Background: Shifts in consumer behavior and clinical practice have increased reports of biotin interference in immunoassays that incorporate biotin-streptavidin linkages in their design. This rise has significant implications because immunoassays are used to measure a wide range of analytes across medical specialties. The objective of this article was to review the mechanisms of biotin interference, define the scope of affected immunoassays, and summarize strategies for identifying and minimizing biotin interference in clinical samples. Content: The literature was reviewed for reports of biotin interference and sorted by manufacturer. Abstracts from recent scientific meetings and manufacturer-provided data were also reviewed. Summary: Immunoassays across a range of different manufacturer platforms are subject to interference by exogenous biotin supplementation. Providers and laboratorians must be aware of this potential interference to avoid patient harm.

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