Pathophysiology

Both iron deficiency anemia (macrocytic anemia) and vitamin B12 deficiency anemia (macrocytic anemia) are associated with hypothyroidism [Starr2005, pg 112].

Diagnosis

Differential Diagnosis

  • Check CBC
  • Copper deficiency or zinc excess
  • Iron deficiency (check ferritin)
  • Vitamin B12 deficiency
  • Vitamin B9 (folate or folic acid) deficiency
  • Poor bone marrow function
  • Abnormal red blood cell function (sickle cell anemia, thalassemia, etc)
  • Hemolytic anemia

Differential Diagnosis

  • Check CBC
  • Copper deficiency or zinc excess
  • Iron deficiency (check ferritin)
  • Vitamin B12 deficiency
  • Vitamin B9 (folate or folic acid) deficiency
  • Poor bone marrow function
  • Abnormal red blood cell function (sickle cell anemia, thalassemia, etc)
  • Hemolytic anemia

Management

Be sure to identify the nutritional imbalance before taking copper, zinc, or iron supplements! Taking the wrong supplement can be harmful!

Controversies / Research Directions

One possible explanation for the association of anemia and hypothyroidism is that hypothyroidism lowers body temperature resulting in reduced activity of red bone marrow [Starr2005, pg 138].

References