Prevalence and Types of Anemia in Patients With Hypothyroidism in Buraidah, Saudi Arabia

Background Anemia is a common and often underrecognized comorbidity in patients with hypothyroidism. Its etiology is multifactorial and is influenced by thyroid hormone deficiency, nutritional status, and concomitant chronic conditions. Understanding the prevalence, hematological patterns, and predictors of anemia in patients with hypothyroidism is necessary to improve clinical outcomes. This study aimed to assess the prevalence of anemia, describe its types and features, examine its association with thyroid hormone status, and identify the independent predictors of anemia in patients with hypothyroidism. Materials and methods A retrospective study was conducted in 444 patients diagnosed with hypothyroidism. Demographic, clinical, and laboratory data were extracted from the electronic medical records. Hematological indices were compared between the anemic and non‑anemic groups using independent t-tests and chi-square tests. Multivariate logistic regression was performed to identify the independent predictors of anemia after adjusting for age, sex, diabetes, and hypertension. Results Anemia was present in 112 (25.2%) patients. In anemic patients, the most common type was normocytic anemia, occurring in 64 (57.1%), followed by microcytic anemia in 46 (41.1%) and macrocytic anemia in two (1.8%). Patients with anemia had significantly higher platelet counts than those without anemia (p < 0.001). Markers of thyroid function (TSH, T3, and T4) did not differ significantly between the groups (p > 0.05). Multivariate analysis revealed that female sex (adjusted odds ratio (AOR) = 3.210, 95% confidence interval (CI): 1.323-7.789, p = 0.010) and the presence of chronic diseases (AOR = 3.458, 95% CI: 1.829-6.536, p < 0.001) were independent predictors of anemia. Conclusions One in four patients with hypothyroidism had anemia, and the most common type was normocytic anemia. No significant differences in thyroid hormone levels were observed between anemic and non-anemic patients. Female sex and chronic diseases were significant risk factors for anemia, emphasizing the importance of targeted screening and comprehensive evaluation of these subgroups. Early diagnosis and treatment of anemia may improve overall clinical outcomes in patients with hypothyroidism.