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: November 2023

Mnemonic Test Number Test Name
ACTH IHC 2003427 ACTH by Immunohistochemistry
ADENOV IHC 2003430 Adenovirus by Immunohistochemistry
ACTH 0070010 Adrenocorticotropic Hormone
ACTH IVC1 0070279 Adrenocorticotropic Hormone, IVC1
ACTH LP1 0070300 Adrenocorticotropic Hormone, LP1
ACTH RP1 0070311 Adrenocorticotropic Hormone, RP1
ALKD5F3 IP 2007324 ALK (D5F3) with Interpretation by Immunohistochemistry
A1 AT IHC 2003424 Alpha-1-Antitrypsin (AAT) by Immunohistochemistry
AFP IHC 2003436 Alpha-1-Fetoprotein (AFP) by Immunohistochemistry
ASYN IHC 2003419 Alpha-Synuclein by Immunohistochemistry
ALK1 IHC 2003439 Anaplastic Lymphoma Kinase 1 (ALK-1) by Immunohistochemistry
AR IHC 3002791 Androgen Receptor by Immunohistochemistry
BEREP4 IHC 2003463 Anti-Human Epithelial Antigen, Ber-EP4 by Immunohistochemistry
AQP4 2003036 Aquaporin-4 Receptor Antibody
AQP4 R 2013327 Aquaporin-4 Receptor Antibody by ELISA with Reflex to Aquaporin-4 Receptor Antibody, IgG by IFA
ARG1 IHC 2011890 Arginase 1 by Immunohistochemistry
ATRX IHC 2014499 ATRX by Immunohistochemistry
BOB1 IHC 2003442 B Cell Specific Octamer Binding Protein-1 (BOB-1) by Immunohistochemistry
BAP1 IHC 3004244 BAP1 by Immunohistochemistry
BCL10 IHC 3003393 BCL-10 by Immunohistochemistry
BCL2 IHC 2004513 BCL-2 by Immunohistochemistry
BCL6 IHC 2003457 BCL-6 by Immunohistochemistry
BCAT1 IHC 2003454 Beta-Catenin-1 by Immunohistochemistry
BHCG TM 0070029 Beta-hCG, Quantitative (Tumor Marker)
BHCG CSF 0020730 Beta-hCG, Quantitative (Tumor Marker), CSF
BF1 IHC 2003466 BF-1 by Immunohistochemistry
BRACHY IHC 3003824 Brachyury by Immunohistochemistry
C1 INH PAN 0050139 C-1-Esterase Inhibitor Panel
CMYCIHC 2008317 C-MYC by Immunohistochemistry
CTX 0070416 C-Telopeptide, Beta-Cross-Linked, Serum
C1 INH F 0050141 C1-Esterase Inhibitor Functional
C4D IHC 2003475 C4D by Immunohistochemistry
CALCIT IHC 2003481 Calcitonin by Immunohistochemistry
CALDES IHC 2003484 Caldesmon by Immunohistochemistry
CALPON IHC 2003487 Calponin by Immunohistochemistry
CALRET IHC 2003490 Calretinin by Immunohistochemistry
CA125 0080462 Cancer Antigen 125
CA-BREAST 0080464 Cancer Antigen-Breast (CA 15-3)
CA-GI 0080461 Cancer Antigen-GI (CA 19-9)
CA-GI FL 0020746 Cancer Antigen-GI (CA 19-9), Body Fluid
CAIX IHC 3001697 Carbonic Anhydrase IX by IHC
CEA 0080080 Carcinoembryonic Antigen
CEA FL 0020742 Carcinoembryonic Antigen, Fluid
CEA M IHC 2003824 Carcinoembryonic Antigen, Monoclonal (CEA M) by Immunohistochemistry
CD10 IHC 2003523 CD10 (CALLA) by Immunohistochemistry
CD117 IHC 2003806 CD117 (c-Kit) by Immunohistochemistry
CD123 IHC 2003809 CD123 by Immunohistochemistry
CD138 IHC 2003812 CD138 (Syndecan-1) by Immunohistochemistry
CD15 IHC 2003529 CD15, Leu M1 by Immunohistochemistry
CD163 IHC 2003815 CD163 by Immunohistochemistry
CD19 IHC 2005114 CD19 by Immunohistochemistry
CD1A IHC 2003502 CD1a by Immunohistochemistry
CD2 IHC 2003505 CD2 by Immunohistochemistry
CD20 IHC 2003532 CD20, L26 by Immunohistochemistry
CD200 IHC 2012844 CD200 by Immunohistochemistry
CD21 IHC 2003535 CD21 (Dendritic Cell) by Immunohistochemistry
