Endocrine Abstracts

Introduction: During Ramadan, Muslims change their eating and sleeping habits. All these changes can cause metabolic and hormonal variations. The main treatment for hypothyroidism is L-thyroxine. It is known that the absorption of L-thyroxine is optimal when taken on an empty stomach. Very few studies have been conducted to examine the best time to administer L-thyroxine during Ramadan.

Objective of the study: To evaluate the impact of Ramadan fasting on hormonal balance and to compare the use of L-thyroxine 30mn before Fotour and at Sohour.

Material and methods: Prospective study including 62 patients followed in consultation for hypothyroidism. A TSH measurement was performed before and after 6 weeks. The evaluation of the therapeutic compliance was evaluated by the MORISKY Medication Adherence Scale.

Results: We recruited 62 patients, 53 of whom were women (85.5% of cases) and 9 men (14.5% of cases). The average age was 50.4 years (29-80). Hypothyroidism of peripheral origin was present in 24 patients (38.7% of cases) while hypothyroidism secondary to total thyroidectomy was present in 38 patients which is 61.3% of cases. Twenty-nine patients preferred to take L-thyroxine at the time of Fotour (46.8% of cases), while 33 patients preferred to take it at the time of Sohour (53.2% of cases). Compliance was good in 87.1% of cases and average in 12.9% of cases. In post-Ramadan, 75.8% of patients remained euthyroid, 17.7% hypothyroid and 6.5% hyperthyroid without significant correlation between the two therapeutic schemes (P=0.07).

Conclusion: Fasting during the month of Ramadan may be responsible for hormonal imbalance in patients on L-thyroxine, hence the interest of educating these patients on the use of medication and of a close follow-up after the month of fasting.