Serum Vitamin B12 and Folic Acid Levels in Hyperthyroidism

Gyftaki Helen; Matina Kesse-Elias; D. Koutras; P. Pandos; S. Papazoglou; S. Moulopoulos

doi:10.1055/s-0037-1620915

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1979; 18(06): 278-282
DOI: 10.1055/s-0037-1620915

Originalarbeiten – Original Articles

Schattauer GmbH

Serum Vitamin B₁₂ and Folic Acid Levels in Hyperthyroidism

Serum-Vitamin Bu und Folsäure-Spiegel bei der Hyperthyreose

Gyftaki Helen

¹ From the University Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece

,

Matina Kesse-Elias

¹ From the University Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece

,

D. Koutras

¹ From the University Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece

,

P. Pandos

¹ From the University Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece

,

S. Papazoglou

¹ From the University Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece

,

S. Moulopoulos

¹ From the University Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece

› Author Affiliations

Abstract

Summary

Serum vitamin B₁₂ and folic acid levels were measured in 48 hyperthyroid patients and in a group of euthyroid controls. The levels of vitamin B₁₂ ranged from 120-900 pg/ml with a mean of 429.3 ± 30.9 pg/ml (SE). The mean serum vitamin B ? level was lower in hyperthyroid patients than in normal controls, the difference being statistically significant (t = 2.584, p < 0.025). Serum vitamin B₁₂ levels showed a statistically significant negative correlation with the clinical index of Grooks et al. (r = 0.344, p < 0.05). The findings, although not excluding the involvement of auto-immune gastritis in patients with low serum vitamin B₁₂ levels, suggest a direct action of increased thyroid hormone concentrations. Serum folic acid levels ranged from 0.5- 13.8 ng/ml with a mean of 6.8 ± 0.46 ng/ml (SE). The mean serum folic acid levels were higher in the hyperthyroid patients than in normal controls but the difference was not statistically significant (t = 1.2, p > 0.2). The serum folic acid levels did not show any statistically significant correlation with the clinical index of Grooks et al. The fact that no statistically significant difference was found between the mean value in hyperthyroid patients and the mean value in normal controls is probably due to the high folic acid intake in Greece.

Zusammenfassung

Bei 48 hyperthyreoten Patienten und bei einer Gruppe von Kontrollpersonen wurde das Vitamin B₁₂ im Serum bestimmt. Die Vitamin B₁₂-Werte schwankten zwischen 120 und 900 pg/ml, mit einem Mittelwert von 429,3 ± 30,9 pg/ml (SE). Der Mittelwert des Vitamin B₁₂-Spiegels war bei hyperthyreoten Patienten niedriger als bei der Kontrollgruppe. Der Unterschied ist statistisch signifikant (t = 2,584, p < 0,025). Die Serum-Vitamin B₁₂-Werte wiesen eine statistisch signifikante negative Korrelation mit dem klinischen Index nach Grooks et al. auf (r = 0,344, p < 0,05). Die Ergebnisse sprechen für eine direkte Wirkung einer erhöhten Schilddrüsenhormonkonzentration, trotzdem kann man das Vorhandensein einer auto-immunen Gastritis bei Patienten mit niedrigem Vitamin B₁₂-Spiegel nicht ausschließen. Die Folsäurespiegel schwankten zwischen 0,5-13,8 ng/ml mit einem Mittelwert von 6,8 ± 0,46 ng/ml (SE). Der Mittelwert der Folsäure im Serum war bei den hyperthyreoten Patienten höher als bei der Kontrollgruppe. Der Unterschied war statistisch nicht signifikant (t = 1,2, p > 0,2). Der Wert der Folsäure im Serum zeigte keine statistisch signifikante Korrelation mit dem klinischen Index nach Grooks et al. Da statistisch kein signifikanter Unterschied zwischen den Mittelwerten der beiden Gruppen nachgewiesen werden konnte, nehmen wir an, daß dies die Folge einer erhöhten Folsäure-Aufnahme in Griechenland ist.

Full Text

References

References
1 Alperin J B, Haggard ME, Haynie TP. A study of vitamin B12 requirements in a patient with pernicious anaemia and thyrotoxicosis: Evidence of an increased need for vitamin B12 in the presence of hyperthyroidism. Blood 36: 632 1970;
2 Chanarin I. The Megaloblastic Anaemias. Blackwell Scientific Publications, Oxford 1969.
3 Doniach D, Roit IM, Taylor KB. Autoimmune phenomena in pernicious anemia. Serological overlap with thyrotoxicosis and systemic lupus erythematosus. Brit. med. J. 1: 1374 1963;
4 Doniach D, Roit IM. In: Clinical Aspects of Immunology (Eds.: Gell, P. G. H., and R. R. A. Coomba) p. 611, Oxford 1963.
5 Grooks J, Murray CIP, Wagne EJ. Statistical methods applied to the clinical diagnosis of thyrotoxicosis. Quart. J. Med. 28: 211 1959;
6 Gyftaki H, Loukopoulos D, Kesse-Elias M, Alevizou-Terzaki V. Estimation of serum folic acid with competitive protein-binding method in beta-thalassaemia. In: Radioimmunoassay and Related Procedures in Medicine, Vol. II, p. 201. International Atomic Energy Agency, Vienna 1974.
7 Lindenbaum J, Klipstein FA. Folic acid clearance and basel serum folate levels in patients with thyroid disease. J.clin. Path. 17: 666 1964;
8 Mantzos J. Radioassay of serum folate with pig plasma folate binders. Acta Haemat. 54: 289 1975;
9 Mantzos J, Gyftaki H, Alevizou V. Isotopic determination of serum vitamin B12 level using sephadex G-25. Nucl.- Med. VI: 311 1967;
10 Mohamed S D, Roberts M. Abnormal histidine metabolism in thyrotoxicosis in man. A possible index of impaired folate function. Lancet 2: 933 1965;
11 Rigas A N, Wilson EA, Montgomery DAD. Folic acid metabolism in thyroid disease. Int. J. med. Sci. 1: 255 1968;
12 Rousso C, Cruchaud A. Pernicious anemia. I. Clinical study of 54 cases, with special reference to associated diseases. Helv. med. Acta 33: 175 1966;
13 Sharpstone P, James DG. Pernicious anaemia and thyrotoxicosis in a family. Lancet 1: 246 1966;
14 Wangel A G, Callender ST, Spray GH, Wright R. A family study of pernicious anemia. I. Autoantibodies, achlorhydria, serum pepsinogen and vitamin B,2. Brit. J. Haemat. 14: 161 1968;
15 Williams M J, Scott GB, Back JS, Blair DW. Antigastric antibodies in hyperthyroidism: Their relationship to impaired acid secretion. Brit. med. J. 1: 388 1966;