CD23 IHC 2003541 CD23 by Immunohistochemistry
CD25 IHC 2003544 CD25 by Immunohistochemistry
CD3 IHC 2003508 CD3 by Immunohistochemistry
CD30 IHC 2003547 CD30 (Ki-1) by Immunohistochemistry
CD31 IHC 2003550 CD31 by Immunohistochemistry
CD33 IHC 2003553 CD33 by Immunohistochemistry
CD34 IHC 2003556 CD34, QBEnd/10 by Immunohistochemistry
CD35 IHC 2003559 CD35 by Immunohistochemistry
CD4 IHC 2003511 CD4 by Immunohistochemistry
CD43 IHC 2003568 CD43, L60 (Leu 22) by Immunohistochemistry
CD45 IHC 2003574 CD45 by Immunohistochemistry
CD52 IHC 2003586 CD52 (CAMPATH-1) by Immunohistochemistry
CD56 IHC 2003589 CD56 (NCAM) by Immunohistochemistry
CD61 IHC 2003595 CD61 (Platelet Glycoprotein IIIA) by Immunohistochemistry
CD68 IHC 2003598 CD68, KP1 by Immunohistochemistry
CD7 IHC 2003517 CD7 by Immunohistochemistry
CD71 IHC 3003704 CD71 by Immunohistochemistry
CD79A IHC 2003800 CD79A by Immunohistochemistry
CD8 IHC 2003520 CD8 by Immunohistochemistry
CDK4 IHC 2005534 CDK4 by Immunohistochemistry
CDX2 IHC 2003821 CDX2 by Immunohistochemistry
CHROMO IHC 2003830 Chromogranin A by Immunohistochemistry
CHYMO IHC 3003423 Chymotrypsin by Immunohistochemistry
COTININE 2007081 Cotinine Screen, Urine
COV19G SQ 3003648 COVID-19 IgG (Spike), Semi-Quantitative by CIA
CXCL13 IHC 2008622 CXCL13 by Immunohistochemistry
CYCSP4 IHC 2003842 Cyclin D1, SP4 by Immunohistochemistry
CYFRA 0081344 CYFRA 21-1 (Cytokeratin 19 Fragment), Serum
CYTO20 IHC 2003848 Cytokeratin 20 (CK 20) by Immunohistochemistry
CYTO56 IHC 2003851 Cytokeratin 5,6 (CK 5,6) by Immunohistochemistry
CYTO 7 IHC 2003854 Cytokeratin 7 (CK 7) by Immunohistochemistry
CAM5.2 IHC 2003493 Cytokeratin 8,18 Low Molecular Weight (CAM 5.2) by Immunohistochemistry
CYT13 CSF 3003259 Cytokine Panel 13, CSF
CYT13 PLA 3002601 Cytokine Panel 13, Plasma
CYT 12 SE 0051394 Cytokine Panel 13, Serum
CYT MON P 3002616 Cytokine Panel, Monokines, Plasma
CYT MON SE 0051524 Cytokine Panel, Monokines, Serum
CYT TH1 P 3002617 Cytokine Panel, TH1, Plasma
CYT TH1 SE 0051408 Cytokine Panel, TH1, Serum
CYT TH2 P 3002627 Cytokine Panel, TH2, Plasma
CYT TH2 SE 0051518 Cytokine Panel, TH2, Serum
CMV IHC 2003833 Cytomegalovirus (CMV) by Immunohistochemistry
D240 IHC 2003857 D2-40 by Immunohistochemistry
DHEAS 0070040 Dehydroepiandrosterone Sulfate, Serum
DESMIN IHC 2003863 Desmin by Immunohistochemistry
DOG1 IHC 2010168 DOG1 by Immunohistochemistry
ECADH IHC 2003869 E-Cadherin by Immunohistochemistry
EMA IHC 2003872 Epithelial Membrane Antigen (EMA) by Immunohistochemistry
ERA IHC 2003875 Epithelial-Related Antigen, MOC-31 by Immunohistochemistry
HERCEP IHC 2007332 ERBB2 (HER2) (HercepTest) by Immunohistochemistry
ERG IHC 2012555 ERG by Immunohistochemistry
ER IHC 2004516 Estrogen Receptor (ER) by Immunohistochemistry
O13 IHC 2004055 Ewing Sarcoma (O13) by Immunohistochemistry
FAC 13 IHC 2003878 Factor XIIIa by Immunohistochemistry
FSH 0070055 Follicle Stimulating Hormone, Serum
FUMHYD IHC 3001416 Fumarate Hydratase by Immunohistochemistry
GAST 0070075 Gastrin
GASTRI IHC 2003896 Gastrin by Immunohistochemistry
GAST 1 2012636 Gastrin, 1 Minute
