Bayram Kizilkaya, Osman Cure, Latife Merve Yildiz, Yasemin Emir Gunay
Annals of Clinical and Analytical Medicine - 2026;17(1):1-4
Aim: We aimed to determine the effect of levothyroxine (LT4) use at iftar or suhur during Ramadan, compared to other times, on thyroid-stimulating hormone (TSH) and free T4 (FT4) levels. Materials and Methods: 245 patients with primary hypothyroidism receiving LT4 treatment were included in our study. The patients were divided into those who used LT4 within 30 minutes to 1 hour before the iftar meal (dinner) (group 1) and those who used LT4 within 30 minutes to 1 hour before the suhur meal (pre-dawn meal) (group 2). The TSH and FT4 values of the patients in the 4 weeks before Ramadan were compared with the TSH and FT4 values in the 1-4 weeks after Ramadan. Results: The change in drug intake time (suhur /iftar) did not have a significant effect on FT4 and TSH values (p > 0.050). While there was no dose change after Ramadan in 70.2% (n = 172) patients, the need for medication increased in 18% (n = 44) and decreased in 11.8% (n = 29). When FT4 and TSH levels were compared before and after Ramadan, the LT4 dose change in patients taking medication at suhur was higher than those taking medication at iftar, but it was not found to be statistically significant. Discussion: The most important parameter in the treatment of hypothyroidism is ensuring continuity in drug treatment. In Ramadan, unlike other months, drug use during suhur /iftar times did not create a significant difference in treatment.
