Anemia and Hemochromatosis in People With Hypothyroidism

How an Underactive Thyroid Affects Blood Iron Levels

anemia, hemochromatosis, thyroid problems, iron deficiency anemia
Jonathan Knowles / Getty Images

Two conditions related to iron levels in the blood — anemia and hemochromatosis— are more common in people with hypothyroidism than in the general population. Anemia is commonly known as iron deficiency while hemochromatosis is the excessive accumulation of iron in the blood.

Hypothyroidism and Anemia

While anemia is a common condition that can affect most anyone, it tends to occur more frequently in people with hypothyroidism.

In fact, anemia is often the symptom that leads a person to a hypothyroid diagnosis.

Studies suggest that the rate of anemia in people with symptomatic hyperthyroidism is almost twice that of the general population (43 vs. 26 percent). Even in people with few hypothyroid symptoms, an estimated 39 percent will have some form of anemia

The causes for anemia are complex, ranging from thyroid-related digestive disorders to an ability to oxidize iron-containing compounds (called heme) in the liver.

In terms of digestion, people with hypothyroidism do not produce gastric acid as well as others unaffected by the disease. Gastric acid is essential for the uptake of minerals such as iron, calcium, magnesium, and zinc. As such, low thyroid activity can alter one's ability to properly absorb nutrients, leading to the development of anemia and other mineral-related deficiencies.

Symptoms of anemia include:

  • fatigue
  • a pale appearance to the lining of lower eyelids
  • heart palpitations
  • fast or irregular heartbeats
  • faintness and breathlessness
  • hair loss
  • easy bruising
  • dizziness
  • long or unusually heavy menstrual periods

Iron supplementation is commonly prescribed for people with anemia. For more severe cases, a blood transfusion may be required.

In addition, changes in diet are known to help. This includes eating foods high in vitamin C, eating more red meat, and increasing dietary fiber to prevent constipation.

Hemochromatosis and Hypothyroidism

Hemochromatosis is rare but is more common in people with hypothyroidism, typically affecting those 40 to 60 years of age.

Hemochromatosis is a genetic disorder, also known as iron overload disease, where excessive amounts of iron are absorbed from food. As the iron begins to accumulate in the liver, heart, and pancreas, it can cause damage to the organs and lead to liver disease, heart disease, and the development of diabetes.

Despite its rarity, hemochromatosis is considered the most common genetic disorder in the U.S. with an estimated 37 million " silent carriers" Of these, as many as three million are at risk for developing symptomatic disease.

In addition to the genetic factors, some experts believe that hemochromatosis also has an autoimmune component, which would explain why there is a higher rate of the disease in people with hypothyroidism.

Symptoms of hemochromatosis include:

  • chronic fatigue
  • arthritis-like pain in joints, particularly the two middle fingers
  • loss of libido and impotence
  • early absence of menstrual periods
  • darkening of the skin
  • generalized weakness
  • redness in the palms
  • abdominal pain
  • shortness of breath
  • heart arrhythmia (uneven beats)
  • depression
  • elevated blood sugar

Treatment for hemochromatosis includes doctor-supervised therapeutic phlebotomy in which blood is routinely drawn to remove excess iron.


Mehmet, E.; Aybik, K.; Ganidagli, S.; et al. "Characteristics of anemia in subclinical and overt hypothyroid patients" Endocrine Journal. 2012; published online ahead of print December 27, 2011.

Barton, J. and Barton, J. "Autoimmune Conditions in 235 Hemochromatosis Probands with HFE C282Y Homozygosity and Their Relatives." Journal of Immunology Research. 2015; article 435046:1-11.