Key Takeaways

Abnormalities in thyroid function have been associated with several hematological abnormalities including anemia, changes in the mean corpuscular volume, other cytopenias and changes in primary and secondary hemostasis.

Hypothyroidism associated with:

  • Macrocytosis in up to 35% of patients.
  • Anemia in 5-25% of patients, usually normocytic.
  • A shift of the hemostatic balance towards a hypocoagulable and hyperfibrinolytic (bleeding) state, including acquired von Willebrand disease (VWD).

Hyperthyroidism associated with:

  • Anemia in 5-20% of patients, usually normocytic but occasionally microcytic.
  • Thrombocytopenia, leukopenia, or pancytopenia in a minority of cases.
  • A shift of the hemostatic balance towards a hypercoagulable and hypofibrinolytic (clotting) state.

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