Wolfgang Tiefensee, top SPD co-candiate, speaks on stage after the first forecasts of the election results in Erfurt, Germany on October 27, 2019 | Sebastian Willnow/AFP via Getty Images Far left and right outflank center in regional German vote Angela Merkel’s conservatives knocked down from first to third place in east German state of Thuringia.

BERLIN — Parties from the far left and far right won more than half the votes in a state election in eastern Germany on Sunday, while Chancellor Angela Merkel's Christian Democrats suffered heavy losses to finish third.

The far-left Die Linke party largely held steady to secure first place at 31 percent of the vote in the state of Thuringia, thanks in part to the popularity of state premier Bodo Ramelow, according to preliminary results. Meanwhile, the far-right Alternative for Germany (AfD) once again demonstrated its strong support in the east of the country by surging ahead to finish second at 23.4 percent, more than doubling its vote share in the last election of 2014.

The election dealt a serious blow to establishment, centrist parties including Merkel's Christian Democrats (CDU) and her national coalition partners, the Social Democrats (SPD). The CDU was knocked into third place at 21.8 percent — down from first place in 2014 — while the SPD came far behind in fourth place at about 8 percent.

The Greens and liberal Free Democrats (FDP) won about 5 percent each, enough to scrape past the necessary threshold of votes for the state legislature.

The ballot in the state of a little more than 2 million is expected to have limited impact at national level as Thuringia is a rural region of small towns rather than teeming metropolises. However, the result means efforts to build a coalition will be fraught, testing party red lines. The prior coalition made up of Die Linke, the SPD and the Greens now falls short of a majority.

Immediately after the results were announced, the CDU's Secretary-General Paul Ziemiak ruled out forming a coalition with Die Linke or the AfD. An unwieldy four-way coalition of Die Linke, the SPD, the Greens and the FDP would also fall short of a majority.

All parties have ruled out working with the AfD. Its regional leader, Björn Höcke, is a right-wing firebrand whose controversial statements about the Nazi era have prompted some within the party to try to oust him from its ranks.

This article has been updated.