Impact of Increasing Levothyroxine Dose in Ramadan for UAE Patients With Hypothyroidism

The present study is an open-label, two-arm parallel groups, randomized controlled clinical trial that included Emirati patients with hypothyroidism who attended the Family Promotion Centre, Endocrinology Clinic, regularly. Eligible participants (n = 103) were randomly allocated to the treatment group (patients who received an increased dose of L-thyroxine, 25 mcg, n = 50) and the control group (patients who received standard/regular dose of L-thyroxine, n = 46). Both groups attended 5 visits before, during, and after Ramadan. Several tests were conducted including thyroid function, lipid profile, HbA1c, and Vitamin D.

The inclusion criteria for participants will include:

• Male and female patients with primary hypothyroidism.
• Patients with stable TSH
• Aged between 18 and 70 years.
• Patients regularly fasting for at least 25- 30 days during Ramadan.
• Emirati nationals (100% health care coverage)

Exclusion criteria

• Patients with any end organ damage
• Pregnant or Breast-feeding women
• Thyroid cancer
• Patients not adhering to initial thyroxine medications.
• Those receiving proton pump inhibitory therapy, dietary fiber, bile acid sequestrates, ferrous sulfate, sucralfate, calcium carbonate, aluminum-containing antacids, phosphate binders, and raloxifene.
• Disease interferes with thyroxine absorption, coeliac disease, inflammatory bowel disease, lactose intolerance as well as Helicobacter pylori (H. pylori) infection and atrophic gastritis,
• Several other factors cause treatment failures such as fiber-rich food, soy protein, grapefruit, and aluminum antacids, which interfere with Thyroxine absorption. In addition to calcium carbonate and ferrous sulfate.
• Patients were diagnosed with cardiovascular disorders, including angina, coronary artery disease, and hypertension.