AACE MENA 2025-Thyroid and Ramadan: In Health and Disease

Video Transcription

Video Summary

The discussion focuses on thyroid health and hypothyroidism management during Ramadan fasting. Studies across various countries show that in healthy individuals, fasting generally causes no change or a mild increase in TSH, with T4 and T3 levels mostly stable. Hypothyroidism prevalence among Muslims may range from 4.6% to 14%, affecting an estimated 30 to 51 million people requiring levothyroxine. Proper dosing timing is critical; the American Thyroid Association recommends levothyroxine either 60 minutes before iftar or 3-4 hours after to optimize absorption. Multiple regimens exist to accommodate social and fasting schedules, with patient adherence being the most crucial factor influencing thyroid hormone control. Alternative dosing strategies, such as once or twice weekly levothyroxine, have shown safety and effectiveness in motivated, compliant patients. Post-Ramadan, TSH levels tend to rise but often normalize after two months. Guidelines emphasize personalized timing, caution against early dose adjustments post-Ramadan, and suggest weekly dosing for select patients to maintain euthyroidism effectively during Ramadan.

Keywords

thyroid health

hypothyroidism

Ramadan fasting

levothyroxine dosing

TSH levels

patient adherence