A comprehensive investigation of biochemical status in patients with telogen effluvium: Analysis of Hb, ferritin, vitamin B12, vitamin D, thyroid function tests, zinc, copper, biotin, and selenium levels.

Irem Nur Durusu Turkoglu, Aziz Kaan Turkoglu, Seçil Soylu, Gülcan Gencer, Rümeysa Duman

Other Journal of cosmetic dermatology 2024 7 citations

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Study Design

Type d'étude: case-control study
Taille de l'échantillon: 180

Intervention: A comprehensive investigation of biochemical status in patients with telogen effluvium: Analysis of Hb, ferritin, vitamin B12, vitamin D, thyroid function tests, zinc, copper, biotin, and selenium lev not applicable
Comparateur: Placebo
Direction de l'effet: Mixed
Risque de biais: Moderate

Abstract

AIM: The etiology of telogen effluvium (TE) includes situations that may cause physiological stress, surgical trauma, inflammatory, infectious, iatrogenic causes, medications and nutritional deficiencies. TE has been associated with iron deficiency, vitamin B12 deficiency and thyroid diseases. In recent years, the use of over-the-counter food supplements containing vitamins and minerals such as biotin, vitamin D, zinc (Zn), copper (Cu) and selenium (Se) has been increasing in TE patients. The aim of this study is to investigate whether there are differences in nutritional status, vitamin and mineral levels by comparing individuals with TE and a control group. MATERIALS AND METHODS: This case-control study included 90 female patients diagnosed with chronic telogen effluvium (CTE), and 90 female controls volunteered to participate in the study who consulted for reasons other than TE. Both groups aged 18 and over and applied to dermatology polyclinic between 01.09.2022 and 01.09.2023. A detailed anamnesis was taken from all patients, a hair pull test was performed, and TE was diagnosed after a dermoscopic examination was performed on all areas of the scalp. Then, serum vitamin D, Zn, Cu, Se levels and biotin levels in serum and urine were measured. Hemoglobin (Hb), ferritin, vitamin B12 and thyroid function tests were retrospectively scanned from the hospital database. RESULTS: It was determined that Zn levels were significantly lower in CTE patients than in controls. Se levels were found to be significantly higher in patients than in controls. There was no difference in Hb, ferritin, vitamin B12, thyroid function tests, vitamin D, Cu levels, serum and urine biotin levels between the two groups. Zn, Cu/Zn and Se levels were found to have statistically significant diagnostic performance in predicting the diagnosis of CTE. Cu/Zn ratio and Se value were found to be significant predictors of CTE. CONCLUSION: This study shows us that nutritional deficiencies are not as common as thought in patients diagnosed with TE. Other causes that may cause TE should be investigated by a detailed anamnesis and a good physical examination. After all, tests for suspected conditions should be performed and individualized treatment options should be created for each patient.

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Tables

TABLE 1

Variables	Patient				Control
Variables	Min.	Max.	Mean	SD	Min.	Max.	Mean	SD
Age	18	58	28.52	9.57	18	59	28.07	9.61
Weight	44	106	63.18	12.81	45	102	64.67	12.85
Height	150	180	162.64	5.86	145	178	163.15	7.13
BMI	17.01	36.68	23.84	4.34	15.92	39.84	24.35	4.91

TABLE 2

Variables	Patient		Control
Variables	N	Percentage	N	Percentage
Smoking
No	69	76.7	71	78.9
Yes	21	23.3	19	21.1
Alcohol consumption
No	85	94.4	83	92.2
Yes	5	5.6	7	7.8
Socioeconomic status
Low	44	48.9	41	45.6
Medium	39	43.3	41	45.6
High	7	7.8	8	8.9

TABLE 3

Dermoscopic findings	N	Percentage
Decrease in hair density	89	98.8
Empty follicles	89	98.8
Yellow dots	56	62.2
Increase in the follicular unit with a single hair follicle	82	91.1
Newly growing short and normal hair	76	84.4

TABLE 4

Variables	Patient	Control	p‐value
Vit‐D (ng/mL)	17.57 ± 7.44	19.5 ± 8.74	0.206 ^b
Cu (μg/dL)	139.99 ± 45.07	136.16 ± 32.56	0.656 ^b
Zn (μg/dL)	49.91 ± 22.21	60.53 ± 29.27	0.004 ^b
Biotin (ng/mL)	86.42 ± 37.15	93.82 ± 39.47	0.324 ^b
Urine Biotin (ng/mL)	158.48 ± 39.08	164.96 ± 43.30	0.293 ^a
Se (μg/L)	71.76 ± 9.84	66.96 ± 9.33	0.001 ^a
Hb (g/dL)	13.25 ± 1.21	13.04 ± 1.30	0.277 ^b
Ferritin (μg/L)	45.60 ± 142.11	30.55 ± 27.56	0.508 ^b
Vit B12 (ng/L)	352.70 ± 129.45	366.72 ± 127.81	0.231 ^b
TSH (mIU/L)	3.05 ± 9.45	2.13 ± 1.21	0.183 ^b
St4 (ng/dL)	1.29 ± 0.17	1.29 ± 0.25	0.835 ^b