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Serum folate concentrations do not differ significantly in patients with various thyroid disordersComparing Folate Levels in People with Different Types of Thyroid Disorders

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Key Takeaway
Note that serum folate concentrations do not differ significantly in patients with hypothyroidism or other thyroid disorders.

This meta-analysis evaluated serum folate concentrations in 5492 adults with various thyroid disorders, including hypothyroidism, subclinical hypothyroidism, autoimmune thyroid disease, and hyperthyroidism, compared against healthy controls. The study aimed to determine if serum folate levels differ significantly across these clinical populations.

The analysis reported no statistically significant differences in serum folate concentrations across all four thyroid conditions. Specifically, hypothyroidism showed an SMD of -0.73 (95% CI: -1.48 to 0.02; P >.05), subclinical hypothyroidism showed an SMD of -0.35 (95% CI: -1.05 to 0.35; P >.05), autoimmune thyroid disease showed an SMD of 0.04 (95% CI: -0.37 to 0.29; P >.05), and hyperthyroidism showed an SMD of 0.79 (95% CI: -0.17 to 1.74; P >.05).

No specific limitations or safety data were reported in the source. Clinical application of these findings suggests that serum folate levels may not serve as a reliable indicator for the presence or severity of these specific thyroid disorders. The results are consistent across the diverse thyroid conditions studied.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the nutritional status of patients with thyroid disorders. While previous coverage noted that Vitamin D and gut microbiota interact to regulate immunity and improve Vitamin D bioavailability in thyroid disease, this study specifically examines folate levels. The finding that serum folate concentrations do not differ significantly in hypothyroidism, subclinical hypothyroidism, autoimmune thyroid disease, or hyperthyroidism suggests that folate is not a distinguishing biomarker for these conditions.

Researchers looked at a large group of over 5,000 people to see if folate levels were different in those with thyroid problems. They compared people with low thyroid function, high thyroid function, and autoimmune thyroid issues against a group of healthy people.

Folate is a vitamin that helps the body function correctly. Some people wonder if thyroid conditions change how much folate is in the blood. This study checked if those with hypothyroidism or hyperthyroidism had different levels than those without these conditions.

The results showed that folate levels were very similar across all groups. People with low thyroid function, high thyroid function, and autoimmune thyroid disease had levels that were not significantly different from healthy people. This suggests that a thyroid condition does not automatically mean a person has low folate.

These findings help doctors understand that thyroid issues and folate levels are not directly linked in these specific ways. While folate is important for health, the study did not find a clear link between it and the specific types of thyroid disorders tested.

What this means for you:
People with various thyroid conditions had folate levels similar to those of healthy individuals.

Common questions

Does hypothyroidism affect folate levels?

This analysis found no statistically significant difference in serum folate between adults with hypothyroidism and healthy controls. The effect size was -0.73 with a 95% confidence interval of -1.48 to 0.02 and a P value greater than .05. That means the result was not statistically significant. If you have concerns about your folate or thyroid, talk with your doctor.

Should I get my folate checked if I have a thyroid condition?

This analysis does not provide guidance on testing. It found no significant folate differences across hypothyroidism, subclinical hypothyroidism, autoimmune thyroid disease, or hyperthyroidism compared with healthy controls. Decisions about testing should be made with your doctor based on your individual health.

How many people were in this thyroid and folate analysis?

The analysis included 5,492 adults with thyroid disorders and healthy controls. It looked at serum folate concentrations in hypothyroidism, subclinical hypothyroidism, autoimmune thyroid disease, and hyperthyroidism. No significant differences were found in any group compared with controls.

What were the folate findings for hyperthyroidism?

For hyperthyroidism, the analysis found no statistically significant difference in serum folate compared with healthy controls. The effect size was 0.79 with a 95% confidence interval of -0.17 to 1.74 and a P value greater than .05. This means the result was not statistically significant.

Study Details

Study typeMeta analysis
Sample sizen = 5,492
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
Nutritional factors, including folate, may modulate thyroid function; however, evidence comparing folate concentrations in adults with thyroid disorders (TD) and healthy individuals remains inconsistent. This systematic review and meta-analysis (PROSPERO registration number: CRD420251087038) synthesized evidence on differences in serum folate concentrations between these groups. Multiple databases were systematically searched without restrictions to identify observational studies comparing serum folate concentrations between adults with hypothyroidism, subclinical hypothyroidism (SH), autoimmune thyroid disease (AITD), or hyperthyroidism and healthy controls. Random-effects metanalyses were performed, with the standardized mean difference (SMD) as the effect measure. Overall, 28 studies (n = 5492 participants) were included. No significant differences in serum folate concentrations were observed between healthy controls and patients with hypothyroidism (SMD: -0.73; 95% CI: -1.48 to 0.02; P > .05), SH (SMD: -0.35; 95% CI: -1.05 to 0.35; P > .05), AITD (SMD: 0.04; 95% CI: -0.37 to 0.29; P > .05), and hyperthyroidism (SMD: 0.79; 95% CI: -0.17 to 1.74; P > .05). No statistically significant differences were observed in serum folate concentrations between adults with TD (hypothyroidism, SH, AITD, and hyperthyroidism) and healthy controls.
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