Study of impact of subclinical hypothyroidism on iron status and hematological profile

Abstract

Background: Thyroid hormones play an important physiological role to maintain balance of metabolism of entire human body. Erythrocyte abnormalities are frequently associated with thyroid disorder. Subclinical hypothyroidism, often a hidden entity, is associated with iron-deficiency anemia along with other hematological disorders. Thyroid hormones have a crucial role in metabolism and proliferation of blood cells. Thyroid dysfunction has profound effects on blood cells such as anemia, alters RBC indices including MCV, MCHC as well as iron stores. Present study was carried out to investigate and explore subclinical hypothyroid patients, to know the effect of subclinical hypothyroidism on hematological parameters and body iron store.Methods: This retrospective study included 200 newly diagnosed, untreated subclinical hypothyroid, and 200 healthy euthyroid individuals. The hematological parameters and thyroid profile of the subjects were assessed by the mean, standard deviation (SD). Student’s t-test was used to report our results, with p-value <0.05 considered as statistically significant.Results: In this study we have compared hemoglobin level, red cell indices, serum Ferritin among study group and euthyroid healthy group and found that mean hemoglobin, serum ferritin and RBC indices were significantly depleted in subclinical hypothyroid patient in comparison to euthyroid group. 37 of total 200 [18.22%] newly diagnosed subclinical hypothyroid patients was suffering from Iron deficiency anemia with significant number of patients having hemoglobin level less than 10 gm%.Conclusions: Iron deficiency anemia is quite common in Subclinical hypothyroidism and is often associated with depleted body iron store and complication of getting converted into primary hypothyroidism. As there is no significant clinical manifestation of SCH at earlier stages with anemia it is advisable to routinely investigate it for early detection allowing its early management.

Trace elements in hypothyroidism in relation to L-thyroxine therapy

“…Our study showed decreased serum iron which was in accordance with the studies conducted by Dahiya K et al, 32 Eftekhari M et al, 33 Mishra A et al, 34 Cinemere H et al, 35 Onat A et al, 36 Bashboosh N et al, 37 and Kammak M et al, 38 Shukla A et al 39 showing anemia in hypothyroidism condition. Iron is considered a co-factor in catalysis of various important biological enzymes including Thyroperoxidase affecting the overall thyroid hormone metabolism.…”

Altered Iron Metabolism in Subclinical Hypothyroidism: Myth or Reality

“…Many studies have attempted to study the relationship between subclinical hypothyroidism and iron deficiency anemia, but due to limited number of large cohort studies, a definitive status of this entity is still eluting the clinicians posing problems in management. Not many reports are available in literature to report on iron profile in hypothyroid patients (6).…”

The effect of subclinic thyroid pathologies on erythropoietine dose in hemodialysis patients

“…It is known that thyroid hormones increase the oxygen capacity of the blood by increasing the production of erythropoietin (EPO) and improve perfusion through vasodilation after the increase of adrenomedullin. The hematopoietic system is one of the most affected systems in thyroid diseases, and anemia is one of the most common findings in these patients [1]. It is thought that hypothyroidism increases anemia by suppressing bone marrow and decreasing EPO production; and in the pathogenesis, thyroid hormone induces EPO gene expression by increasing hypoxia inducible factor 1 [2,3].…”