• Monique Abraham HHP

Hypothyroidism and Anemia What your Doctor is not telling you!

Ever been pushed an iron pill by Doctor to help with your "anemia",

Or in my case a Pediatrician to be exact, that did not care enough to run the proper test to help me function properly or better yet treat my real issues versus a band aid effect. I spent years of my young life laid on the floor, missing school, unbearable pain missing days from school. And "No" I was not throwing a temper tantrum, I would lay my stomach on the cold dirty floor to relieve stomach pain and cool down my body. Or in some cases was simply too dizzy to stand. If only I was tested for more than just anemia, the doctors would have been able to treat my sickle cell trait,which normally does not have an effect your body on such a high level but did with me. Or maybe If they checked my Heart when I gasped for air they would of discovered my heart murmur. And please don't take this as a Doctor bashing article, however more doctors have to be held accountable for common knowledge effects of the body in all communities. And unfortunately, I do feel that I was brushed over because the type of insurance I had my race and most importantly my ignorance. When something is not right after years of the same treatment questions should have arose in my mother and I. Questions like why is the treatments not working? Are there any other tests? Do I need another Doctor?However like many in similar situations we trusted the Doctor and I silently endured for years until one day at a VA clinic an African Doctor asked me have I ever been tested for sickle cell, she seemed upset when I told her know and tested me gave me answers and changed my life. The doctor told me that sickle cell and thyroid conditions were common in the African American and darker skinned nationalities and was surprised this was not ruled out years ago. In other words take authority over your health, demand results, tests and whatever it takes because if you don't most of the time it simply won't get done!


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.

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.

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.
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