JMERC
Owner
Janbazan Medical and Engineering Research Center (JMERC) is the owner of IJWPH.
1.0
Cite Score 2025
SJR: 0.129 / SNIP: 0.140
Volume 18, Issue 2 (2026)
Iran J War Public Health 2026, 18(2): 235-241 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2026/06/16 | Accepted: 2026/08/3 | Published: 2026/08/8
Received: 2026/06/16 | Accepted: 2026/08/3 | Published: 2026/08/8
How to cite this article
Tahir N, ALShaban S, Akram R, Shalgam D, Ammar Waham Ashor A, Alrubaye H. Comparison of Vitamin B12 Levels between Diabetic Patients with and without Hypothyroidism. Iran J War Public Health 2026; 18 (2) :235-241
URL: http://ijwph.ir/article-1-1804-en.html
URL: http://ijwph.ir/article-1-1804-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Authors
N.T. Tahir *1, S.A.W. ALShaban2, R.S. Akram2, D.O. Shalgam1, A.W. Ammar Waham Ashor3, H.D. Alrubaye3
1- National Diabetes Center, Mustansiriyah University, Baghdad, Iraq
2- Department of Chemistry and Biochemistry, Faculty of Medicine, Mustansiriyah University, Baghdad, Iraq
3- Department of Internal Medicine, Faculty of Medicine, Mustansiriyah University, Baghdad, Iraq
2- Department of Chemistry and Biochemistry, Faculty of Medicine, Mustansiriyah University, Baghdad, Iraq
3- Department of Internal Medicine, Faculty of Medicine, Mustansiriyah University, Baghdad, Iraq
Abstract (233 Views)
Aims: This study aimed to assess vitamin B12 levels in Iraqi participants in three groups: those with type 2 diabetes mellitus and hypothyroidism, those with type 2 diabetes mellitus without hypothyroidism, and healthy individuals.
Materials & Methods: This comparative cross-sectional study included 90 participants divided into three equal groups: patients with type 2 diabetes and hypothyroidism, patients with type 2 diabetes without hypothyroidism, and healthy controls. Demographic data and blood samples were collected from all participants after obtaining informed consent. Thyroid function, glycemic status, lipid profile, renal function, and vitamin B12 levels were assessed using standardized automated analyzers.
Findings: Age did not differ significantly among the groups (p=0.104), whereas participants with type 2 diabetes—particularly those with hypothyroidism—had higher body mass index, fasting blood sugar, HbA1c, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and thyroid-stimulating hormone levels and lower high-density lipoprotein cholesterol, TT3, and TT4 levels than controls. Mean vitamin B12 levels were significantly lower in participants with type 2 diabetes and hypothyroidism (202±31ng/mL) and type 2 diabetes without hypothyroidism (264±42ng/mL) than in controls (460±99ng/mL; p=0.0001). Vitamin B12 levels were inversely correlated with body mass index, Fasting blood sugar, HbA1c, total cholesterol, triglycerides, and thyroid-stimulating hormone (all p≤0.0001) but positively correlated with age (p=0.0001) and TT3 (p=0.001). Correlations between vitamin B12 and high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and TT4 were not statistically significant.
Conclusion: Vitamin B12 deficiency is more prevalent among diabetic patients with hypothyroidism
Materials & Methods: This comparative cross-sectional study included 90 participants divided into three equal groups: patients with type 2 diabetes and hypothyroidism, patients with type 2 diabetes without hypothyroidism, and healthy controls. Demographic data and blood samples were collected from all participants after obtaining informed consent. Thyroid function, glycemic status, lipid profile, renal function, and vitamin B12 levels were assessed using standardized automated analyzers.
