Thyroid Function and Blood

Thyroid dysregulation affects blood function. I see alterations to routine hematological parameters with thyroid dysregulation, such as hemoglobin, hematocrit, blood cell volume, mass and shape, and white blood cell and platelet count. In addition, there is often just less blood, period.This will throw all parameters out the window because the labs measure the size and volume of red blood cells from a blood sample, but this won't reflect a low volume of bloodless blood in the system—which causes the same symptoms as anemia or a decrease in red blood cell mass.

Blood and red blood cells bring oxygen from the lungs to all the tissues in our body and carry the CO2 back to the lungs for elimination. Many people with hypothyroidism have anemia. Anemia is twice as prevalent in women than in men, and 2 to 8 times more women than men have thyroid issues; more women than men are hypothyroid with anemia. Low thyroid function significantly impairs the absorption of nutrients and can also cause heavy bleeding during the menstrual cycle, making women even more at risk. Add in the unfortunate fact that women get and eat much less meat in all cultures. The combination of low iron and low thyroid function is a serious health issue for women globally. Adolescent females are most at risk.

Hypothyroidism interferes with iron and vitamin B absorption, precisely that of B12. If you get less meat, you get less B12. However, with low thyroid function, you could have good nutrition, with plenty of iron-rich red meat and other animal proteins rich in B12. Still, your hypothyroid gut won't be able to absorb or synthesize them. The hypothyroid gut doesn't have enough hydrochloric acid, digestive enzymes, or bile. B12, and of course iron, are only found in bioavailable forms in animal food. For this reason, the carnivore or meat-based diet is crucial to obtain adequate nutrients.

Hydrochloric acid, digestive enzymes, and bile are essential for successfully absorbing B12 and iron. Yet even if absorption is successful, I have seen many cases where assimilation is not. I often see either low or very high levels of both B12 and iron in hypothyroidism. Both mean a deficiency. Thyroid hormone increases the absorption of B12 and the mobilization of B12 from where the liver stores it. The autoimmune condition of pernicious anemia with B12 deficiency is not that rare. It's malnourishment and often a hypothyroid condition. As far as we know, it's due to the lack of a protein in the stomach called intrinsic factor. No matter how much Vitamin B12-rich food you consume, without intrinsic factors, it can't be absorbed; in hypothyroidism, the parietal cells secrete much fewer intrinsic factors secreted by the stomach.

There are different kinds of anemias. Microcytic anemia is low iron due to a lack of absorption and assimilation or heavy bleeding. Macrocytic anemia is low B12. We need B12 to regulate red blood cell size.

Folate/Vitamin B9 gets written about a lot as being essential for this, but who needs B9 if you've got B12, in this case? Biochemist Lucy Wills isolated what was for years called the Wills Factor in 1931 while researching macrocytic anemia and pregnancy among poor Muslim women working in textile factories in Mumbai, India. Muslim Indian families do eat some meat, but they are still 67% vegetarian, especially those who are poor. Between 1928 and 1933, she researched the maternity wards of different hospitals. Lucy Wills gave pregnant women patients both crude liver extracts and pure liver extracts containing arsenic. Another group of patients received an injection of a liver extract. The women in both groups improved. While she did use the yeast-derived Marmite when she returned to work at a hospital in England, she wrote in her papers that the animalderived liver extract was the best treatment option for anemic pregnant women. Brewers yeast and Marmite were just cheaper. In 1941, Herschel K. Mitchell, Esmond E. Snell, and Roger J. Williams isolated synthetic folate from 4 lbs of spinach. It became a B vitamin called B9. Folic acid was much cheaper than a meat extract. Previously, no one needed folate. They just ate meat. Today, most blood tests include a test for folic acid. Folic acid is not a necessary nutrient if you eat meat.

Without the proper regulation of the size of red blood cells, you get megaloblastic anemia, when the bone marrow produces red blood cells (megaloblasts) too big to get into the bloodstream. While pernicious anemia is often described as a rare blood disorder, up to 40% of hypothyroid patients have a B12 deficiency, and that's just those tested with the routine vitamin B12 test, the one that doesn't measure active B12, the test that shows the proper vitamin B12 level. Therefore, many more people with low thyroid function may have B12 deficiencies. Iodine is also essential for good iron levels. Several significant studies have shown that supplementing with iron and iodine increases iron levels more quickly.Gut health and diet aren't the only causes of low iron in thyroid dysregulation. Erythropoiesis, which produces red blood cells in bone marrow, is slowed down, like everything else, with low T3 hormone. T3 increases the secretion of the erythropoietin hormone, which increases oxygen availability by boosting the production of red blood cells— low t3, low red blood cell production, and low oxygen.

Anemia makes you feel tired and weak because tissues aren't getting enough oxygen, but this lack can damage organs and tissues over time. The lack of oxygen can cause the inflammation seen in rheumatoid arthritis. Anemia also causes changes in heart rhythm and lung function, leading to inflammatory conditions, infections, and cancers. It makes a person feel cold, can cause hair loss, and makes skin pale. All these symptoms return to normal if there is enough thyroid hormone.

Another important aspect of low thyroid and blood health is how your blood clots. Hypothyroidism reduces clotting factors. Easy bruising is something I look for in my patients. If the person always has bruises and says, "Oh, I've always bruised easily. I have no idea what causes my bruises. I didn't fall or hit anything, and no one hit me." I then check for anemia and investigate their thyroid function. Reduced clotting can cause prolonged bleeding after surgery or minor injuries.

This deranged clotting factor explains the menstrual hemorrhaging and nose bleeds typical in hypothyroidism. Several of my patients had been diagnosed with Willebrand's Disease in their forties. Willebrand's Disease is similar to hemophilia but affects women more, causing excessive bruising and heavy periods due to a deficiency in pro-von Willebrand factor, a glycoprotein in blood. They were women who had had heavy bleeding during their cycles. Despite the heavy periods, they were assured they were fine for decades and were happy to finally get a clue as to what caused their symptoms. Their doctors had only tested TSH until I asked them to test free T3. All had lower than optimal free T3 levels, so I diagnosed them as hypothyroid.

I can't emphasize enough how important it is to eat to be sure you are getting plenty of iron and B12. You need to eat plenty of red meat. It does not mean eating leafy, green vegetables.+ pro-von Willebrand factor. Affected people may complain of excessive bruising, prolonged bleeding from mucosal surfaces, and prolonged bleeding after minor trauma.