Evaluation of anemia frequency and types in patients with subclinical and clinical hypothyroidism in the endemic goiter region

Aim: Hypothyroidism is an illness that emerges in consequence of deficiency or occasionally inefficiency of thyroid hormone. One of the organs and systems, which hypothyroidism affects on body, is hematopoietic system. Thyroid hormones stimulate, directly or indirectly, evolution of colony in marrows with a great number of mechanisms and thyroid hormone deficiency serves a function in development of microcytic, normocytic and macrocytic anemia. Frequency of anemia existed in hypothyroid patients varies between 20% and %60. In this study, it is aimed to examine the frequency and types of anemia existed in clinical and subclinical hypothyroid patients living in an endemic goiter region. Material and Method: This study has been performed prospectively to evaluate the types and frequency of anemia existed in patients those who have applied to department of endocrinology and metabolic diseases of Recep Tayyip Erdoğan University between the dates 01.12.2012 and 01.05.2013 and those who have been diagnosed with subclinical and clinical hypothyroid. The study includes ninety six subclinical hypothyroid patients, thirty clinical hypothyroid patients and one hundred healthy people as a control group. The normal value of ft4 and ft3, the high value of TSH are used in the diagnosis of subclinical hypothyroidism. The low level of ft4 and/or ft3 are used, the high level of TSH is used in the diagnosis of clinical hypothyroidism. In diagnosis of anemia, the level of hemoglobin has been taken as <13g/dl for men and <12g/dl for women in the control group, subclinical hypothyroid group and clinical hypothyroid group. Findings: A total of two hundred and twenty six people have been involved in this study and when it is examined on the basis of group, the rate of anemia in the subclinical hypothyroid patient group has been determined as 30,2%, in the clinical hypothyroid patient group has been determined as 40% and in the control group has been determined as 25%. It has been statistically found a significant difference between the clinical hypothyroid group and the control group in terms of the frequency of anemia (p=0.033). It has not been statistically found a significant difference in terms of the frequency of anemia between the subclinical hypothyroid group and the control group (p=0.0586). It has been statistically found a significant difference between the patient group (subclinical + clinical hypothyroidism) and the control group in terms of the frequency of anemia (p=0.049). The most frequent type of anemia existed in the subgroup examination of a total of sixty six anemic patients in the control group and the patient group is anemia of chronic disease in both groups. However, v among the groups, it has not been statistically found a significant difference in terms of anemia of chronic disease (p=0,223). In the subgroup examination of the anemic patients, it has not been statistically found a significant difference among all the groups with regards to dispense of iron deficiency anemia, B12 deficiency anemia and folate deficiency anemia. Conclusion: It has been determined that hypothyroidism increases the frequency of anemia and observed that the most frequent type of anemia existed in hypothyroid patients is anemia of chronic disease (normocytic). Key words: Anemia, Subclinical hypothyroidism, Clinical hypothyroidism