Findings: Age did not differ significantly among the groups (p=0.104), whereas participants with type 2 diabetes—particularly those with hypothyroidism—had higher body mass index, fasting blood sugar, HbA1c, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and thyroid-stimulating hormone levels and lower high-density lipoprotein cholesterol, TT3, and TT4 levels than controls. Mean vitamin B12 levels were significantly lower in participants with type 2 diabetes and hypothyroidism (202±31ng/mL) and type 2 diabetes without hypothyroidism (264±42ng/mL) than in controls (460±99ng/mL; p=0.0001). Vitamin B12 levels were inversely correlated with body mass index, Fasting blood sugar, HbA1c, total cholesterol, triglycerides, and thyroid-stimulating hormone (all p≤0.0001) but positively correlated with age (p=0.0001) and TT3 (p=0.001). Correlations between vitamin B12 and high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and TT4 were not statistically significant.
Conclusion: Vitamin B12 deficiency is more prevalent among diabetic patients with hypothyroidism
Keywords:
Diabetes Mellitus [MeSH], Hypothyroidism [MeSH], Lipids [MeSH], Thyroid Function Test [MeSH], Vitamin B12 [MeSH]
References
1. Tahir NT, Falih IQ, Alkubaisi MR, Alabdaly AR. Apelin as a potential marker in Iraqi children with type 1 diabetes mellitus. J Contemp Med Sci. 2023;9(6):408-12. [Link] [DOI:10.22317/jcms.v9i6.1425]
2. Isaa MQ, Tahir NT. Effect of apelin level in Iraqi diabetic women with hypothyroidism. POLSKI MERKURIUSZ LEKARSKI. 2025;53(2):218-21. [Link] [DOI:10.36740/Merkur202502110]
3. Taheriniya S, Arab A, Hadi A, Fadel A, Askari G. Vitamin D and thyroid disorders: A systematic review and meta-analysis of observational studies. BMC Endocr Disord. 2021;21(1):171. [Link] [DOI:10.1186/s12902-021-00831-5]
4. Benites-Zapata VA, Ignacio-Cconchoy FL, Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcón-Braga EA, Al-Kassab-Córdova A, et al. Vitamin B12 levels in thyroid disorders: A systematic review and meta-analysis. Front Endocrinol. 2023;14:1070592. [Link] [DOI:10.3389/fendo.2023.1070592]
5. Knezevic J, Starchl C, Tmava Berisha A, Amrein K. Thyroid-gut-axis: How does the microbiota influence thyroid function?. Nutrients. 2020;12(6):1769. [Link] [DOI:10.3390/nu12061769]
6. Gupta R, Choudhary S, Chatterjee T. A study on vitamin B12 levels in hypothyroid patients presenting to a tertiary care teaching hospital. Cureus. 2023;15(8):e44197. [Link] [DOI:10.7759/cureus.44197]
7. Aon M, Taha S, Mahfouz K, Ibrahim MM, Aoun AH. Vitamin B12 (Cobalamin) deficiency in overt and subclinical primary hypothyroidism. Clin Med Insights Endocrinol Diabetes. 2022;15:11795514221086634. [Link] [DOI:10.1177/11795514221086634]
8. Batulwar PS, Anjankar A. Individuals diagnosed with type 2 diabetes mellitus and the status of vitamin B12 deficiency: A review. Cureus. 2024;16(2):e55103. [Link] [DOI:10.7759/cureus.55103]
9. Ahmed GA. Serum Vitamin D and B12 Deficiencies as Predictors of Thyroid Dysfunction: A Cross Sectional Analysis. J Sulaimani Med College. 2025;15(2):245-52. [Link] [DOI:10.17656/jsmc.10508]
10. Kacharava T, Giorgadze E, Janjgava S, Lomtadze N, Taboridze I. Correlation between vitamin B12 deficiency and autoimmune thyroid diseases. Endocr Metab Immune Disord Drug Targets. 2023;23(1):86-94. [Link] [DOI:10.2174/1871530322666220627145635]
