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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1513904
Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial
Provisionally accepted- 1 Emirates Health Services (EHS), Dubai, United Arab Emirates
- 2 College of Medicine, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
- 3 Ministry of Health And Prevention (United Arab Emirates), Dubai, United Arab Emirates
- 4 Al Qassimi Hospital for Women and Children (AQWCH), Sharjah, United Arab Emirates
Introduction:Management of hypothyroidism during Ramadan represents a tangible challenge as levothyroxine (L-thyroxine), first-line treatment for hypothyroidism, must be administered on an empty stomach at least 30 minutes before a meal to enhance its absorption.Aim:The present study aims to compare Thyroid Stimulating Hormone (TSH) levels among patients with hypothyroidism treated with extra dose of L-thyroxine (L-thyroxine 25 mcg, treatment group) versus standard/regular dose (1.6 mcg/kg) of L-thyroxine (control group) during the month of Ramadan. Methods:The present study is, randomized controlled clinical trial that included patients with hypothyroidism. Eligible participants (n = 103) were randomly allocated to the treatment group and the control group. Both groups attended 5 visits before, during, and after Ramadan. Several tests were conducted including thyroid function, lipid profile, HbA1c, and Vitamin D.Results:One of the most significant findings of the present study is that extra dose of 25 mcg of L-thyroxine during Ramadan maintaining patients’ TSH within the normal reference range of 0.55 - 4.78 mI U/L at each visit during and after Ramadan without the need to wait 30 mins before the meal. The mean value of the TSH levels were comparable between the treatment group and control group, during the 5 visits (Visit 1, 3.00 ± 2.44, 3.45 ± 3.02; Visit 2, 3.62 ± 3.21, 3.74 ± 2.74; Visit 3, 4.19 ± 3.85, 4.89 ± 2.92; Visit 4, 3.54 ± 2.96, 5.15 ± 4.26; Visit 5, 3.61 ± 3.05, 3.32 ± 2.57), respectively.Conclusion:The present study demonstrated that extra dose of L-thyroxine has a positive effect on keeping patients’ thyroid levels in the normal reference range at each visit during and after Ramadan, whereas in the control group the mean TSH level was higher than the normal range in visits 4 and 5.
Keywords: Hypothyroidism, Levothyroxine, Fasting, ramadan, TSH, FT3, FT4, Thyroid peroxidase antibody
Received: 19 Oct 2024; Accepted: 24 Feb 2025.
Copyright: © 2025 Al Mutawa, Mussa, Akhlaq, Zeenat AbdulWahid and Qawas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bashair M Mussa, College of Medicine, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
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