Interactions of ferrokinetics and thyroid function

الملخص EN

Background : Thyroid diseases like any other systemic disease, can be associated with anemia.

Different types of anemia, normocytic, microcytic, and macrocytic anemia can occur in thyroid gland disorders.

On the other hand, iron deficiency anemia was reported to be associated with low plasma thyroid hormone levels, in addition, iron deficient anemic rats appeared to be hypothyroid in many aspects.

Objective : To study the effect of thyroid dysfunction on body iron status, and to evaluate the possible changes in thyroid hormone profiles in iron deficiency anemia.

Study Design : The study was conducted on 60 subjects, 15 patients with hyperthyroidism, 15 patients with hypothyroidism, 15 patients with iron deficiency anemia, and 15 healthy subjects as a control group.

Complete blood count, and red cell indices, in addition to serum iron, serum ferritin, FTp TT3 and TSH levels were determined in all the subjects.

Results: Compared to healthy subjects, patients with hyperthyroidism had significantly lower Hb concentration (11.7±2.18 vs 13.7 ± 1.6gm / dl), red cell count (3.5 ± 0.91 vs 4.4 ± D.5 million / CC), and MCV (79.8 ± 7.9 vs 84.9 ± 3.2 fl), with P < 0.

05.

Serum iron level in hyperthyroid patients was non significantly lower than the control group (81.7±49.4 vs 87.8± 25.9 /./ g / dL, P > 0.05).

Serum ferritin level was significantly higher in patients with hyperthyroidism compared to healthy control (74.0±51.3 vs 44.3±29.2 ng/ml, P<0.05).

On comparing patients with hypothyroidism to the healthy control, they had significantly lower Hb concentration (11.2 + 1.9 vs 13.7 ± 1.6 gm/dL, P < 0.05), and non significantly lower red cell count (3.9 ± 1.2 vs 4.410.5 million ICC), and MCV (83.9 ± 7.4 vs 84.9 ± 3.2 ju3) with P > 0.05.

Serum iron in hypothyroid patients (84.6 + 39.4 jUg / dL) was non significantly lower than the control group (87.8125.9 jug / dL) and non significantly higher than serum iron in hyperthyroid patients (81.7 ± 49.4 fJgldL) P was >0.05.

Serum ferritin level was non significantly lower in hypothyroid patients (30.7121.2 ngl ml) compared to the control group (44.3129.2 ngl ml, P>0.05), and was significantly lower than in hyperthyroid patients (74.0d£1.3 ngl ml, P < 0.05').

On comparing patients with iron deficiency anemia, to the healthy control, non significant difference was detected as regard serum FT4 level (1.610.3 vs 1.3 ±0.32 ng %), TT3 (1.3110.47 vs 1.1210.37 ngl ml) and TSH level (1.87 ± 1.05 vs 1.95 ± 1.22 fjIU / ml) with P>0.05.

A highly significant positive correlation was found between serum ferritin level and both FT4 (r = 0.56, P < 0.001) and TT3 (r = 0.43, P<0.001), and a significant negative correlation was detected between serum ferritin and TSH levels (r = - 0.28, P < 0.05).

Conclusion: (1) Normocytic normochromic anemia is common both in hypo and hyperthyroidism, (2) serum ferritin level is significantly higher in hyperthyroid patients compared to the control group and to the hypothyroid patients, which points to the role of thyroid hormones to upregulate serum ferritin level, (3) thyroid hormone profile is not significantly affected by mild to moderate iron deficiency anemia.