Thyroid disorders are frequently accompanied by red blood cell abnormalities. Thyroid hormones often have important effect on erythropoiesis. They enhance erythropoiesis through hyper proliferation of immature erythroid progenitors and increase secretion of erythropoietin (EPO) by inducing erythropoietin gene expression. Thyroid hormones also augment repletion of hypoxia inducible factor1 (HIF-1) and then motivate growth of erythroid colonies (BFU-E, CFU-E).These hormones also intensify erythrocyte 2, 3 DPG compactness, which enhances the delivery of oxygen to tissues.
Hypothyroidism can cause various forms of anemia (normochromic-normocytic, hypochromic-microcytic or macrocytic) through reducing the oxygen metabolism. Microcytic anemia generally attribute to malabsorption of Iron and loss of Iron by menorrhagia, whereas, macrocytic anemia causes or induces malabsorption of vitamin B12 , folate, pernicious anemia and insufficient nutrition.
On the other hand, anemia frequently is not seen in patients with hyperthyroidism, while there were erythrocytosis in this situation, but when anemia present, may be morphologically similar to that observed in hypothyroidism. Patients with hypothyroidism have a decreased erythrocyte mass due to reduction of plasma volume and may undetectable by routine measurement such as hemoglobin concentration, whereas an increased erythrocyte mass is observed in most hyperthyroid patients. Alteration in other hematological parameters such as hemoglobin (HG), hematocrit (HCT), mean corpuscular volume (MCV) ,mean corpuscular hemoglobin (MCH), white blood cell (WBC) count and platelet count is associated with thyroid dysfunction is observed as well, but all changes return to normal if an euthyroid (normal) state is obtained.
Also, another reason of anemia due to abnormal glucose metabolism is
common in thyrotoxicosis, the effect of overt hypothyroidism on glucose metabolism is still a subject of debate. Hemoglobin A1c levels were significantly higher in patients with overt hypothyroidism. However, A1c levels decreased after thyroid hormone replacement in patients with overt hypothyroidism. Serum Erythropoietin level, reticulocyte count, and MCH also increased after thyroid hormone replacement, therefore we consider that thyroid hormone stimulates erythropoiesis, and there normal levels much important to prevent from anemia and diabetes.
Most of the Hypothyroidism cases having anemias, Iron deficiency anemia also more common in females, Macrocytic anemia in both genders reported in some studies.
Sir Kenneth Braunstein I think I stated above that, Thyroid hormones also augment repletion of hypoxia inducible factor1 (HIF-1) and then motivate growth of erythroid colonies (BFU-E, CFU-E). Thyroid hormones intensify erythrocyte 2, 3 DPG compactness, which enhances the delivery of oxygen to tissues. Due to the reduction of oxygen metabolism, various forms of anemia (normochromic-normocytic, hypochromic-microcytic or macrocytic) in Hypothyroidism.
If you have any reason for your answer ""NO"", then I am waiting for your feedback, share knowledge to us.
I am a practicing hematologist of 39 years experience. I treat patients with anemia of all kinds including thyroid disorders. The answer I gave is what I see and what is the current teaching of hematology. Unless the anemia is secondary to an abnormal hemoglobin that either has increased or decreased affinity for oxygen or hemolytic anemia, then the oxygen saturation in an anemic patient is dependent upon the oxygen transport of the lungs and the inspired oxygen, carbon monoxide, carbon dioxide, nitrogen, helium, and other inhaled gases concentrations, and whether or not they have a right to left shunt in their heart or elsewhere or a ventilation perfusion defect in their lungs. In hemolytic anemia the breakdown of hemoglobin by the body will lead to an increased carbon monoxide blood level due to the catabolic breakdown of hemoglobin. There is also a rise in carbon monoxide secondary to internal bleeding and the resultant breakdown of hemoglobin from the hematoma.
It has been repeatedly demonstrated that in severely anemic patients giving oxygen therapy including hyperbaric oxygen has limited benefit since their oxygen saturations are already high. All you get is an increase in dissolved oxygen. In Sickle Cell therapy giving oxygen is of limited if any benefit and may deter the production of reticulocytes. Hyperbaric oxygen therapy is restricted to patients whose hemoglobin level has dropped below a level felt to be compatible with life.
