Management of Hyperandrogenism Confounded by Dermatology Biotin Prescriptions

The document highlights the issue of biotin interference in immunoassays, particularly affecting the diagnosis of hyperandrogenism. A case study of a 28-year-old woman with acne, hirsutism, and hair loss showed that biotin supplementation led to falsely elevated testosterone and insulin levels, complicating her diagnosis. After stopping biotin, her hormone levels normalized, revealing the interference. The paper stresses the importance of clinicians being aware of biotin's potential to skew test results and recommends discontinuing biotin before testing to prevent misdiagnosis. It also discusses the management of hyperandrogenism, emphasizing the differentiation between ovarian and adrenal androgen-secreting neoplasms and the role of imaging studies in diagnosis.