Hypothyroidism and anemia

Background: Hypothyroidism is a common endocrine disorder frequently associated with hematological disturbances, particularly anemia. The pathophysiology is multifactorial, and the prevalence and type of anemia may vary based on thyroid control status and regional nutritional factors. Aim: This study aimed to evaluate the percentage, type, and severity of anemia in a sample of Egyptian hypothyroid patients, with a specific focus on differentiating between controlled hypothyroid and uncontrolled hypothyroid patients. Methods: This study is a cross sectional study was conducted on 100 hypothyroid patients (43 controlled hypothyroid, 57 uncontrolled hypothyroid, based on TSH >4.5 mIU/L) recruited from the Endocrinology Clinic at Minia University Hospital. All participants underwent detailed history, clinical examination, thyroid function tests, complete blood count, ferritin, and lipid profile. Results: The overall percentage of anemia was 43%. A significantly higher percentage was found in uncontrolled hypothyroid patients (52.6%) compared to controlled patients (30.2%) (p=0.02). Uncontrolled hypothyroidism was associated with more severe anemia. Microcytic hypochromic anemia was the predominant type in uncontrolled hypothyroid patients (63.3%), whereas controlled patients showed an equal distribution of microcytic and macrocytic anemia (46.2% each). Strong negative correlations were observed between TSH levels and hemoglobin , MCV (r = -0.35, p<0.001), MCH , and MCHC. Uncontrolled patients also had significantly higher BMI, triglycerides, and total cholesterol. Conclusion: we concluded that patients with hypothyroidism are often affected by anemia, continuous monitoring is essential to detect and manage this complication, early regular follow up helps improve treatment outcomes and ensures a better quality of life.