Endocrine Abstracts

Introduction: Hypothyroidism is a chronic pathology, which can have several etiologies and which requires long-term treatment. The modification of meal times during the month of Ramadan which can modify the absorption of L-thyroxine, knowing that it interferes with the taking of meals.

Purpose of the study: Assess the impact of L-thyroxine intake schedule on the therapeutic balance during Ramadan in patients with hypothyroidism.

Materials and methods: This is a prospective study that included all patients followed for hypothyroidism on levothyroxine, including patients followed in thyroid carcinoma consultation, having consulted during the pre-Ramadan 2022 period. All the patients included were in euthyroidism before Ramadan or within the TSH objective for patients operated on for thyroid carcinoma. We divided the patients into three groups according to the schedule for taking the treatment (before Shour, before Ftour and without a fixed schedule) and we evaluated the impact on TSHus 6 weeks after the end of the month of Ramadan. We assessed therapeutic compliance based on the Morisky questionnaire.

Results: We collected 177 patients. The average age is 49.8 years with a female predominance of 67.8%. Peripheral hypothyroidism was present in 64 patients (36.5% of cases) while hypothyroidism secondary to total thyroidectomy was present in 113 patients, i.e. 63.5% of cases including 43 thyroidectomized patients for thyroid carcinoma. During the month of Ramadan, therapeutic compliance was good in 81% of cases, average in 11% and poor in 8% of cases. Among our patients, 55% took the treatment before the fasting meal and 43% took it before the dawn meal and 2% did not have a fixed intake schedule. Post-Ramadan, 83% of patients remained in euthyroidism or within the TSH objective in those followed for carcinoma, 8% in hyperthyroidism and 9% in hypothyroidism with no significant correlation between the first two groups.

Conclusion: The change in the schedule for taking L-thyroxine during the month of Ramadan can affect the hormonal balance as observed in our study, hence the importance of monitoring and specific therapeutic education of patients.