Hypothyroidism and Anemia

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Hypothyroidism is not an isolated condition affecting the thyroid gland and its functions.

It is connected to various other conditions of which Anemia is an important one.

Several studies have been done to delve into the actual link between anemia and hypothyroidism.  The link is of great significance as it helps to treat anemia due to impaired thyroid function effectively and restore the iron levels in the body to a healthy and normal state.

Let us see more about anemia caused due to hypothyroidism.

Anemia as a sign of hypothyroidism

A 1999 study on hypothyroidism published in a Croatian medical journal indicates that hypothyroidism can lead to development of different forms of anemia including macrocytic, normocytic and microcytic anemia. The study indicates that nearly 20% to 60% of patients with hypothyroidism have anemia.

The study reveals that in hypothyroidism the low plasma volume can lead to false increase in levels of hemoglobin, hence radio isotopic analysis is done to estimate the true value of hemoglobin.

The study indicates that when anemia of unknown causes is present hypothyroidism should be suspected as the cause as in many cases overt hypothyroidism does not show any evident signs.

And in case of symptomatic hypothyroidism, the incidence of anemia is twice that of the normal population.

Role of Thyroid hormone in red blood cell growth

Thyroid hormones help to stimulate growth of red blood cell colonies via erythropoietin. A study published in 2012 conducted on 100 overt hypothyroid and 100 subclinical hypothyroid patients against a control of 200 healthy individuals proves the role of thyroid in red blood cell growth.

In overt hypothyroidism, the prevalence of anemia was about 43%. The condition characterized low levels T4 and T3 in free form and high TSH levels. In case of sub clinical hypothyroid patients nearly 39% had anemia and exhibited high TSH levels but normal free T3 and T4 levels.

This indicates that anemia frequency is nearly similar in both overt and subclinical forms of the condition. Another finding of significance was that all patients had similar levels of iron, folic acid and vitamin B12.

This study corroborates the earlier study that indicates that hypothyroidism should be suspected when anemia of unknown cause is present.

Anemia: Different types found in hypothyroidism

Deficiency of thyroid hormone (hypothyroidism) results in impaired red blood cell production in the bone marrow. This leads to formation of anemia of chronic disease or chronic inflammation. This anemic condition is related to different types of inflammatory conditions of chronic nature like autoimmune disease, cancer, kidney disease or infection.

Besides the chronic disease causing anemia, hypothyroidism is also related to pernicious anemia. This type of anemia is related to autoimmune conditions and is linked to about 10% of patients with Hashimoto’s thyroiditis.  In this condition, the anemia is caused by impaired absorption of vitamin B12 from food due to lack of intrinsic factor in the stomach.

This leads to vitamin B12 deficiency which results in reduced production of red blood cells causing anemia.

Absorption problems in the intestine can also cause vitamin B12 deficiency related anemia. This is due to reduced motility of gut seen in hypothyroidism.

The intestinal issues can also cause folic acid deficiency related anemia also known as iron deficiency anemia.

The main factor to note from the above observations is that anemia and hypothyroidism are interlinked. Iron deficiency can affect the function of thyroid hormone just as hypothyroidism can trigger anemia.

Iron is very important for production of hormone in the thyroid gland. In case of severe iron deficiency leading to anemia, the thyroid function can be affected leading to hypothyroidism.

Anemia symptoms

While most individuals suffering from anemia do not exhibit any symptoms, they develop certain symptoms as the disease progresses which include:

  • Weakness
  • Breathlessness
  • Feeling faint, tired or weak
  • Breathlessness at rest
  • Pale lower eyelid lining
  • Irregular heartbeats

Treatment of hypothyroidism related anemia

If hypothyroidism is the underlying cause of anemia, it is important to treat the hypothyroidism to correct the anemia. You need to first diagnose the hypothyroidism by taking the necessary diagnostic tests. The tests will help in determining the progression of the disease. Thyroid medications may be needed. Our article on naturally boosting thyroid levels may also help.

By treating the anemia alone it is not possible to bring the red blood cells to normal levels as the underlying thyroid condition is not addressed.

So you need to try a combination of thyroid hormones such as levothyroxine and iron in supplement form to effectively treat the anemia.

In some cases of severe anemia, transfusion of blood may be needed.

Final takeaway

With the frequency of anemia in hypothyroidism being high, it is important to identify the anemia and the cause that triggers it.

Anemia may be the only or first symptom that indicates the thyroid is not functioning properly. If you have anemia, it is necessary to take the appropriate thyroid tests.

This will help in deciding on the proper treatment protocol and better prognosis of the condition.

Make sure you take the proper dose of thyroid hormone as excessive hormones can lead to insomnia, tremors and heart palpitations.

  1. Reply
    Karen S June 9, 2019 at 8:57 pm

    I’ve been Hypo since birth, not sure if I even have a thyroid. You would think that would be a primary concern with my healthcare, right? Nope, my thyroid tests are always “within normal range” so my issues could Never be Thyroid related! Well guess what, I’ve been Anemic for over a Year, somehow that was lost in the system and I was not informed of this fact until May 1!! I’ve already had an Endoscopy, a Colonoscopy and X-rays with Barium to see if I’m bleeding anywhere, no signs of this so far. Hopefully I won’t have to fight with Doctor about looking at a new Thyroid replacement solution! I’m on SSDI, so I have Medicare and Masshealth, will they even cover an alternative??

  2. Reply
    donnetta November 15, 2018 at 10:54 pm

    my name is donnetta I have an Hypothyroidism, and I was not feeling well until I got home from school. I was pass out and faint at that day. because I eat something at home eating some ham, and or steak, and chicken, and ribs too. so I wasn’t look so good. and I start to vomit, putrid in the floor pass out in consciousness. I was in coma laid in the floor. so then I was wake I couldn’t remember what happen to me. so then next few month, I went to the doctor to ask these questions of how ill I was and what, cause it so she look up into list of cart. and said I might have an Hypothyroidism, issues prevent an thyroid cancer. and I was in shock I didn’t know I have that, or neither my family had it. and it might have explanation,to these question of why I was Diagnosis of hypothyroidism, and of course anemia.

  3. Reply
    Sue September 15, 2018 at 11:00 pm

    I fainted yesterday & have a hx of subclinical hypothyroidism after being treated for hyperthyroidism with radiated iodine.. I had had a birthday dinner with alcohol.. now RBC’S & Hematocit low.. I was also dehydrated.. could these low labs be from dehydration??

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