The bidirectional relationship between thyroid dysfunction and anemia in children: A comprehensive review

ABSTRACT Thyroid disorders in children represent a common and usually treatable endocrine disorder. Anemia in children is another prevalent illness that can present in a variety of ways, ranging from mild and asymptomatic to more severe types with obvious symptoms. Moreover, anemia is a frequent, although often underestimated, clinical problem accompanying thyroid diseases and constitutes an important clinical issue. Anemia has been documented in 20%–60% of hypothyroid children and 33% of cases of Graves’ disease (GD). On the other hand, iron deficiency anemia (IDA) and thalassemia major can be associated with impaired thyroid function, particularly hypothyroidism. The causative relationship between both disorders appears to be complex and occasionally unclear. This article offers a thorough summary of the relationship and reciprocal impact of anemia and thyroid problems in children. It is important for the clinician to evaluate thyroid status in children with anemia and vice versa, considering the possible connection between thyroid problems and anemia. Adequate correction of the anemia and early identification and treatment of thyroid dysfunction are essential to significantly improve clinical outcomes of these children.