GAST 10 2012734 Gastrin, 10 Minute
GAST 2 2012638 Gastrin, 2 Minute
GAST 30 2012736 Gastrin, 30 Minute
GAST 5 2012732 Gastrin, 5 Minute
GAST BASE 2012738 Gastrin, Baseline
GFAP IHC 2003899 Glial Fibrillary Acidic Protein (GFAP) by Immunohistochemistry
GLUT1 IHC 2003905 Glucose Transporter-1 (GLUT-1) by Immunohistochemistry
GLYC A IHC 2003908 Glycophorin A by Immunohistochemistry
GLYP3 IHC 2011925 Glypican 3 by Immunohistochemistry
GRANZB IHC 2007173 Granzyme B by Immunohistochemistry
HGH IHC 2003929 Growth Hormone by Immunohistochemistry
H3K27M IHC 3004370 H3K27M by Immunohistochemistry
H3K27M3IHC 3004364 H3K27me3 by Immunohistochemistry
HPYLOR IHC 2003941 Helicobacter pylori by Immunohistochemistry
HAVAB 0020591 Hepatitis A Virus Antibodies (Total)
HAVABM 0020093 Hepatitis A Virus Antibody, IgM
HEP A PAN 0020597 Hepatitis A Virus Panel
HBV PAN PN 2014285 Hepatitis B Virus (HBV) Perinatal Exposure Follow-up by CIA, Panel
HEPCHRONIC 0020454 Hepatitis B Virus Panel, Chronic with Reflex to HBsAg Confirmation
HBSAB 0020090 Hepatitis B Virus Surface Antibody
HBSAG 0020089 Hepatitis B Virus Surface Antigen with Reflex to Confirmation
HBSAG PN 2007573 Hepatitis B Virus Surface Antigen with Reflex to Confirmation, Prenatal
HEP SA IHC 2003923 Hepatocyte Specific Antigen (HSA) by Immunohistochemistry
HSV IHC 3000101 Herpes Simplex Virus (HSV) Types I/II by Immunohistochemistry
HHV8 IHC 2003932 Herpes Virus 8 by Immunohistochemistry
HGAL IHC 3004201 HGAL by Immunohistochemistry
HNF1B IHC 3001791 HNF-1B by Immunohistochemistry
HCG IHC 2003920 Human Chorionic Gonadotropin (Beta-hCG) by Immunohistochemistry
HE4 2003020 Human Epididymis Protein 4 (HE4)
IDH1 IHC 2005857 IDH1 R132H by Immunohistochemistry
IGD IHC 2003960 Immunoglobulin D (IgD) by Immunohistochemistry
IGG IHC 2003963 Immunoglobulin G (IgG) by Immunohistochemistry
IGG4 IHC 2005844 Immunoglobulin G4 by Immunohistochemistry
INHIBI IHC 2003969 Inhibin by Immunohistochemistry
BAF47 IHC 2003448 INI1 (BAF47) by Immunohistochemistry
IFNG PLA 3002628 Interferon gamma, Plasma
IFNG DO 0051531 Interferon gamma, Serum
IL1B PLA 3002629 Interleukin 1 beta, Plasma
IL1B DO 0051536 Interleukin 1 beta, Serum
IL10 PLA 3002623 Interleukin 10, Plasma
IL10 DO 0051534 Interleukin 10, Serum
IL12 PLA 3002624 Interleukin 12, Plasma
IL12 DO 0051530 Interleukin 12, Serum
IL13 PLA 3002625 Interleukin 13, Plasma
IL13 DO 0051535 Interleukin 13, Serum
IL17 PLA 3002626 Interleukin 17, Plasma
IL17 2013115 Interleukin 17, Serum
IL2R CSF 3003261 Interleukin 2 Receptor, Soluble, CSF
IL2R PLA 3002631 Interleukin 2 Receptor, Soluble, Plasma
IL2R DO 0051529 Interleukin 2 Receptor, Soluble, Serum
IL2 PLA 3002630 Interleukin 2, Plasma
IL2 DO 0051588 Interleukin 2, Serum
IL4 PLA 3002622 Interleukin 4, Plasma
IL4 DO 0051532 Interleukin 4, Serum
IL5 PLA 3002621 Interleukin 5, Plasma
IL5 DO 0051533 Interleukin 5, Serum
IL6 CSF 3003260 Interleukin 6, CSF
IL6 PLA 3002620 Interleukin 6, Plasma
IL6 DO 0051537 Interleukin 6, Serum
IL8 PLA 3002619 Interleukin 8, Plasma
IL8 DO 0051538 Interleukin 8, Serum
K903 IHC 2003978 Keratin 903 (K903) High Molecular Weight by Immunohistochemistry
