Folic Acid Deficiency in severe hypothyroidism: a Case Report and a Review of Literature

Abstract Folate deficiency can be caused by an insufficient diet, conditions that impede folate absorption, certain medications, and congenital problems. It may also be resulted from alcoholism, pregnancy, breastfeeding, hemolytic anemia, and dialysis. According to the European prevalence estimates, hypothyroidism affects up to 5% of the population, while up to 5% of the community may very well have unrecognized thyroid insufficiency. Although, it’s widely accepted that the most common type of anemia in hypothyroidism patients is normocytic normochromic anemia as reported by various studies, macrocytic anemia in case of folic acid deficiency can also occur. Folic acid deficiency can present with a newly diagnosed hypothyroidism as in our case. Despite the relationship between hypothyroidism and folic acid deficiency, it has not been studied deservedly and the case reports with this combination are scarce in the literature. In this case report, we present a case of 22-year- old woman who presented with folic acid deficiency anemia and hypothyroidism. The patient symptoms improved after treatment with folic acid and thyroid replacement therapy.