Interdependance of iron load and thyroid function - Thyroid UK

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Interdependance of iron load and thyroid function

diogenes profile image

The interrelationship between iron load and thyroid function is pretty well accepted, but I post here a paper showing the effect in children (can extrapolate safely to adults I think). It underlines the need for good iron loading to help rule out or confirm hypothyroidism.

Journal of Clinical and Diagnostic Research. 2018 Jan, Vol-12(1): BC01-BC05

DOI: 10.7860/JCDR/2018/32762.11023

Thyroid Function among Children with Iron Deficiency Anaemia: Pre and Post Iron Replacement Therapy



Metabolism of thyroid hormones and iron is quite interdependent. Data indicates that Iron Deficiency (ID) could impair thyroid metabolism.


To investigate the possible occurrence of thyroid dysfunction among children with isolated Iron Deficiency Anaemia (IDA) of various severities, and test if the oral iron replacement therapy alone can reverse the associated thyroid function disturbances, if present or additional therapies are required.

Materials and Methods:

This prospective study was carried out on 60 children selected from the attendants to the outpatient paediatric clinics of Al-Azhar University, Assiut and Qena university hospitals, Egypt, in addition to 60 controls. Complete blood count, thyroid profile, ferritin, iron, Total Iron Binding Capacity (TIBC), Transferrin Saturation% (TFS%), unsaturated iron binding capacity and Urinary Iodine Excretion (UIE) were assessed in the studied groups at baseline, then haemoglobin level and thyroid profile repeated among the studied patients after three months of oral iron supplementation therapy. Thyroid profile and ferritin were measured using commercially available Enzyme Linked Immunosorbent Assay (ELISA) kits; while, iron, TIBC and UIE were measured using colorimetric methods.


Significant higher serum Thyroid Stimulating Hormone (TSH) levels with significant lower serum levels of Free Triiodothyronine (FT3) and Free Thyroxine (FT4) among patients versus controls (p<0.001 for all). Significant positive correlation between serum iron and FT3 (r=0.284, p<0.05) with significant negative correlations between TSH versus both serum iron (r=-0.635, p<0.001) and ferritin (r=-0.342, p<0.01). Significant decrease in the serum levels of TSH, with significant increase in the serum levels of FT3 and FT4 (p<0.001 for all) to euthyroid status following oral iron replacement therapy.


Subclinical or primary hypothyroidism can occur among children suffering from moderate to severe IDA, which is reversible following oral iron replacement therapy only, without need to add thyroid replacement therapy.

4 Replies
helvella profile image

Full paper freely available as a PDF:

Journal site:

Thanks for posting. Please, are you able to tell me, how relevant to me (hypothyroid, TSH without meds over 95 which is highest lab goes to) is this? My ferritin scrapes along the bottom of the range and even after 2 years of prescribed ferrous fumarate had barely risen. Cause not explored because I'm vegan (have been for around 20 years) so presumed dietary. I am prescribed 60 mcg T3 daily. Should I take the ferritin level more seriously?

diogenes profile image
diogenes in reply to thyr01d

Yes I would do as it's rare to be healthy with low ferritin

Thank you Diogenes. Great post as usuall. Many of us are not told by Dr's that Iron is a very big component of our thyroid meds to work well for us. Dr's are very negligent and in some cases ignorant . It's not just take the thyroid meds and you'll be well. There is more to it then meets the eye.

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