Imperial College London
Alternate

Professor Karim Meeran

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology
 
 
 
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Contact

 

+44 (0)20 8846 1065k.meeran

 
 
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Location

 

9E05Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Alkaf:2022:10.1089/thy.2021.0512,
author = {Alkaf, B and Siddiqui, M and Ali, T and Bakir, A and Murphy, K and Meeran, K and Lessan, N},
doi = {10.1089/thy.2021.0512},
journal = {Thyroid},
pages = {368--375},
title = {Ramadan fasting and changes in thyroid function in hypothyroidism: identifying patients at risk},
url = {http://dx.doi.org/10.1089/thy.2021.0512},
volume = {32},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Ramadan fasting (RF) is associated with major changes in meal times. This can affect thyroxine absorption and thyroid function (TF) in patients with hypothyroidism. We aimed to examine the short- and long-term impact of RF on TF in patients with primary hypothyroidism on levothyroxine.Methods: TF tests in patients with primary hypothyroidism attending an endocrine center in the United Arab Emirates were retrospectively analyzed. The impact of RF on TF, namely serum thyrotropin (TSH) TSH, free thyroxine (fT4) and free triiodothyronine (fT3), was investigated in 481 patients within 3 months before Ramadan (BR), 1–2 weeks (PR1), and 3–6 months (PR2) post-Ramadan. Controlled TF was defined as TSH between 0.45 and 4.5 μIU/mL. Inadequate control was defined as TSH >4.5 μIU/mL. Loss of control was defined as having controlled TF at BR and inadequate control at PR1. Multivariable regression analyses were used to assess the association of baseline TSH, baseline levothyroxine dose, and medication use with loss of thyroid control in Ramadan.Results: TSH increased significantly from a median of 2.0 (0.8–3.7) μIU/mL at BR to 2.9 (1.4–5.6) μIU/mL at PR1 (p < 0.001). This was accompanied by a fall in fT4 and fT3 at PR1 (p < 0.001). 25.5% of patients with previously controlled TF at BR had deterioration in TF at PR1. Sixty-one percent of patients with previously uncontrolled TF at BR remained uncontrolled at PR1. Baseline TSH was significantly associated with loss of thyroid control in Ramadan with an odds ratio (95% confidence interval) of 1.5 (1.17–1.92) (p < 0.001), whereas other variables, including medications known to affect levothyroxine absorption were not associated with loss of control. TSH, fT4, and fT3 levels returned to normal at PR2.Conclusions: RF can negatively affect TF of patients on levothyroxine replacement. Although this effect is modest and
AU  - Alkaf,B
AU  - Siddiqui,M
AU  - Ali,T
AU  - Bakir,A
AU  - Murphy,K
AU  - Meeran,K
AU  - Lessan,N
DO  - 10.1089/thy.2021.0512
EP  - 375
PY  - 2022///
SN  - 1050-7256
SP  - 368
TI  - Ramadan fasting and changes in thyroid function in hypothyroidism: identifying patients at risk
T2  - Thyroid
UR  - http://dx.doi.org/10.1089/thy.2021.0512
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000790888200004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://www.liebertpub.com/doi/10.1089/thy.2021.0512
UR  - http://hdl.handle.net/10044/1/101446
VL  - 32
ER  -
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