Can Taking a Biotin Supplement Throw Off Your COVID Test Results?
Taking a COVID-19 test at home is fairly simple (if you can find one) and while it's not seamless (particularly during a pre-holiday rush), the experience of getting a COVID test now is very different from the beginning of the pandemic. Even then, testing is not perfect. Besides verifying that you didn't accidentally buy a fake COVID test kit, you have to then make sure you're doing the test correctly. But you're in the clear at that point, right?
In fact, when reading the instructions on your COVID test kit, you may have noticed a warning concerning biotin — a note that says taking a biotin supplement could interfere with your test results. Biotin (yes, the supplement known to boost hair, skin, and nail health) could potentially interfere with some tests for COVID-19, according to Michael Daignault, M.D. chief medical advisor at Reliant Health Services and practicing ER physician. To be clear, this isn't a new discovery, as, in 2017, the Food and Drug Administration (FDA) issued a warning that taking biotin supplements of more than 0.03 mg (or 30 mcg) could interfere with some types of lab test results.
So, should you be worried about the accuracy of your COVID test if you're routinely taking a biotin supplement? Don't toss out your biotin gummies (or that at-home COVID test) just yet. Below is everything you need to know about biotin and COVID testing and what the experts say you should do if you're taking biotin supplements and need to take a COVID-19 test. (More: Wait, Should You Swab Your Throat for COVID-19 Too?)
What Is Biotin, and How Is It Used In Lab Testing?
Biotin (aka vitamin B7) is an essential vitamin that is found in foods and supplements, especially those for hair, skin, and nails. Although there is no recommended dietary allowance (RDA) of biotin, there is a daily value (DV) of 30 mcg for adults, according to the National Institutes of Health (NIH). There is technically no upper limit (UI) level for biotin, but by most expert accounts, 5,000 mcg or more is considered high, according to Sharis M. Simonian, M.D. board-certified emergency physician, pediatric emergency care coordinator at Sollis Health. For reference, the amount of biotin you can find in supplements varies, but in general, the dose of biotin in a supplement is usually between 10-300mcg, according to the Harvard School of Public Health. Consuming high amounts of biotin is not known to be toxic, but research thus far has only looked into the safety for people with biotin deficiency taking a maximum of 200 mg a day specifically, according to the NIH.
Although biotin is a popular supplement for boosting hair, skin, and nail health, there is not a lot of research that backs up the claims that it's truly a wonder beauty supplement, according to Dr. Daignault. The research that has been done is inconclusive, although it is understood that those who are diagnosed as deficient in biotin, which doctors can detect via a blood or urine test, can experience negative effects on their hair, skin, or nails, according to Harvard School of Public Health.
To reiterate, taking high amounts of biotin could skew lab test results (including in-office and at-home COVID tests) because of the way some tests produce results, explains Dr. Daignault.
"Many lab tests use biotin technology due to its ability to bond with specific proteins which can be measured to detect certain health conditions," which can include heart disease and thyroid issues, says Dr. Daignault.
However, not all COVID-19 tests utilize biotin in this way.
How Biotin May Interfere with COVID Test Results
"There have been reports that certain blood COVID-19 antibody tests and rapid COVID antigen tests are affected by taking high doses of biotin and may lead to a false negative [or positive]," says Dr. Simonian. (Related: What You Need to Know About False Positive COVID-19 Test Results) Still, if you're taking a biotin supplement daily, the odds that it will affect your COVID test results, or any other lab test, is low unless you are taking a dose closer to 5,000 mcg, she says.
However, research on the matter can be conflicting or unclear at best, as "case reports [of biotin levels altering test results] showed people taking biotin amounts in doses commonly found in supplements (10-300 mg)," but there doesn't readily appear to be a specific maximum dosage that triggers a false test result, according to the Harvard School of Public Health.
The efficacy of test results is not just about verifying your current COVID status, as biotin could affect blood-based antibody tests to detect prior infection and immunology too, says Dr. Daignault.
However, since COVID-19 infection tests are nasal- or saliva-based, they may not be as sensitive to biotin levels in your body compared to a blood test, according to Dr. Daignault. "It's unlikely that there's sufficient biotin in the nose and mouth (if any at all) to alter either a rapid antigen or PCR test," he adds. (Related: Wait, Should You Swab Your Throat for COVID-19, Too?)
Should You Stop Taking Biotin If You're Worried About Your COVID-19 Test Results?
First, verify how much biotin you're taking in your supplements or multivitamin. Then, if you think it could be on the higher end of the admittedly complicated spectrum, consult with your doctor or pharmacist about which COVID test is best for you in order to provide the most accurate results, says Dr. Simonian
Know this: If your test does use biotin technology, the test manufacturer has to include a warning label on or with your test, says Dr. Daignault. "If a rapid antigen test uses biotin technology, the FDA requires it to conduct biotin interference testing; if there's a chance for that [biotin interfering with results], specific warning labels are required in the instructions," he explains. Since you won't see that warning until you buy a test and open the package, this is why it's useful to talk with a pharmacist beforehand.
What's more, you may not be in the clear if you're taking biotin and then stop right before you take a test either. "There is also insufficient evidence on whether stopping biotin supplement (or for how long) prior to doing a rapid antigen test will guarantee an accurate test," says Dr. Daignault. "If you want to err on the side of caution, though, my advice for those who take high amounts of biotin is to simply avoid rapid antigen tests that include biotin technology."
TL;DR, unless you are taking very high doses of biotin, you shouldn't be too worried about test accuracy. But if you're concerned at all, seek out a test that you feel confident doesn't use biotin technology, and double-check that with the test company, your doctor, or pharmacist to be safe.
The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it's possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.