Introduction: Elevated anti-thyroid peroxidase (Anti-TPO) antibodies and thyroid stimulating hormone (TSH) levels in hypothyroidism have been linked to the alter the vitamin B12 metabolic pathway thereby imparting the anemia. Thyroid peroxidase is an important enzyme responsible during organification of iodide for synthesis of thyroid hormone. Antibodies to TPO are formed as a part of autoimmune response of body causing autoimmune thyroiditis in patients. Antibodies to thyroid peroxidase (TPO) are clinically useful markers of thyroid autoimmunity