Samih Abed Odhaib
Faihaa Specialized Diabetes Endocrine and Metabolism Center, Iraq
Title: How biotin induces thyroid function tests misleading results: case series
Biography
Biography: Samih Abed Odhaib
Abstract
Introduction: We present four cases that show a misleading increase in the thyroid function test towards a false diagnosis of Grave's disease after biotin administration of 20-30 mg for different periods, although all patients are free of signs and symptoms of hyperthyroidism, and all the results returned to normal after biotin withdrawal within 24-48 hours.
Case 1: A 23-year-old female was diagnosed as Grave's disease after a routine checking after she ingested prescribed 20 mg biotin per day for three months for excessive hair fall.
Case 2: A 19-year-old female with hair and nail problems associated with iron deficiency anemia. She had self-prescribed biotin dose of 20 mg a day for a month. She asked an endocrinologist opinion about a recent increase in her thyroid function tests, yet no signs of hyperthyroidism were found.
Case 3: A 45-year-old man with subtotal thyroidectomy for a retrosternal multinodular goiter with compressive symptoms, his usual levothyroxine dose had been decreased from 100 to 50 microgram per day, after which he felt unwell and gained four kilograms with signs and symptoms of hypothyroidism. His investigations were consistent with hyperthyroidism while his signs were of hypothyroidism which was illogical. He administered 30 mg medically prescribed biotin for a recent mild psoriasis nail changes.
Case 4: The author himself volunteered to take 30 mg of biotin daily for one week. His initial investigations were normal but changed within this period to be Grave's disease-like, with no signs or symptoms to be felt.