Correlation of thyroid stimulating hormone levels and hematological parameters among euthyroids, hypothyroids and hyperthyroids

Pushparaj T .

Abstract


BACKGROUND Thyroid hormones have a crucial role in metabolism and proliferation of blood cells. Thyroid dysfunction induces different effects on blood cells such as anemia, erythrocytosis and alters RBC indices. This study was attempted to evaluate the effect of hypothyroidism and hyperthyroidism on Hemoglobin (Hb), Hematocrit (HCT) and Mean Corpuscular Volume (MCV). METHODS This observational study was performed on 90 women visiting endocrinology department. Thyroid stimulating hormone (TSH) levels of the subjects was determined and according to TSH ranges, patients were divided into euthyroids (TSH - 0.30-5.50IUmL), hyperthyroids (TSH 0.30IUmL) and hypothyroids (TSH 5.50IUmL). EDTA samples were subjected for complete blood count in which Hb, HCT and MCV were taken for this study. Anemia was defined by hemoglobin level 12 gm in women, further classified as microcytic, normocytic, or macrocytic in the presence of MCV values of less than or equal to 80 fL, 80 to 95fL, and greater than or equal to 95 fL respectively. The results were analyzed by SPSS software using independent student t test and pvalue 0.05 was considered to be statistically significant. RESULTS There was statistically significant difference in Hb, MCV and HCT when euthyroids were compared with hypothyroids and hyperthyroids. MCV values were significantly decreased in hyperthyroidism while significantly increased in hypothyroidism. Hb and HCT were significantly decreased in both hyperthyroidism and hypothyroidism compared to euthyroids. CONCLUSION Thyroid hormones have a significant influence on erythropoiesis. Thyroid dysfunction produces anemia, mostly microcytic anemia in hyperthyroids and macrocytic in hypothyroids.All the patients with hypothyroidism and hyperthyroidism should be periodically evaluated for hematological changes and the patients with unknown hematological dysfunctions must be evaluated for thyroid function tests.

Full Text:

PDF

References


Ambika Gopalakrishnan Unnikrishnan, Usha V Menon. Thyroid disorders in India: An epidemiological perspective. Indian journal of endocrinology and metabolism 2011; 15(6):78-81.

Golde DW, Bersch N, Chopra IJ, Cline MJ. Thyroid hormones stimulate erythropoiesis in vitro. The British Journal of Hematology 1977; 37(2):173–177.

Fujita H. Fine structure of the thyroid gland. Int Rev Cytol 1975; 40:197–280.

Ahmed OM, El-Gareib AW, El-Bakry AM, Abd El-Tawab SM, Ahmed RG. Thyroid hormones states and brain development interactions. Int J Dev Neurosci 2008; 26(2):147–209.

Baloch Z, Carayon P, et al. Guidelines committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of the thyroid disease. Thyroid 2003; 13(1):3-126.

Bain BJ, Lewis SM, Bates I. Basic hematological techniques. Lewis SM,Bain BJ, Bates I. Dacie and Lewis practical hematology. 3rd ed.Philadelphia: Elsevier; 2006:25-59.

Omar S, Hadj-Taeib S, Kanoun F, Hammami MB, Kamoun S, Ben Romdhane N et al. Erythrocyte abnormalities in thyroid dysfunction.Tunis Med 2010;88(11):783-8.

Axelrod AR, Berman L. The bone marrow in hyperthyroidism and hypothyroidism. Blood 1951; 6(5):436–453.

Golde DW, Bersch N, Chopra IJ, Cline MJ. Thyroid hormones stimulate erythropoiesis in vitro. Br J Haematol 1977;37(2):173–7.

Geetha J, Srikrishna R. Role of red blood cell distribution width (rdw) in thyroid dysfunction. Int J Biol Med Res 2012;3(2): 1476–78.

Kawa MP, Grymua K, Paczkowska E, Bakiewicz-Masiuk M, Dbkowska E, Kozioek M, et al. Clinical relevance of thyroid dysfunction in human haematopoiesis: biochemical and molecular studies. Eur J Endocrinol 2010;162(2): 295–305.

Armstrong MD, Klein JR. Immune-endocrine interactions of the hypothalamus-Pituitary–thyroid axis: interaction, communication and homeostasis. Arch Immunol Ther Exp 2001; 49:231-237

Horton L, Coburn RJ, England JM, Himsworth RJ. The hematology of hypothyroidism. Q J Med 1976;45(177): 101-23.

Antonijevic N, Nesovic M, Trbojevic B, Milosevic R. Anemia in hypothyroidism. Med Pregl. 1999 Mar-May; 52(3-5):136-40.

Nightingale S, Vitek PJ & Himsworth R.L. The haematology of hyperthyroidism. Q J Med 1978, 47:35-47.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr M.G.R. Medical University