Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial
IntroductionThe management of hypothyroidism during Ramadan represents a tangible challenge as levothyroxine (L-thyroxine), the first-line treatment for hypothyroidism, must be administered on an empty stomach at least 30 min before a meal in order to enhance its absorption.AimThe present study aime...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1513904/full |
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| author | Nawal Al-Mutawa Bashair M. Mussa Suhair Akhlaq Zeenat AbdulWahid Ahmad Qawas |
| author_facet | Nawal Al-Mutawa Bashair M. Mussa Suhair Akhlaq Zeenat AbdulWahid Ahmad Qawas |
| author_sort | Nawal Al-Mutawa |
| collection | DOAJ |
| description | IntroductionThe management of hypothyroidism during Ramadan represents a tangible challenge as levothyroxine (L-thyroxine), the first-line treatment for hypothyroidism, must be administered on an empty stomach at least 30 min before a meal in order to enhance its absorption.AimThe present study aimed to compare the thyroid-stimulating hormone (TSH) levels among patients with hypothyroidism treated with an extra dose of l-thyroxine (25 mcg L-thyroxine, treatment group) versus a standard/regular dose (1.6 mcg/kg) of l-thyroxine (control group) during the month of Ramadan.MethodsThis study is a 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 five visits before, during, and after Ramadan. Several tests were conducted, including thyroid function, lipid profile, HbA1c, and vitamin D.ResultsOne of the most significant findings of the present study is that the extra dose of 25 mcg of L-thyroxine during Ramadan maintained the TSH levels of patients within the normal reference range, i.e., 0.55–4.78 mIU/L, at each visit during and after Ramadan without the need to wait 30 min before the meal. The mean TSH values were comparable between the treatment group and the control group during the five visits (visit 1, 3.00 ± 2.44 and 3.45 ± 3.02; visit 2, 3.62 ± 3.21 and 3.74 ± 2.74; visit 3, 4.19 ± 3.85 and 4.89 ± 2.92; visit 4, 3.54 ± 2.96 and 5.15 ± 4.26; and visit 5, 3.61 ± 3.05 and 3.32 ± 2.57, respectively).ConclusionThe present study demonstrated that the extra dose of L-thyroxine had a positive effect on keeping the TSH levels of patients in the normal reference range at each visit during and after Ramadan. However, in the control group, the mean TSH levels were higher than the normal range at visits 4 and 5. |
| format | Article |
| id | doaj-art-5e0db06c20b941de959d6002a48ea53e |
| institution | OA Journals |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-04-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-5e0db06c20b941de959d6002a48ea53e2025-08-20T02:26:15ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15139041513904Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trialNawal Al-Mutawa0Bashair M. Mussa1Suhair Akhlaq2Zeenat AbdulWahid3Ahmad Qawas4Endocrinology Department, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab EmiratesBasic Medical Science Department, College of Medicine, University of Sharjah, Sharjah, United Arab EmiratesStatistics and Research Center, Ministry of Health and Prevention, Dubai, United Arab EmiratesDepartment of Endocrinology, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab EmiratesStatistics and Research Center, Ministry of Health and Prevention, Dubai, United Arab EmiratesIntroductionThe management of hypothyroidism during Ramadan represents a tangible challenge as levothyroxine (L-thyroxine), the first-line treatment for hypothyroidism, must be administered on an empty stomach at least 30 min before a meal in order to enhance its absorption.AimThe present study aimed to compare the thyroid-stimulating hormone (TSH) levels among patients with hypothyroidism treated with an extra dose of l-thyroxine (25 mcg L-thyroxine, treatment group) versus a standard/regular dose (1.6 mcg/kg) of l-thyroxine (control group) during the month of Ramadan.MethodsThis study is a 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 five visits before, during, and after Ramadan. Several tests were conducted, including thyroid function, lipid profile, HbA1c, and vitamin D.ResultsOne of the most significant findings of the present study is that the extra dose of 25 mcg of L-thyroxine during Ramadan maintained the TSH levels of patients within the normal reference range, i.e., 0.55–4.78 mIU/L, at each visit during and after Ramadan without the need to wait 30 min before the meal. The mean TSH values were comparable between the treatment group and the control group during the five visits (visit 1, 3.00 ± 2.44 and 3.45 ± 3.02; visit 2, 3.62 ± 3.21 and 3.74 ± 2.74; visit 3, 4.19 ± 3.85 and 4.89 ± 2.92; visit 4, 3.54 ± 2.96 and 5.15 ± 4.26; and visit 5, 3.61 ± 3.05 and 3.32 ± 2.57, respectively).ConclusionThe present study demonstrated that the extra dose of L-thyroxine had a positive effect on keeping the TSH levels of patients in the normal reference range at each visit during and after Ramadan. However, in the control group, the mean TSH levels were higher than the normal range at visits 4 and 5.https://www.frontiersin.org/articles/10.3389/fendo.2025.1513904/fullhypothyroidismlevothyroxinefastingRamadanTSHFT3 |
| spellingShingle | Nawal Al-Mutawa Bashair M. Mussa Suhair Akhlaq Zeenat AbdulWahid Ahmad Qawas Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial Frontiers in Endocrinology hypothyroidism levothyroxine fasting Ramadan TSH FT3 |
| title | Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial |
| title_full | Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial |
| title_fullStr | Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial |
| title_full_unstemmed | Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial |
| title_short | Extra levothyroxine dose in Ramadan maintained normal thyroid hormone levels in patients with hypothyroidism: a randomized controlled trial |
| title_sort | extra levothyroxine dose in ramadan maintained normal thyroid hormone levels in patients with hypothyroidism a randomized controlled trial |
| topic | hypothyroidism levothyroxine fasting Ramadan TSH FT3 |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1513904/full |
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