Effect of levothyroxine dosing time during Ramadan on thyroid functions among adult patients with primary hypothyroidism
Year: 2025
Type: article
Study design: Observational Study
Abstract: ABSTRACT Background: Ramadan fasting alters meal timing and poses challenges to optimal levothyroxine (LT4) absorption in patients with hypothyroidism. Evidence is limited regarding the best dosing time during Ramadan fasting. Objective: The objective of this study was to evaluate the impact of different LT4 administration timings during Ramadan on thyroid functions among adults with primary hypothyroidism. Materials and Methods: This prospective, observational study enrolled 68 adults (18–60 years) with primary hypothyroidism who fasted throughout Ramadan 2025. Participants were stratified into three groups: Group 1 (preiftar, n = 34), Group 2 (presuhoor, n = 22), and Group 3 (random timing, n = 12). Thyroid-stimulating hormone (TSH) and total thyroxine (T4) were measured within 1 month before and after Ramadan. TSH control was defined as per standard reference ranges. Statistical analysis included analysis of variance and Chi-square tests. Results: Baseline demographics were comparable across the groups. The mean pre-Ramadan TSH was highest in the random timing group (23.19 ± 24.37 mIU/L) and lowest in the presuhoor group (4.85 ± 6.67 mIU/L) (P = 0.03). Post-Ramadan TSH decreased in all groups but without statistical significance (P = 0.38). No significant intragroup changes in TSH or T4 were observed. TSH control rates improved modestly in the preiftar group (from 16 to 18; P = 0.75) and presuhoor group (from 18 to 22; P = 0.12) but remained unchanged in the random group. Conclusion: No significant differences were found in thyroid function outcomes across different LT4 dosing timings during Ramadan. These findings suggest that consistent adherence and appropriate fasting intervals may be more important than specific dosing timings.
Source: Thyroid Research and Practice
Authors: Naima Parveen, Shefali Gond, Sachin Chittawar, Deepak Khandelwal
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416587992