Biotin for Hair Loss May Skew Critical Cancer Labs

As an oncodermatologist at The Ohio State University Wexner Medical Center, Brittany Dulmage, MD, specializes in managing the complex hair, skin, and nail adverse effects that arise from cancer therapies. In her clinical practice, she frequently treats patients experiencing significant hair loss—a common and distressing byproduct of chemotherapy and long-term hormonal medications, such as those used to treat breast cancer. For many of these patients, restoring hair growth becomes a primary goal of their recovery.

The Misconception of Biotin Efficacy

Dulmage observes a growing trend where patients, in an attempt to self-manage their hair loss, turn to over-the-counter hair, skin, and nail vitamins. Most of these supplements utilize biotin as their primary active ingredient. However, she highlights a critical disconnect between marketing and medicine: the American Academy of Dermatology (AAD) has issued a position statement urging caution regarding biotin. According to Dulmage, there is very little clinical evidence to suggest that biotin effectively promotes hair regrowth in patients whose hair loss is triggered by cancer treatment.

The Risk of Lab Interference

Beyond its lack of efficacy, biotin poses a specific, under-recognized danger to oncology patients. Dulmage explains that biotin can interfere with the accuracy of blood tests, particularly those measuring hormone levels. Crucially, the vitamin does not physically alter the patient’s internal hormone levels; rather, it interferes with the chemical reagents used inside the laboratory testing equipment. This interaction can skew results, producing falsely high or falsely low readings.

For patients with cancer, this interference is particularly high-stakes. Oncologists rely on these lab results to:

• Assess how a patient is responding to therapy.
• Monitor for toxic side effects.
• Make critical decisions regarding future treatment protocols.

Addressing the Awareness Gap

Research conducted in Dulmage’s lab underscores the scale of this issue. A study of over 200 patients in online support groups revealed that while supplements are the most common self-prescribed remedy for hair loss, only 6% of those patients actually consulted a dermatologist.

Furthermore, Dulmage notes a significant lack of awareness among general medical oncologists. Because biotin is a naturally occurring B vitamin found in most diets (including vegetarian and vegan diets), many physicians view it as a "low-risk" or "safe" suggestion. However, the high doses found in supplements far exceed what is necessary for health and lead to the aforementioned diagnostic errors. Dr. Dulmage emphasizes the need for better communication between dermatologists, oncologists, and patients to ensure that hair loss treatments do not inadvertently compromise the integrity of cancer care.

Read the full interview with Dr Dulmage here.