Vitamin B12 (Cobalamin) Deficiency in Overt and Subclinical Primary Hypothyroidism

Mohamed Aon; Sherif Taha; Khaled Mahfouz; Mohamed M Ibrahim; Ahmed H Aoun

doi:10.1177/11795514221086634

Vitamin B12 (Cobalamin) Deficiency in Overt and Subclinical Primary Hypothyroidism

Clin Med Insights Endocrinol Diabetes. 2022 Mar 22:15:11795514221086634. doi: 10.1177/11795514221086634. eCollection 2022.

Authors

Mohamed Aon¹, Sherif Taha^{1

2}, Khaled Mahfouz², Mohamed M Ibrahim^{3

4}, Ahmed H Aoun⁵

Affiliations

¹ Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt.
² Department of Internal Medicine, Jahra Hospital, Jahra, Kuwait.
³ Department of Clinical Pharmacology, Jahra Hospital, Jahra, Kuwait.
⁴ Department of Clinical Pharmacology, 6th October University, 6th October city, Egypt.
⁵ Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt.

Abstract

Background: B12 (cobalamin) deficiency has been reported in hypothyroid patients with variable prevalence rates thus routine screening of hypothyroid patients was recommended by some and discouraged by others. We aimed to assess the prevalence of B12 deficiency among hypothyroid patients and to evaluate for pernicious anemia and celiac disease as etiologies.

Methods: A total 133 patients were included. Thyroid hormones and thyroid peroxidase (TPO) autoantibodies were measured. Serum B12 was measured and if deficient, intrinsic factor antibodies (IFAB) and tissue transglutaminase (tTG) antibodies were evaluated.

Results: Our study included 45 patients with overt hypothyroidism (OH), 48 patients with subclinical hypothyroidism (SCH), and 40 patients as controls. Mean age was 34.3 years and 82% were females. TPO antibodies were positive in 73.5% of OH and 51.1% of SCH patients. B12 deficiency was detected in 33.3%, 47.9%, and 37.5% of OH, SCH, and controls, respectively with no significant difference (P = .334). Borderline-to-low B12 level was more prevalent in the OH and the SCH groups compared to controls (68.9%, 85.4%, and 57.5%, respectively; P = .014). Among B12-deficient hypothyroid patients, 7.5% had positive IFAB and 13.3% had positive tTG antibodies. We did not find a significant association of TPO positivity and B12 deficiency (OR, 0.69; 95% CI 0.3-1.57; P = .147).

Conclusion: We did not find a higher prevalence of B12 deficiency among hypothyroid patients nor an association with TPO positivity. Borderline B12 levels were more prevalent among hypothyroid patients.

Keywords: Vitamin B12 deficiency; celiac disease; hypothyroidism; pernicious anemia; subclinical hypothyroidism.