Prevalence of Anemia Among Patients with Subclinical and Clinical Hypothyroidism in Jordan

Malabsorption of iron and/or vitamin B12 and low thyroid hormone levels may cause anemia in patients with hypothyroidism.This cross-sectional study investigates anemia prevalence, types, and potential causes in 69 patients with hypothyroidism.The control group consisted of 31 healthy volunteers.Diagnostic assessments for hypothyroidism and anemia, in addition to participant-completed questionnaires, were conducted.Females with hypothyroidism exhibited a higher anemia prevalence (12:1 ratio) than males.Among L-thyroxine-treated patients, 22.8% had anemia compared to 11.5% in the untreated subclinical group with hypothyroidism (p>0.05).Females under L-thyroxine therapy had significantly lower hemoglobin level than females in the control group (p=0.0001).Also, L-thyroxine-treated females had lower ferritin level compared to the untreated females with hypothyroidism (p=0.026) and females in the control group (p=0.007)while having higher red blood cell distribution width (RDW) compared to the untreated females (p=0.012) and the control group females (p=0.0001).No significant differences in hemoglobin, ferritin, or RDW were found between males with hypothyroidism and the control group.Also, no significant differences were found among patients with hypothyroidism and the control group in Vitamin B12 level.Blood film examination revealed that normochromic normocytic anemia was present in 53.8% of anemic cases with hypothyroidism while hypochromic microcytic anemia was evident in 46.2% of cases.None of the anemic patients had macrocytic anemia.Ferritin level correlated negatively with RDW in patients with hypothyroidism treated with L-thyroxine (r =-0.517, p <0.01).In conclusion, screening and treating anemia in patients with hypothyroidism is recommended.Treatment with L-thyroxine alone may not be sufficient to prevent anemia in hypothyroidism.