AACC Guidance Document on Biotin Interference in Laboratory Tests

Danni Li, Angela Ferguson, Mark A. Cervinski, Kara L. Lynch, Patrick B. Kyle

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


BACKGROUND: Laboratory tests that use streptavidin-biotin binding mechanisms have the potential to be affected by high circulating biotin concentrations, which would produce positive and negative interference in biotinylated competitive and noncompetitive (sandwich) immunoassays, respectively. Consumption of high-dose biotin supplements for cosmetic or health-related reasons has drawn attention to biotin interference in clinical laboratory tests. Case reports and in vivo studies show that ingestion of supplemental biotin can cause clinically significant errors in select biotinylated immunoassays. CONTENT: This AACC Academy document is intended to provide guidance to laboratorians and clinicians for preventing, identifying, and dealing with biotin interference. In vivo and in vitro spiking studies have demonstrated that biotin concentrations required to cause interference vary by test and by manufacturer. This document includes discussion of biotin's mechanisms for interference in immunoassays, pharmacokinetics, and results of in vitro and in vivo studies and cites examples of assays known to be affected by high biotin concentrations. This document also provides guidance recommendations intended to assist laboratories and clinicians in identifying and addressing biotin interference in laboratory testing. SUMMARY: The recent increase in the use of high-dose biotin supplements requires laboratorians and clinicians to be mindful of the potential for biotin interference in biotinylated immunoassay-based laboratory tests. Laboratories, clinicians, regulators, and patients should work together to ensure accurate laboratory results. Laboratories have several options for identifying suspected biotin interference in specimens. Alternatively, the relatively fast elimination of biotin allows the potential for rapid follow-up specimen analysis if necessary.

Original languageEnglish (US)
Pages (from-to)575-587
Number of pages13
JournalThe journal of applied laboratory medicine
Issue number3
StatePublished - May 1 2020

Bibliographical note

Publisher Copyright:
© American Association for Clinical Chemistry 2020. All rights reserved. For permissions, please email: journals.permissions@oup.com.


  • Biotin
  • Biotin Interference
  • Immunoassay Interference

PubMed: MeSH publication types

  • Guideline
  • Journal Article


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