Ramadan and Hypothyroidism: Impact of Ramadan Fasting on Thyroid Status

Background: Fasting Ramadan is the third pillar of Islam. Patients with primary hypothyroidism need levothyroxine replacement when fasting. The aim of this study is to investigate the impact of fasting on thyroid hormone balance in patients with hypothyroidism under levothyroxine. Methods: This was a prospective study carried out during Ramadan of the Hegira years 1439 and 1440. We included all the patients with hypothyroidism who fast and take levothyroxine, with a normal rate of ultra-sensitive thyroid-stimulating hormone (TSH us) before Ramadan. The study was conducted in two phases: a first phase before Ramadan when we evaluated the thyroid status by measuring TSH us and a second phase after Ramadan when we evaluated the thyroid status, the therapeutic compliance, the respect of the interval during the month of Ramadan. Treatment compliance was assessed using Morisky’s questionnaire. Results: We collected 65 patients. Treatment adherence was good in 82.1% of cases, moderate in 12.5% of cases, and poor in 5.4% of patients After Ramadan, 80% of patients remained in euthyroidism while 9% of patients were in hyperthyroidism and 10% patients in hypothyroidism. Conclusion: Our study highlighted the importance of treatment adherence and respect of interval between the meal and levothyroxine intake to maintain euthyroidism.