DOI: http://dx.doi.org/10.18203/2349-3933.ijam20194240

A study of anemia in hypothyroidism with reference to vitamin B12 deficiency

Palak Bhuta, Amit Shah, Arti Muley

Abstract


Background: Hypothyroidism is the most common of thyroid disorders in India. Anemia and hypothyroidism often occur simultaneously. Only few studies have assessed the role of vitamin B12 deficiency in this anemia. So, we planned this study to assess prevalence of anemia in hypothyroidism and to see if there is any association between vitamin B12 deficiency and anemia in these patients.

Methods: It was an observational study. All hypothyroid patients attending the medicine OPD or admitted to medicine wards were enrolled for the study. Total 60 patients were included. Data was analyzed to assess the burden of anemia and B12 deficiency in hypothyroid and to find out any correlation between TSH level, anemia and vitamin B12 deficiency.).

Results: About one third of hypothyroid had decreased vitamin B 12 levels. TSH level showed significant positive correlation with hemoglobin value. 28% of the hypothyroid patients had vitamin b12 deficiency, but TSH levels itself did not correlate with vitamin B12 level. However, it was seen that those who had combined thyroid and B12 deficiency had significantly higher chances of developing generalized swelling and breathlessness.

Conclusions: Although there is no correlation between TSH level and B12 deficiency, it may be helpful to determine B12 level in hypothyroid patients who present with anemia, generalized swelling and/or breathlessness as B12 supplementation may give better symptomatic relief in them as compared to treating with thyroxine alone. More elaborative studies with larger sample size are required to explore this rather unattended relation of anemia in hypothyroidism with B12 deficiency.


Keywords


Anaemia, Hypothyroidism, Vitamin B12

Full Text:

PDF

References


Bagcchi S. Hypothyroidism in India: more to be done. The Lancet Diabetes Endocrinol. 2014 Oct 2;2(2):778.

Kosenli A, Erdogan M, Ganidagli S, Kulaksizoglu M, Solmaz S, Kosenli O, et al. Anemia frequency and etiology in primary hypothyroidism. In 11th European Congress of Endocrinol. 2009 Apr 1;20. Bio Scientifica.

Omar S, Hadj ST, Kanoun F, Hammami MB, Kamoun S, Ben NR, et al. Erythrocyte abnormalities in thyroid dysfunction. La Tunisie Medicale. 2010 Nov;88(11):783-8.

Mehmet E, Aybike K, Ganidagli S, Mustafa K. Characteristics of anemia in subclinical and overt hypothyroid patients. Endocrine J. 2012;59(3):213-20.

Jabbar A, Yawar A, Waseem S, Islam N, Ul Haque N, Zuberi L, et al. Vitamin B12 deficiency common in primary hypothyroidism. J Pak Med Associ. 2008;58(5):258.

Iddah MA, Macharia BN. Thyroid Hormones and Hematological Indices Levels in Thyroid Disorders Patients at Moi Teaching and Referral Hospital Western Kenya. ISRN Endocrinol; 2013;6:385940.

Colon-Otero G, Menke D, Hook CC. A practical approach to the differential diagnosis and evaluation of the adult patient with macrocytic anemia. Med Clin North Am. 1992;76:581.

Kawa MP, Grymuła K, Paczkowska E, Baśkiewicz-Masiuk M, Dąbkowska E, Koziołek M, et al. Clinical relevance of thyroid dysfunction in human haematopoiesis: biochemical and molecular studies. European J Endocrinol. 2010 Feb 1;162(2):295-305.

Ladenson PW, Goldenheim PD, Ridgway EC. Prediction and reversal of blunted ventilatory responsiveness in patients with hypothyroidism. Am J Med. 1988;84:877.

Jabbar A, Yawar A, Wasim S et al. Vitamin B12 deficiency common in primary hypothyroidism. J Pak Med Assoc. 2008;58(5):258.

Hussain WI, Green R, Jacobsen DW. Normalisation of hyperhomcysteine and L thyroxine in hypothyroidism. Ann Int Med. 1999;131:348-51.

Lien EA, Nedrebo BG, Varhang JE. Plasma total homocysteine levels during short term iatrogenic hypothyroidism. J Clin Endo Metab. 2000;85:1049-53.