Hey #MedTwitter,
An asymptomatic patient came to the outpatient clinic because of low TSH, high fT4/T3, and positive TRAb
Final diagnosis: Biotin supplement use🤔
Follow the 🧵
#Endotip #MedEd
An asymptomatic patient came to the outpatient clinic because of low TSH, high fT4/T3, and positive TRAb
Final diagnosis: Biotin supplement use🤔
Follow the 🧵
#Endotip #MedEd
Biotin supplements are commonly used and do not change thyroid function.
On the other hand, biotin often causes lab assay interference mimicking Graves' disease:
⬇️ TSH
⬆️ fT4 and T3
⬆️ TRAb
On the other hand, biotin often causes lab assay interference mimicking Graves' disease:
⬇️ TSH
⬆️ fT4 and T3
⬆️ TRAb
TRAb is a marker of Graves' disease, the most common cause of thyrotoxicosis/hyperthyroidism, and has a high accuracy :
- Sensitivity: ~ 97%
- Specificity: ~ 99%
📢Beware that despite high reliability, TRAb result can be falsely elevated in the setting of biotin use
- Sensitivity: ~ 97%
- Specificity: ~ 99%
📢Beware that despite high reliability, TRAb result can be falsely elevated in the setting of biotin use
How to deal with it?
This biotin effect lasts for only a few hours.
📢Recommend your patients who will have thyroid function assessment not to take biotin for 2 days!
👊👊
This biotin effect lasts for only a few hours.
📢Recommend your patients who will have thyroid function assessment not to take biotin for 2 days!
👊👊
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