11. Aktaş HŞ. Vitamin B12 and Vitamin D levels in patients with autoimmune hypothyroidism and their correlation with anti-thyroid peroxidase antibodies. Med Princ Pract. 2020;29(4):364-70. [Link] [DOI:10.1159/000505094]
12. Kibirige D, Mwebaze R. Vitamin B12 deficiency among patients with diabetes mellitus: Is routine screening and supplementation justified?. J Diabetes Metab Disord. 2013;12(1):17. [Link] [DOI:10.1186/2251-6581-12-17]
13. Shahwan M, Hassan N, Noshi A, Banul N. Prevalence and risk factors of vitamin B12 deficiency among patients with type II diabetes on metformin: A study from northern region of United Arab Emirates. Asian J Pharm Clin Res. 2018;11(8). [Link] [DOI:10.22159/ajpcr.2018.v11i8.26052]
14. Shahwan M, Ait Gacem S, Shahwan M, Najjar O. Assessment of vitamin B12 deficiency and associated risk factors among type 2 diabetic patients in Palestine. Hum Nutr Metab. 2020;20:200113. [Link] [DOI:10.1016/j.hnm.2020.200113]
15. Madlool AK, Numan HA, Ali HA, Mashkour MS, Ali RA. Vitamin B12 as risk marker in diabetic retinopathy patients: Case-control study. Front Health Inform. 2024;13(3). [Link]
16. Al Zoubi MS, Al Kreasha R, Aqel S, Saeed A, Al-Qudimat AR, Al-Zoubi RM. Vitamin B12 deficiency in diabetic patients treated with metformin: A narrative review. Ir J Med Sci. 2024;193(4):1827-35. [Link] [DOI:10.1007/s11845-024-03634-4]
17. Abed HH, Ali AM, Al-Ziaydi AG. Evaluation level of serum vitamin B12 in Iraqi patients with diabetes mellitus type 2, who used the metformin drug as a hypoglycemic agent. Pak J Pharm Sci. 2023;36(2):425-9. [Link]
18. Al Saeed RR, Baraja MA. Vitamin B12 deficiency in patients with type 2 diabetes mellitus using metformin and the associated factors in Saudi Arabia. Saudi Med J. 2021;42(2):161-5. [Link] [DOI:10.15537/smj.2021.2.25693]
19. Kadhim NM, Hussain KS. The impact of vitamin D3 and B12 in patients with thyroid disorders in Kirkuk-Iraq. Int J Health Sci. 2022;6(S6):8036-49. [Link] [DOI:10.53730/ijhs.v6nS6.12200]
20. Adaikalakoteswari A, Jayashri R, Sukumar N, Venkataraman H, Pradeepa R, Gokulakrishnan K, et al. Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes. Cardiovasc Diabetol. 2014;13:129. [Link] [DOI:10.1186/s12933-014-0129-4]
21. Al-Musharaf S, Aljuraiban GS, Danish Hussain S, Alnaami AM, Saravanan P, Al-Daghri N. Low serum vitamin B12 levels are associated with adverse lipid profiles in apparently healthy young Saudi women. Nutrients. 2020;12(8):2395. [Link] [DOI:10.3390/nu12082395]
22. Khan A, Shah N, Thakkar M. Study of clinical profile of hypothyroidism with emphasis on vitamin B12 levels. Headache. 2019;28:33-7. [Link]
23. Emamifar A, Hansen IM. The influence of thyroid diseases, diabetes mellitus, primary hyperparathyroidism, vitamin B12 deficiency and other comorbid autoimmune diseases on treatment outcome in patients with rheumatoid arthritis: An exploratory cohort study. Medicine. 2018;97(21):e10865. [Link] [DOI:10.1097/MD.0000000000010865]
24. Al-Mousawi M, Salih S, Ahmed A, Abdullah B. Serum vitamin B12 and holotranscobalamin levels in subclinical hypothyroid patients in relation to thyroid-stimulating hormone (TSH) levels and the positivity of anti-thyroid peroxidase antibodies: A case-control study. Cureus. 2024;16(6):e61513. [Link] [DOI:10.7759/cureus.61513]