Document Detail

Vitamin B12 deficiency common in primary hypothyroidism.
MedLine Citation:
PMID:  18655403     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the prevalence and clinical features of B12 deficiency in hypothyroid patients and to evaluate clinical response in symptoms to B12 replacement therapy. METHODS: One hundred and sixteen hypothyroid patients from our endocrine clinic were evaluated for signs and symptoms of vitamin B12 deficiency. Laboratory parameters including Haemoglobin (Hb), MCV, Vitamin B12 levels and presence of anti thyroid antibodies were analyzed. Patients with low B12 levels were treated with parenteral intramuscular vitamin B12 monthly, and monitored for improvement of symptoms. RESULTS: A total of 116 patients (95 females and 21 males) were evaluated. Forty six (39.6%) hypothyroid patients had low vitamin B12 levels. Males and females had the same prevalence of B12 deficiency. Generalized weakness, impaired memory, depression, numbness and decreased reflexes were more frequently noted in B12 deficient patients, but failed to achieve statistical significance when compared with B12 sufficient patients. The mean Hb in B12 deficient group was 11.9 +/- 1.6 mg/dl and 12.4 +/- 1.7 mg/dl in the B12 sufficient group, however the mean MCV did not differ in the two groups. Patients with B12 deficiency did not have a higher prevalence of anaemia. Thyroid antibodies were checked in half the patients and 67% had positive titers for anti thyroid antibodies. Prevalence of vitamin B12 deficiency did not differ in patients with positive antibodies (43.2%) compared to those with negative antibodies (38.9%) (p= 0.759). Twenty four hypothyroid patients with B12 deficiency received intramuscular vitamin B12 injections monthly and improvement in symptoms was noted in 58.3% of these subjects. Additionally, 21 subjects complained of symptoms consistent with B12 deficiency but who had normal range B12, levels and were prescribed monthly B12 injections and 8 (40%) had good subjective clinical response at 6 months. CONCLUSIONS: There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration.
Abdul Jabbar; Aasma Yawar; Sabiha Waseem; Sabeha Wasim; Najmul Islam; Naeem Ul Haque; Lubna Zuberi; Ataullah Khan; Jaweed Akhter
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JPMA. The Journal of the Pakistan Medical Association     Volume:  58     ISSN:  0030-9982     ISO Abbreviation:  J Pak Med Assoc     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-09-02     Revised Date:  2009-03-05    
Medline Journal Info:
Nlm Unique ID:  7501162     Medline TA:  J Pak Med Assoc     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  258-61     Citation Subset:  IM    
Department of Medicine, Aga Khan University, Karachi, Pakistan.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Hypothyroidism / blood,  complications*
Injections, Intramuscular
Middle Aged
Pakistan / epidemiology
Retrospective Studies
Vitamin B 12 / administration & dosage*,  pharmacokinetics
Vitamin B 12 Deficiency / drug therapy,  epidemiology*,  etiology
Vitamin B Complex / administration & dosage*,  pharmacokinetics
Reg. No./Substance:
12001-76-2/Vitamin B Complex; 68-19-9/Vitamin B 12
Erratum In:
J Pak Med Assoc. 2009 Feb;59(2):126
Note: Wasim, Sabeha [corrected to Waseem, Sabiha]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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