What medication should not be taken with biotin?

January 6, 2026 •

3 min read

According to the FDA, high-dose biotin can significantly interfere with certain laboratory tests, causing potentially dangerous misdiagnoses, particularly for critical tests like troponin for heart attacks. It is critical to know what medication should not be taken with biotin to ensure accurate test results and overall health.

Quick Summary

High-dose biotin interferes with critical lab tests for heart and thyroid function, potentially leading to misdiagnosis. Certain medications, including anticonvulsants and some antibiotics, can lower your body's biotin levels.

Key Points

Lab Test Interference: High-dose biotin can cause falsely high or low results in critical lab tests, particularly for heart and thyroid function, potentially leading to misdiagnosis.
Anticonvulsants Deplete Biotin: Long-term use of certain anti-seizure medications like phenytoin and phenobarbital can lower your body's biotin levels.
Antibiotics Impact Gut Production: Prolonged use of broad-spectrum antibiotics can disrupt the gut bacteria that naturally produce biotin, potentially leading to lower levels.
Raw Eggs and Alcohol Affect Absorption: Consuming raw egg whites or excessive alcohol can inhibit the absorption and utilization of biotin.
Inform Your Healthcare Provider: Always disclose all supplements, including biotin, to your doctor and lab technicians, especially before blood draws for diagnostic tests.
Discontinue Biotin Before Tests: For accurate lab results, it is often necessary to stop taking biotin supplements for at least 72 hours, depending on the dosage.

The Critical Concern: Biotin and Lab Test Interference

While not technically a direct drug-biotin interaction in the body, the most significant risk associated with high-dose biotin supplementation involves its interference with laboratory tests. This is a serious concern that the U.S. Food and Drug Administration (FDA) has highlighted in a safety communication. Many common and critical lab tests use a biotin-streptavidin system to capture the substance being measured. When excess biotin from supplements is present in a blood sample, it can saturate the streptavidin, leading to inaccurate test results.

Lab Tests Affected by High-Dose Biotin

The most commonly affected tests include:

Cardiac Troponin (cTn): A key biomarker for diagnosing a heart attack. High biotin levels can cause a falsely low troponin result, potentially leading to a missed or delayed diagnosis.
Thyroid Function Tests (TFTs): Biotin can cause falsely low Thyroid-Stimulating Hormone (TSH) and falsely high free thyroxine (T4) and free triiodothyronine (T3) levels. This can mimic Graves' disease (hyperthyroidism) and lead to unnecessary treatment.
Other Hormone Tests: This includes tests for Parathyroid Hormone (PTH), Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), and Vitamin D.

How to Prevent Lab Test Interference

To prevent misdiagnosis, it is essential to inform your doctor and lab technicians about any biotin supplements you are taking. For low doses, you may need to stop taking biotin for at least 8 hours before a blood draw, while for high mega-doses, abstinence for 72 hours or more is recommended.

Interactions with Anticonvulsant Medications

Beyond lab tests, certain medications can impact your body's biotin levels. Long-term use of specific anticonvulsant drugs, which are used to treat seizures and epilepsy, can significantly lower blood biotin levels. These medications are believed to accelerate the metabolism and breakdown of biotin, leading to a potential deficiency. In such cases, supplementation may be necessary, but it should be managed under a doctor's supervision.

Anticonvulsants that can affect biotin levels include:

Carbamazepine (e.g., Tegretol)
Phenobarbital
Phenytoin (e.g., Dilantin)
Primidone (e.g., Mysoline)

The Effect of Antibiotics on Biotin Levels

Chronic or long-term use of certain antibiotics can affect the gut bacteria responsible for producing biotin naturally. By disrupting the normal intestinal flora, these drugs can lead to a decrease in the body's intrinsic biotin production. This does not mean you should avoid antibiotics, but rather be aware of this potential side effect, especially during prolonged courses. Discussing supplementation with your healthcare provider may be wise if you are on long-term antibiotic therapy.

Other Substances and Potential Interactions

Dietary and Lifestyle Factors

Raw Egg Whites: Contain a protein called avidin that binds to biotin, preventing its absorption in the gut. Consuming raw egg whites excessively could lead to a biotin deficiency. Cooking the eggs denatures the avidin, eliminating this risk.
Alcohol: Chronic, excessive alcohol consumption can interfere with the absorption and metabolism of biotin.
Alpha-Lipoic Acid: This dietary supplement competes with biotin for the same transporters in the body, which may decrease the levels of certain biotin-dependent enzymes.

Key Medications and Their Impact on Biotin


Medication/Substance	Type of Interaction	Effect on Biotin or Lab Tests	Management Strategy
High-Dose Biotin	Lab Test Interference	Causes falsely high or low lab results, especially for thyroid and troponin tests.	Stop supplementation 72+ hours before blood draw; inform doctor.
Anticonvulsants (e.g., Phenytoin)	Nutrient Depletion	Lowers biotin levels by increasing metabolism.	May require biotin supplementation; discuss with doctor.
Antibiotics (Prolonged Use)	Gut Flora Disruption	Decreases biotin production by beneficial gut bacteria.	Consider biotin supplementation under medical guidance.
Raw Egg Whites	Absorption Inhibition	Avidin protein binds to biotin, preventing its absorption.	Cook eggs thoroughly to prevent binding.
Alcohol (Chronic)	Absorption/Metabolism	Interferes with biotin utilization in the body.	Reduce alcohol intake; maintain balanced diet.

Conclusion: Prioritizing Patient Safety

Understanding which medications and substances can interact with biotin is vital for patient safety. While direct pharmacological interactions are less common, the significant risk posed by high-dose biotin supplements to laboratory test accuracy demands serious attention. Individuals taking long-term anticonvulsants or extended courses of antibiotics should also be mindful of potential biotin deficiency. The core takeaway is to always disclose all supplements to your healthcare providers, especially before undergoing any lab tests. This proactive approach helps prevent misdiagnosis and ensures effective, safe medical treatment. For more information on the FDA's safety communication regarding biotin and lab tests, visit their website FDA Safety Communication.

Frequently Asked Questions

Yes, standard multivitamins typically contain low doses of biotin that are unlikely to cause significant lab test interference or other interactions. However, if you are also taking a separate, high-dose biotin supplement, you should be mindful of potential lab test interference.

Several anticonvulsant drugs, including carbamazepine, phenytoin, phenobarbital, and primidone, have been shown to deplete biotin levels with long-term use. Valproic acid may have a lesser effect but can still impact biotin status.

For accurate lab results, experts recommend stopping biotin intake. For low doses, this might be 8 hours, but for high mega-doses (e.g., 5mg or more), abstaining for at least 72 hours is recommended before a blood draw.

Prolonged use of antibiotics can disrupt the balance of your intestinal flora, including the beneficial bacteria that naturally produce biotin. This can lead to a decrease in the body's total biotin levels.

No, consuming raw egg whites is not recommended when taking biotin supplements or trying to increase your biotin intake. Raw egg whites contain avidin, a protein that binds to biotin and prevents its absorption in your body. Cooking the eggs denatures the avidin.

The primary danger is misdiagnosis based on inaccurate test results. For example, a falsely low troponin level could cause a doctor to miss a heart attack diagnosis, while skewed thyroid test results could lead to inappropriate treatment for a thyroid condition.

If you remember after the fact, inform your healthcare provider immediately. They can re-evaluate your test results in light of the potential biotin interference and may order a re-test if necessary.