October - December 2010, Volume 6, Issue 4

Purice M, Ursu IH, Baicus C, Goldstein A, Niculescu DA

Hyperhomocysteinemia in moderate and severe hypothyroidism

Acta Endo (Buc) 2010, 6 (4): 431-442
doi: 10.4183/aeb.2010.431

The aim of the study was to evaluate the prevalence of hyperhomocysteinemia in hypothyroid patients and the effect of folic acid supplementation when serum homocysteine\r\n(Hcy) was over risk level.\r\nPatients and methods. Patients with moderate (Group1) and severe hypothyroidism (Group 2) were evaluated before any therapy and after 6 months of combined folic acid and\r\nlevothyroxine substitution, versus control subjects. Hcy, folic acid, thyroid hormones and lipids were measured for all subjects. Thyroglobulin and antithyroglobulin antibodies were measured only for Group 2.\r\nResults. Only 17 % of the cases had basal Hcy at non risk level (<10 mmol/L). Both groups had higher Hcy levels than control (p <0.0001). In Group 1 basal folic acid was lower\r\nthan in control and group 2 (p<0.001). No correlation was found between high levels of Hcy (> 12 mmol/L ) and positive thyroglobulin. After 3 months of combined therapy, significant decrease of Hcy (p<0.0001) was observed compared with the basal level. Normalization of\r\nHcy appears during next 3 months even with reducing the folic acid supplementation.\r\nConclusion. Our results report moderate hyperhomocysteinemia in hypothyroid patients. This may exacerbate the cardiovascular risk traditionally attributed to lipid changes. Six months of combined therapy (L-thyroxine and folic acid) corrected hyperhomocysteinemia excluding the additional risk.

Keywords: hyperhomocysteinemia, folic acid, hypothyroidism, risk factor

Correspondence: Mariana Purice, PhD, ?C.I.Parhon? National Institute of Endocrinology - Nuclear Medicine and Endocrine Tumors, Bd. Aviatorilor nr 34-36 Bucharest 011863, Romania, Tel: +40 723658763 Fax: +4021 3170515 Email: mariana.purice@gmail.com