MIB1 IHC 2004519 Ki-67, MIB-1, by Immunohistochemistry
LANGER IHC 2013802 LANGERIN by Immunohistochemistry
LH/FSH 0070193 Luteinizing Hormone and Follicle Stimulating Hormone
LH 0070093 Luteinizing Hormone, Serum
LYSOZY IHC 2003990 Lysozyme (Muramidase) by Immunohistochemistry
MASTCT IHC 2003993 Mast Cell Tryptase by Immunohistochemistry
MELANA IHC 2003996 Melan A by Immunohistochemistry (DAB Detection)
MELA R IHC 3003729 Melan A by Immunohistochemistry (Red Detection)
HMB 45 IHC 2003935 Melanoma Antibody, HMB45 by Immunohistochemistry (DAB Detection)
HMB45R IHC 3003741 Melanoma Antibody, HMB45 by Immunohistochemistry (Red Detection)
MITF IHC 2011998 MITF by Immunohistochemistry
MUC1 IHC 2004002 Muc-1 by Immunohistochemistry
MUC4 IHC 2004008 Muc-4 by Immunohistochemistry
IRF4 IHC 2003975 MUM1/IRF4 by Immunohistochemistry
MUSA IHC 2004011 Muscle-Specific Actin (MSA) by Immunohistochemistry
MYELOP IHC 2004014 Myeloperoxidase (MPO) by Immunohistochemistry
MYF4 IHC 2004017 Myogenin (Myf4) by Immunohistochemistry
MYOGL IHC 2004031 Myoglobin by Immunohistochemistry
MYOG-S 0020224 Myoglobin, Serum
MYOG-U 0020223 Myoglobin, Urine
MYOSIN IHC 2004034 Myosin by Immunohistochemistry
NAPSIN IHC 2008716 Napsin A by Immunohistochemistry
NEUROF IHC 2004049 Neurofilament by Immunohistochemistry
NEUN IHC 2004046 Neuronal Nuclei (NeuN) by Immunohistochemistry
NKX2.2 IHC 3004316 NKX2.2 by Immunohistochemistry
NUT IHC 3002780 Nuclear Protein in Testis by Immunohistochemistry
OCT2 IHC 2004061 Octamer Transcription Factor-2 (Oct 2) by Immunohistochemistry
OCT3/4 IHC 2004058 Octamer Transcription Factor-3 and -4 (Oct 3/4) by Immunohistochemistry
OSTEO NMID 0020728 Osteocalcin by Electrochemiluminescent Immunoassay
P16 IHC 2004064 p16 by Immunohistochemistry
P40 IHC 2010142 P40 by Immunohistochemistry
P501S IHC 3001890 P501S (Prostein) by IHC
P504S IHC 2004076 P504S (AMACR) by Immunohistochemistry
P53 IHC 2004522 p53 by Immunohistochemistry
P57 IHC 2005542 P57 by Immunohistochemistry
P63 IHC 2004073 p63 by Immunohistochemistry
PHFTAU IHC 2004094 Paired Helical Filament-Tau (PHF-Tau) by Immunohistochemistry
AE1,3 IHC 2003433 Pan Cytokeratin (AE1,3) by Immunohistochemistry
PTH IHC 2004118 Parathyroid Hormone (PTH) by Immunohistochemistry
PTH FNA 2001491 Parathyroid Hormone, Fine Needle Aspiration (FNA)
PTH-INT 0070346 Parathyroid Hormone, Intact
PTHI 0070172 Parathyroid Hormone, Intact with Calcium
PAX5 IHC 2004082 Pax-5 by Immunohistochemistry
PAX8 IHC 2010787 PAX8 by Immunohistochemistry
PD1 IHC 2004085 PD-1 by Immunohistochemistry
PIN4 IHC 2010045 PIN4 Prostate Triple Stain by Immunohistochemistry
PLAP IHC 2004097 Placental Alkaline Phosphatase (PLAP) by Immunohistochemistry
PRO BNP 0050083 proBrain Natriuretic Peptide, NT
PR IHC 2004525 Progesterone Receptor (PR) by Immunohistochemistry
PROLAC IHC 2004109 Prolactin by Immunohistochemistry
PSA IHC 2004112 Prostate Specific Antigen by Immunohistochemistry
PSA FP 0080206 Prostate Specific Antigen, Free Percentage (Includes Free PSA and Total PSA)
PSA 0070121 Prostate Specific Antigen, Total
