC2003920Human Chorionic Gonadotropin (Beta-hCG) by Immunohistochemistry
HE42003020Human Epididymis Protein 4 (HE4)
IDH1 IHC2005857IDH1 R132H by Immunohistochemistry
IGD IHC2003960Immunoglobulin D (IgD) by Immunohistochemistry
IGG IHC2003963Immunoglobulin G (IgG) by Immunohistochemistry
IGG4 IHC2005844Immunoglobulin G4 by Immunohistochemistry
INHIBI IHC2003969Inhibin by Immunohistochemistry
BAF47 IHC2003448INI1 (BAF47) by Immunohistochemistry
IFNG PLA3002628Interferon gamma, Plasma
IFNG DO0051531Interferon gamma, Serum
IL1B PLA3002629Interleukin 1 beta, Plasma
IL1B DO0051536Interleukin 1 beta, Serum
IL10 PLA3002623Interleukin 10, Plasma
IL10 DO0051534Interleukin 10, Serum
IL12 PLA3002624Interleukin 12, Plasma
IL12 DO0051530Interleukin 12, Serum
IL13 PLA3002625Interleukin 13, Plasma
IL13 DO0051535Interleukin 13, Serum
IL17 PLA3002626Interleukin 17, Plasma
IL172013115Interleukin 17, Serum
IL2R CSF3003261Interleukin 2 Receptor, Soluble, CSF
IL2R PLA3002631Interleukin 2 Receptor, Soluble, Plasma
IL2R DO0051529Interleukin 2 Receptor, Soluble, Serum
IL2 PLA3002630Interleukin 2, Plasma
IL2 DO0051588Interleukin 2, Serum
IL4 PLA3002622Interleukin 4, Plasma
IL4 DO0051532Interleukin 4, Serum
IL5 PLA3002621Interleukin 5, Plasma
IL5 DO0051533Interleukin 5, Serum
IL6 CSF3003260Interleukin 6, CSF
IL6 PLA3002620Interleukin 6, Plasma
IL6 DO0051537Interleukin 6, Serum
IL8 PLA3002619Interleukin 8, Plasma
IL8 DO0051538Interleukin 8, Serum
K903 IHC2003978Keratin 903 (K903) High Molecular Weight by Immunohistochemistry
MIB1 IHC2004519Ki-67, MIB-1, by Immunohistochemistry
LANGER IHC2013802LANGERIN by Immunohistochemistry
LH/FSH0070193Luteinizing Hormone and Follicle Stimulating Hormone
LH0070093Luteinizing Hormone, Serum
LYSOZY IHC2003990Lysozyme (Muramidase) by Immunohistochemistry
MASTCT IHC2003993Mast Cell Tryptase by Immunohistochemistry
MELANA IHC2003996Melan A by Immunohistochemistry (DAB Detection)
MELA R IHC3003729Melan A by Immunohistochemistry (Red Detection)
HMB 45 IHC2003935Melanoma Antibody, HMB45 by Immunohistochemistry (DAB Detection)
HMB45R IHC3003741Melanoma Antibody, HMB45 by Immunohistochemistry (Red Detection)
MITF IHC2011998MITF by Immunohistochemistry
MUC1 IHC2004002Muc-1 by Immunohistochemistry
MUC4 IHC2004008Muc-4 by Immunohistochemistry
IRF4 IHC2003975MUM1/IRF4 by Immunohistochemistry
MUSA IHC2004011Muscle-Specific Actin (MSA) by Immunohistochemistry
MYELOP IHC2004014Myeloperoxidase (MPO) by Immunohistochemistry
MYF4 IHC2004017Myogenin (Myf4) by Immunohistochemistry
MYOGL IHC2004031Myoglobin by Immunohistochemistry
MYOG-S0020224Myoglobin, Serum
MYOG-U0020223Myoglobin, Urine
MYOSIN IHC2004034Myosin by Immunohistochemistry
NAPSIN IHC2008716Napsin A by Immunohistochemistry
NEUROF IHC2004049Neurofilament by Immunohistochemistry
NEUN IHC2004046Neuronal Nuclei (NeuN) by Immunohistochemistry
NKX2.2 IHC3004316NKX2.2 by Immunohistochemistry
NUT IHC3002780Nuclear Protein in Testis by Immunohistochemistry
OCT2 IHC2004061Octamer Transcription Factor-2 (Oct 2) by Immunohistochemistry
OCT3/4 IHC2004058Octamer Transcription Factor-3 and -4 (Oct 3/4) by Immunohistochemistry
OSTEO NMID0020728Osteocalcin by Electrochemiluminescent Immunoassay
P16 IHC2004064p16 by Immunohistochemistry
P40 IHC2010142P40 by Immunohistochemistry
P501S IHC3001890P501S (Prostein) by IHC
P504S IHC2004076P504S (AMACR) by Immunohistochemistry
P53 IHC2004522p53 by Immunohistochemistry
P57 IHC2005542P57 by Immunohistochemistry
P63 IHC2004073p63 by Immunohistochemistry
PHFTAU IHC2004094Paired Helical Filament-Tau (PHF-Tau) by Immunohistochemistry
AE1,3 IHC2003433Pan Cytokeratin (AE1,3) by Immunohistochemistry
PTH IHC2004118Parathyroid Hormone (PTH) by Immunohistochemistry
