Associative relations between hypofunction of the thyroid gland of various origins and iron deficiency anemia
Keywords:hypothyroidism, iron deficiency anemia, autoimmune thyroiditis, nodular nontoxic goiter
Background. Anemia is one of the thyroid deficiency manifestations, more often iron deficiency. The combination of hypothyroidism and anemia is an additional factor complicating the life quality of patients and requiring of adequate preventive measures.
Purpose of the study was to establish the peculiarities of iron deficiency anemia in women with hypothyroidism that arose against the background of autoimmune thyroiditis (AIT) or after surgical treatment of nodular nontoxic goiter (NNG).
Materials and methods. Thyroid status was assessed in 40 women with anemia on the background of hypothyroidism due to AIT (n = 28) and after surgery for NNG (n = 12) by the level of thyroid stimulating hormone and bound tetraiodothyronine, antibodies to thyroperoxidase. Anemia and its severity were determined by the blood hemoglobin level, number of red blood cells and color indicator.
Study results. Level of thyroid stimulating hormone was increased in women of both groups on the background of levothyroxine in an individually selected dose, and it was significantly higher in group with postoperative hypothyroidism. Level of antibodies to thyroid peroxidase testified to the pronounced activity of antithyroid immunity in the group with AIT. Hemoglobin level in both groups ranged from 92 to 116 g/l, which according to WHO criteria corresponded to mild anemia. It was significantly lower than with postoperative hypothyroidism against the background of AIT, despite the best compensation for hypothyroidism. Color index in both groups was reduced, that is typical for hypochromic anemia, which includes iron deficiency anemia.
Conclusions. Effectiveness of levothyroxine treatment in individually selected doses in women with a combination of hypothyroidism and anemic syndrome is higher at autoimmune thyroid pathology than after surgery for NNG. Active autoimmune process in women with hypothyroidism on the background of AIT is associated with more manifest anemia than in women with postoperative hypothyroidism as a result of NNG.
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