Therefore, the short answer remains NO. There is no relation between oxygen saturation, hemoglobin content, and hematocrit in patients with either hypothryroidism or hyperthryroidism since their oxygen saturation level is dependent upon other factors such as the state of their lungs and the inspired oxygen tension.
Dear respected Kenneth; From your answer, I am satisfying just only for your clinically oriented information; but as we see in few articles (above mentioned) talk about their physiological role in the maintenance of oxygen consumption in RBCs, boost Erythropoietin level for erythropoiesis.
In addition, alteration in other hematological parameters such as hemoglobin, hematocrit, MCV, MCH, WBC count and platelet count is associated with thyroid dysfunction is observed as well, but all changes return to normal if an euthyroid (normal) state is obtained.
Thus, thyroid hormone replacement therapy will be benefited to deficient subjects who have low hemoglobin, low MCH value, low retic count, and low erythropoietin level......(without lungs disease). Also, if there is lung abnormality in hypo/hyperthyroid then count the contributing factors from lungs which directly involve oxygen saturation.
I would like to suggest that, current research should be design to focus anemia, hemoglobin concentration, oxygen saturation in thyroid disease subjects. As anemia is secondary, it should be discriminated from nutritional deficiency or other microcytic hypochromic anemias (anemia of chronic disease, chronic kidney disease, thalassemia traits etc).
Question was does thyroid status effect oxygen saturation in patients with anemia secondary to the hypothyroidism (since hyperthyroidism is not a common cause of anemia but is a cause of increased oxygen consumption). The answer remains no it does not affect oxygen saturation. It does affect Red Cell production by various means.
One issue you may consider is hemoglobin oxygen saturation vs. effective tissue oxygenation. Clinically, the infrared sensor placed on patients fingers measure "oxygenation" as a function of hemoglobin saturation, thus the term "O2-sat." As those familiar with carbon monoxide poisoning, in this setting O2-sats read as 100%, as carbon monoxide is 100% binding hemoglobin...nevertheless, the patient is hypoxic.
The amount of Hemoglobin does not impact the ability bind oxygen, only its allosteric sites (Fe, H+) of the enzyme; and therefore, does not impact its ability to oxygenate of tissues (affinity for O2). Yes, hypothryoidism may cause deregulation of Iron stores, but it will not change the ability to bind oxygen. A more precise measurement may be to look at the true oxygen concentration of control vs. hypothyroid patients. This is possible with fMRI using 18F, 18O, or a Ruthenium oxygen sensor probe for real-time measurements. Of course, be careful should you choose to an oxygen consuming probe such as platinum electrodes. There is also a hypoxia stain for histology you can use, pimodazole, to evaluate the extend of hypoxia in tissues for comparison.
Hello Sir Joshua E Mendoza-Elias ,So you are telling there may be deficiency of hemoglobin content in patients with hypothyroidism..And if so is it a common symptom that can be measurable?
I think its hard to form an opinion, and this is not really my area. I searched I did not find any direct study looking at hemoglobin deficiency and oxygenation in hypothyroid patients; except in the case of Iron Deficiency Anemia, which suggests a global nutrient deficiency anemia which can cause hypothyroidism.
Here are some papers that may interest you:
Paper with Hemoglobin Measurement:
Effect of Thyroid Dysfunctions on Blood Cell Count and Red Blood Cell Indice
Dorgalaleh A MSc1, Mahmoodi M BSc2,Varmaghani B MSc1, Kiani node F MSc1, Saeeidi Kia O BSc3, Alizadeh Sh PhD1, Tabibian Sh MSc1, Bamedi T MSc4, Momeni M BSc5, Abbasian S MSc1, Kashani Khatib Z BSc1
>> See Table II, Row 5. Here Hemoglobin is found to be statistically significant and lower than control.
Paper around Hypothyroidism in context of Iron Deficiency Anemia:
Treatment of Iron-deficiency Anemia in Patients with Subclinical Hypothyroidism
May I kindly suggest monitoring pulse ox in hypo and hyperthyroid patients at night when sleep shows the greatest effects During deep sleep. My experience is that it does effect saturation during deep sleep.