PTH FNA2001491Parathyroid Hormone, Fine Needle Aspiration (FNA)
PTH-INT0070346Parathyroid Hormone, Intact
PTHI0070172Parathyroid Hormone, Intact with Calcium
PAX5 IHC2004082Pax-5 by Immunohistochemistry
PAX8 IHC2010787PAX8 by Immunohistochemistry
PD1 IHC2004085PD-1 by Immunohistochemistry
PIN4 IHC2010045PIN4 Prostate Triple Stain by Immunohistochemistry
PLAP IHC2004097Placental Alkaline Phosphatase (PLAP) by Immunohistochemistry
PRO BNP0050083proBrain Natriuretic Peptide, NT
PR IHC2004525Progesterone Receptor (PR) by Immunohistochemistry
PROLAC IHC2004109Prolactin by Immunohistochemistry
PSA IHC2004112Prostate Specific Antigen by Immunohistochemistry
PSA FP0080206Prostate Specific Antigen, Free Percentage (Includes Free PSA and Total PSA)
PSA0070121Prostate Specific Antigen, Total
PSA SCN0070234Prostate Specific Antigen, Total - Medicare Screening
TPSAR0080264Prostate Specific Antigen, Total with Reflex to Free PSA (Includes Free Percentage)
PSA ULTRA0098581Prostate Specific Antigen, Ultrasensitive
PAP IHC2004079Prostatic Acid Phosphatase (PAP) by Immunohistochemistry
RCC IHC2004124Renal Cell Carcinoma (RCC) Antigen by Immunohistochemistry
ROMA2012618Risk of Ovarian Malignancy Algorithm
ROS1 IP2008414ROS1 with Interpretation by Immunohistochemistry with Reflex to FISH if Equivocal or Positive
S100 IHC2004127S-100 Protein by Immunohistochemistry (DAB Detection)
S100 R IHC3003733S-100 Protein by Immunohistochemistry (Red Detection)
S 100B2001766S-100B Protein, Serum
S100B CSF2013358S100B, CSF
SALL4 IHC2005432Sal-like 4 (SALL4) by Immunohistochemistry
SHBG0099375Sex Hormone Binding Globulin
SV40 IHC2004137Simian Virus 40 (SV-40) by Immunohistochemistry
SMA IHC2004130Smooth Muscle Actin (SMA) by Immunohistochemistry
SOX10 IHC3001562SOX-10 By Immunohistochemistry (DAB Detection)
SOX10R IHC3003737SOX-10 by Immunohistochemistry (Red Detection)
SOX11 IHC2012561SOX11 by Immunohistochemistry
STAT6 IHC2013251STAT6 by Immunohistochemistry
SYNAPT IHC2004139Synaptophysin by Immunohistochemistry
T UPTAKE3005977T Uptake
TIA1 IHC2004148T-cell Intracytoplasmic Antigen (TIA-1) by Immunohistochemistry
TCL1 IHC3003595TCL1 by Immunohistochemistry
TCR D IHC3001896TCR DELTA by Immunohistochemistry
TDP43 IHC3003407TDP43 by Immunohistochemistry
TDT IHC2004142TdT by Immunohistochemistry
TESTOS0070130Testosterone (Adult Males or Individuals on Testosterone Hormone Therapy)
BIO T0070102Testosterone, Bioavailable and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy)
FREE T20070111Testosterone, Free (Adult Males or Individuals on Testosterone Hormone Therapy)
FREE T0070109Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy)
TFE3 IHC2010688TFE3 by Immunohistochemistry
ATHYG0050105Thyroglobulin Antibody
THYRO IHC2004145Thyroglobulin by Immunohistochemistry
THYRO0050645Thyroid Antibodies
AMICR0050075Thyroid Peroxidase (TPO) Antibody
TR AB2002734Thyroid Stimulating Hormone Receptor Antibody (TRAb)
TTF1 IHC2004166Thyroid Transcription Factor (TTF-1) by Immunohistochemistry
FT40070138Thyroxine, Free (Free T4)
T4 TOTAL3005978Thyroxine, Total T4
TLR0051589Toll-Like Receptor Function
TOXOPL IHC2004157Toxoplasma gondii by Immunohistochemistry
TPALL IHC3001704Treponema Pallidum by IHC
FT30070133Triiodothyronine, Free (Free T3)
T3 TOTAL0070474Triiodothyronine, Total (Total T3)
CTNT3001831Troponin T (cTnT) 5th Generation
TRYPS IHC3003458Trypsin by Immunohistochemistry
TNFA PLA3002618Tumor Necrosis Factor - alpha, Plasma
TNFA DO0051539Tumor Necrosis Factor - alpha, Serum
UBIQUI IHC2004169Ubiquitin by Immunohistochemistry
UROPII IHC3001149Uroplakin II by Immunohistochemistry
VIMENT IHC2004181Vimentin by Immunohistochemistry
WT1 IHC2004184Wilms Tumor (WT-1), N-terminus by Immunohistochemistry