PSA SCN 0070234 Prostate Specific Antigen, Total - Medicare Screening
TPSAR 0080264 Prostate Specific Antigen, Total with Reflex to Free PSA (Includes Free Percentage)
PSA ULTRA 0098581 Prostate Specific Antigen, Ultrasensitive
PAP IHC 2004079 Prostatic Acid Phosphatase (PAP) by Immunohistochemistry
RCC IHC 2004124 Renal Cell Carcinoma (RCC) Antigen by Immunohistochemistry
ROMA 2012618 Risk of Ovarian Malignancy Algorithm
ROS1 IP 2008414 ROS1 with Interpretation by Immunohistochemistry with Reflex to FISH if Equivocal or Positive
S100 IHC 2004127 S-100 Protein by Immunohistochemistry (DAB Detection)
S100 R IHC 3003733 S-100 Protein by Immunohistochemistry (Red Detection)
S 100B 2001766 S-100B Protein, Serum
S100B CSF 2013358 S100B, CSF
SALL4 IHC 2005432 Sal-like 4 (SALL4) by Immunohistochemistry
SHBG 0099375 Sex Hormone Binding Globulin
SV40 IHC 2004137 Simian Virus 40 (SV-40) by Immunohistochemistry
SMA IHC 2004130 Smooth Muscle Actin (SMA) by Immunohistochemistry
SOX10 IHC 3001562 SOX-10 By Immunohistochemistry (DAB Detection)
SOX10R IHC 3003737 SOX-10 by Immunohistochemistry (Red Detection)
SOX11 IHC 2012561 SOX11 by Immunohistochemistry
STAT6 IHC 2013251 STAT6 by Immunohistochemistry
SP REQUEST 8090010 Surgical Pathology Tissue
SYNAPT IHC 2004139 Synaptophysin by Immunohistochemistry
T UPTAKE 3005977 T Uptake
TIA1 IHC 2004148 T-cell Intracytoplasmic Antigen (TIA-1) by Immunohistochemistry
TCL1 IHC 3003595 TCL1 by Immunohistochemistry
TCR D IHC 3001896 TCR DELTA by Immunohistochemistry
TDP43 IHC 3003407 TDP43 by Immunohistochemistry
TDT IHC 2004142 TdT by Immunohistochemistry
TESTOS 0070130 Testosterone (Adult Males or Individuals on Testosterone Hormone Therapy)
BIO T 0070102 Testosterone, Bioavailable and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy)
FREE T2 0070111 Testosterone, Free (Adult Males or Individuals on Testosterone Hormone Therapy)
FREE T 0070109 Testosterone, Free and Total, Includes Sex Hormone-Binding Globulin (Adult Males or Individuals on Testosterone Hormone Therapy)
TFE3 IHC 2010688 TFE3 by Immunohistochemistry
ATHYG 0050105 Thyroglobulin Antibody
THYRO IHC 2004145 Thyroglobulin by Immunohistochemistry
THYRO 0050645 Thyroid Antibodies
AMICR 0050075 Thyroid Peroxidase (TPO) Antibody
TR AB 2002734 Thyroid Stimulating Hormone Receptor Antibody (TRAb)
TTF1 IHC 2004166 Thyroid Transcription Factor (TTF-1) by Immunohistochemistry
FT4 0070138 Thyroxine, Free (Free T4)
T4 TOTAL 3005978 Thyroxine, Total T4
TLR 0051589 Toll-Like Receptor Function
TOXOPL IHC 2004157 Toxoplasma gondii by Immunohistochemistry
TPALL IHC 3001704 Treponema Pallidum by IHC
FT3 0070133 Triiodothyronine, Free (Free T3)
T3 TOTAL 0070474 Triiodothyronine, Total (Total T3)
CTNT 3001831 Troponin T (cTnT) 5th Generation
TRYPS IHC 3003458 Trypsin by Immunohistochemistry
TNFA PLA 3002618 Tumor Necrosis Factor - alpha, Plasma
TNFA DO 0051539 Tumor Necrosis Factor - alpha, Serum
UBIQUI IHC 2004169 Ubiquitin by Immunohistochemistry
UROPII IHC 3001149 Uroplakin II by Immunohistochemistry
VIMENT IHC 2004181 Vimentin by Immunohistochemistry
WT1 IHC 2004184 Wilms Tumor (WT-1), N-terminus by Immunohistochemistry