To study prevalence of incipient iron deficiency in primary hypothyroidism

Tanveer Hassan Banday, Sadaf Bashir Bhat, Sabreen Bashir Bhat, Naveed Shah, Shahnawz Bashir


Background: Hypothyroidism, affects around 1% of general population. Anemia in association with hypothyroidism has been studied since 1881. Iron deficiency has multiple adverse effects on thyroid metabolism. It decreases circulating thyroid hormone concentration, blunts thyrotrophic response to TRH, decreases serum T3. Objective of current study was to find prevalence of iron deficiency in primary hypothyroid.

Methods:In our study 70 patients were selected, out of which 50 were females and 20 were males, who were suffering from hypothyroidism. Iron deficiency in the study group was confirmed at baseline using multiple iron status indicators (serum ferritin, serum iron, TIBC & percentage Saturation). These patients were between age group 18-65 years.

Results: In our study only 14 patients (20%) manifested with anemia (which was defined as Hb<12gm/dl), where as the prevalence of iron deficiency (with or without anemia) was 34.2%, in which 28.5% were females and 5.70% were males, thus showing that prevalence of iron deficiency (with or without anemia) can be higher than iron deficiency anemia itself, which is supported by literature.

Conclusion:Iron deficiency was present in a significant portion of patients with primary hypothyroidism. It also concluded that frequency of iron deficiency (with or without anemia) was higher than iron deficiency anemia.



Hypothyroid, Iron deficiency, Prevalence

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Stephen J. Mcphee, Maxine A.P. Endocrine disorders. In: Paul A. Fitzgerald, eds. Current Medical Diagnosis & Treatment. 51st ed. New York, NY: McGraw-Hill; 2012: 182.

Henry M. Kornenberg, Shlomo Melmed. Endocrine system diseases. In: Henry M. Kronenberg et al., eds. Willams Text Book of Endocrinology. 11th ed. Philadelphia, PA: Saunders/Elsevie; 2008: 1911.

Kreishman SH, Hennessey JV. Consistent reversible elevation of serum creatinine levels in severe hypothyroidism. Arch Intern Med. 1999;159:79-82.

Antonijevic N, Nesovic M, Trbojević B, Milosević R. Anemia and hypothyriodism. Med Pregl. 1999 Mar-May;52(3-5):136-40.

Perlman JA, Sternthal PM. Effect of 131I on the anaemia of hyperthyroidism. J Chronic Diseases. 1983;36:05-412.

Marqusee E, Mandel SJ. The blood in hypothyroidism. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2000:800-802.

Horton L, Coburn RJ, England JM, Himsworth RL. The haematology of hypothyroidism. Q J Med. 1976;45:101-24.

Malgor LA, Blanc CC, Klainer E, Irizar SE, Torales PR, Barrios L. Direct effects of thyroid hormones on bone marrow erythroid cells of rats. Blood. 1975;45:671-9.

Shakir K M, D Turton, Aprill BS, Drake AJ, Eisold JF. Anemia: a cause of intolerance to thyroxin sodium. American J Clin Nutr Mayo Clin Proceedings. 2000 Feb;75(2):189-92.

Tunbridge WMG, Caldwell G. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. 6th ed. Philadelphia: J. B. Lippincott; 1991: 578-588.

Dawson MA, Yarbo JW. Anemia in hypothyroidism. South Med J. 1970;63:966-70.

Nancy C. Andrews. Iron deficiency and related disorder. Jhon P. Greer, GM Rodgers et al, eds. Wintobe’s Clinical Hematology. 12th ed. Philadelphia: Lippincott Williams & Wilkins Publishers; 2004: 810-815.

J. Larry Jameson, Anthony P. Weetman. Disorders of the thyroid gland. In: Faucci, Kasper, Longo, Jameson, Huaser, Loscalzo, eds. Harrisons Principle of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2011: 4889.

Fandrey J, Pagel H, Frede S, Wolff M, Jelkmann W. Thyroid hormones enhance hypoxia-induced erythropoietin production in vitro. Experiment Hematol. 1994;22:272-7.

Mitra KJ, Ali SA, Syed H, Soraya, Samedani Fard, Esmet et al. Association between hypothyroid and anemia. A clinical study. Int J Hematol Oncol Stem Cell Res. 2010 July;7(4):6-9.

Beard JL, Brigham DE, Kelly SK, Green MH. Plasma thyroid hormone kinetics are altered in iron-deficient rats. J Nutr. 1998;128:1401-8.

Zimmermann MB. The influence of iron status on iodine utilization and thyroid function. Annu Rev Nutr. 2006;26:367-89.

Beard J, Borel MJ, Derr J. Impaired thermoregulation and thyroid function in iron deficiency anemia. Am J Clin Nutr. 1990;52:813-9.