Published: 2019-09-23

Study of prevalence and types of anemia in primary hypothyroidism

Rakesh K. Yadav, Mansoor Ahmad, Manoj K. Mathur, Vishal Dhingra


Background: Hypothyroidism is common disease with varying frequency between countries. Anemia in hypothyroidism can be normocytic normochromic, microcytic hypochromic and macrocytic hypochromic. Anemia severity is associated with hypothyroidism degree. Objective of this study to study the association between anemia and hypothyroidism and prevalence and types of anemia in primary hypothyroidism (subclinical and overt both).

Methods: This cross sectional study was carried out at tertiary care hospital in North India. Newly diagnosed 100 primary hypothyroid patients and 100 controls with age and sex matched evaluated for anemia. Prevalence and types of anemia were studied and severity of anemia was correlated with that of hypothyroidism.

Results: Anemia was observed in 90 patients with hypothyroidism. Symptoms due to anemia were higher in cases than in controls. RBCs morphology showed normocytic normochromic in 59, microcytic hypochromic in 26 and macrocytic hypochromic in 15 cases. Serum anti-TPO positivity was present in 71.1% in cases as compared to 33.33% in controls. Anemia was severe in cases with high TSH.

Conclusions: Anemia was more prevalent in cases of hypothyroidism than in euthyroid controls. Normocytic normochromic type of anemia was most common type in this study. Serum anti-TPO positivity was 71.1% in cases. There was statistically significant negative correlation between TSH and haemoglobin. Symptoms of anemia were more in hypothyroid patients than in euthyroid anemic patients.


Anemia, Anti-TPO, Primary hypothyroid, TSH

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Das C, Sahana PK, Sengupta N, Giri D, Roy M, Mukhopadhyay P. Etiology of anemia in primary hypothyroid subjects in a tertiary care center in Eastern India. Indian J Endocr Metab. 2012;16, Suppl S2:361-3.

Horton L, Coburn RJ, England JM, Himsworth RL. The hematology of hypothyroidism. Q J Med. 1976;45(177):101-23.

Das KC, Mukherjee M, Sarkar TK, Dash RJ, Rastogi GK. Erythropoiesis and erythropoietin in hypoand hyperthyroidism. J Clin Endocrinol Metab. 1975;40:211-20.

Fein HG, Rivlin RS. Anemia in thyroid diseases. Med Clin North Am. 1975;59:1133-1145.

Jason WH, Stephen FH, Rajasehkar R, Govind B, Peter HRG. Anemia in celiac disease is multifactorial in etiology. Am J Hematol. 2007;82:996-1000.

Bamashmous S.A., Al-Nuzaily M.A.K. , Al-Maktari L.A.S. , Taresh S.A.G. and Ali F.H.H. Prevalence and etiology of anemia in overt and subclinical hypothyroid women in Sana’a, Yemen. J Clin Res Letters. 2013,4(1):57-60.

Mehmet E, Aybike K, Ganidagli S, Mustafa K. Characteristics of anemia in subclinical and overt hypothyroid patients. Endocrine J. 2012;59(3):213-20.

Dorgalaleh A, Mahmoodi M, Varmaghani B, Node FK.Effect of thyroid dysfunctions on blood cell count and red blood cell indices. Iran J Ped Haematol Oncol. 2013;3(2):73-7.