Does Biotin Interaction With Any Medications?

In our latest question and answer, the pharmacist discusses whether or not biotin has drug interactions to be concerned about.

Question

I want to take a biotin supplement for hair, skin, and nails. I’m on several medications, among them B12 (5000mcg twice weekly) and Folic Acid (1Mg daily). The supplement also has B12 and Folic Acid. Can this supplement be safely taken? Thank you so much!

Asked by Liz On Jan 18, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jan 19, 2023
Last updated Jan 19, 2023

Key points

  • Biotin, also known as vitamin B7 and vitamin H, is not known to interact with other medications.
  • Biotin can however, interfere with some lab tests so it is important to let your doctor know about all the medications and supplements you are taking.

Answer

Thanks so much for reaching out to us! Biotin, also known as vitamin H or B7, is a water-soluble vitamin important for the metabolism of carbohydrates and fat, and it plays a role in maintaining healthy blood sugar levels.

Biotin deficiency is extremely rare, but it is a popular supplement for those looking to improve the appearance of their hair and nails and there is some evidence to suggest it may be helpful in this regard.

Biotin is considered to be generally safe to take as a dietary supplement and it is not known to interact with any medications.

Additionally, biotin is a water-soluble vitamin, it is not stored in the body and any excess is excreted through urine, which means that toxicity is unlikely to occur from taking high doses. This is why you see some supplements contain very large amounts (e.g., 10,000 mcg) when the 'adequate intake' level (intake assumed to ensure nutritional adequacy) is only 30 mcg for men and women (lactating women have a slightly higher adequate intake level of 35 micrograms daily).

Are There Any Concerns With Biotin?

Although biotin has no known drug interactions and is thought to be safe, even when high doses are taken, it is known to interfere with some lab tests. In fact, I just wrote about this yesterday.

High levels of biotin in the blood can affect the accuracy of lab tests that utilize biotin-streptavidin technology, and many do. This is because biotin has a strong binding affinity with streptavidin, a protein commonly used in lab tests to detect and measure other substances in the blood.

For example, biotin can interfere with lab tests for thyroid-stimulating hormone (TSH) and human chorionic gonadotropin (HCG). TSH is a hormone that helps regulate the thyroid gland and too much or too little of it can indicate a thyroid disorder. Inaccurate results from TSH lab tests can lead to misdiagnosis or inappropriate treatment.

To avoid such interference, it's recommended to stop taking biotin supplements before undergoing a lab test that uses biotin-streptavidin technology. Recommendations for how long prior to a test you need to stop biotin supplements vary, but generally it's a few days.

It is important to note that there are some drugs that are known to decrease biotin levels. These drugs include:

  • Carbamazepine
  • Phenytoin
  • Oxcarbazepine
  • Phenobarbital
  • Primidone

Oftentimes, if you are taking a drug that is known to decrease biotin levels, supplementation with biotin is recommended.

Final Words

You also mentioned the dietary supplement you are looking to take contains folic acid and vitamin B12. Both of these are also generally considered safe to take with other medications (although high doses of folic acid may interfere with some drugs, like methotrexate).

You didn't provide a drug list, so I can't say definitively if the supplement is safe to take, but, again, biotin, folic acid, and B12 are safe with most drugs.

Thanks for reaching out!

References

  • Biotin, PubMed
  • Biotin Interference in Diagnostic Tests, PubMed
  • FDA In Brief: FDA provides draft recommendations to diagnostic manufacturers to help reduce risks of biotin interference with certain lab tests, FDA

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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