Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results
INTRODUCTION : Muslim who fast during Ramadan find it difficult to take L-thyroxine as recommended every morning on empty stomach during sahur.The changes in eating patterns and gastric motility during Ramadan might affect the absorption and efficacy of L-thyroxine.This study is to compare the effi...
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| Language: | English |
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2018
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| Online Access: | http://irep.iium.edu.my/67895/ http://irep.iium.edu.my/67895/1/weekly%20vs%20daily%20thyroxine%20MAC9%202018.pdf |
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iium-678952019-10-02T01:12:00Z http://irep.iium.edu.my/67895/ Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results Zakaria, Nurul Aulia Zakaria, Miza Hiryanti Shahar, Mohammad Arif R Medicine (General) RC Internal medicine RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology INTRODUCTION : Muslim who fast during Ramadan find it difficult to take L-thyroxine as recommended every morning on empty stomach during sahur.The changes in eating patterns and gastric motility during Ramadan might affect the absorption and efficacy of L-thyroxine.This study is to compare the efficacy and safety of weekly vs daily dosing of L-thyroxine during Ramadan. METHODS : This was a randomized opened-label control trial during Ramadan 2017 held in a tertiary centre in Kuantan. Eight hypothyroid patients were randomized into weekly and daily arm (n=4 each arm).The weekly arm took 7x their usual thyroxine dose at least 30 minutes pre-sahur once a week whereas the daily arm took their usual thyroxine dose daily at least 2 hours after the last meal before bed.Thyroid function test (TSH, fT3, fT4), cardiac parameters (ecg, echo,holter), cognitive and psychological assessment were done at week zero.At week 2 repeated cardiac assessment were done for the weekly arm 24-hours after dosing.Thyroid function,cognitive and psychological function of both arm were reassessed at the end of week 4. RESULTS : The median age for weekly and daily group were 37(31.7,45.2) and 36(33.8,48.3) years old with majority(75%each arm) were diagnosed with post-radioiodine hypothyroidism.The median fT4 levels at week 4(weekly arm) was significantly higher compared from baseline [11.7(7.8,14.7) vs12.8(8.7,17.7)mmol/L;p=0.017 ].Nevertheless,it was not accompanied by increase fT3 or reduced TSH. Comparison of TSH, fT4 and fT3 between both arm at week 4 was not statistically significant . In term of toxicity,there was no significant increase in fT3 and fT4 level 24 hours post high doses of L-thyroxine in the weekly arm compared to baseline [fT3:4.3(4.2,4.9) vs4.7(3.6,5.7);p=0.70] and [fT4:11.7(7.8,14.7) vs 15.3(9.6,20.2);p=0.68]. None of the patients in both arm reported any side effects. CONCLUSION : From this pilot study, weekly L-thyroxine dosing during Ramadan appear to be efficient and safe,however a larger sample size is required to confirm the feasibility. 2018 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/67895/1/weekly%20vs%20daily%20thyroxine%20MAC9%202018.pdf Zakaria, Nurul Aulia and Zakaria, Miza Hiryanti and Shahar, Mohammad Arif (2018) Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results. In: Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress 2018, 4th-6th May 2018, Kuala Lumpur. (Unpublished) |
| repository_type |
Digital Repository |
| institution_category |
Local University |
| institution |
International Islamic University Malaysia |
| building |
IIUM Repository |
| collection |
Online Access |
| language |
English |
| topic |
R Medicine (General) RC Internal medicine RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology |
| spellingShingle |
R Medicine (General) RC Internal medicine RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology Zakaria, Nurul Aulia Zakaria, Miza Hiryanti Shahar, Mohammad Arif Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results |
| description |
INTRODUCTION :
Muslim who fast during Ramadan find it difficult to take L-thyroxine as recommended every morning on empty stomach during sahur.The changes in eating patterns and gastric motility during Ramadan might affect the absorption and efficacy of L-thyroxine.This study is to compare the efficacy and safety of weekly vs daily dosing of L-thyroxine during Ramadan.
METHODS :
This was a randomized opened-label control trial during Ramadan 2017 held in a tertiary centre in Kuantan. Eight hypothyroid patients were randomized into weekly and daily arm (n=4 each arm).The weekly arm took 7x their usual thyroxine dose at least 30 minutes pre-sahur once a week whereas the daily arm took their usual thyroxine dose daily at least 2 hours after the last meal before bed.Thyroid function test (TSH, fT3, fT4), cardiac parameters (ecg, echo,holter), cognitive and psychological assessment were done at week zero.At week 2 repeated cardiac assessment were done for the weekly arm 24-hours after dosing.Thyroid function,cognitive and psychological function of both arm were reassessed at the end of week 4.
RESULTS :
The median age for weekly and daily group were 37(31.7,45.2) and 36(33.8,48.3) years old with majority(75%each arm) were diagnosed with post-radioiodine hypothyroidism.The median fT4 levels at week 4(weekly arm) was significantly higher compared from baseline [11.7(7.8,14.7) vs12.8(8.7,17.7)mmol/L;p=0.017 ].Nevertheless,it was not accompanied by increase fT3 or reduced TSH. Comparison of TSH, fT4 and fT3 between both arm at week 4 was not statistically significant . In term of toxicity,there was no significant increase in fT3 and fT4 level 24 hours post high doses of L-thyroxine in the weekly arm compared to baseline [fT3:4.3(4.2,4.9) vs4.7(3.6,5.7);p=0.70] and [fT4:11.7(7.8,14.7) vs 15.3(9.6,20.2);p=0.68]. None of the patients in both arm reported any side effects.
CONCLUSION :
From this pilot study, weekly L-thyroxine dosing during Ramadan appear to be efficient and safe,however a larger sample size is required to confirm the feasibility. |
| format |
Conference or Workshop Item |
| author |
Zakaria, Nurul Aulia Zakaria, Miza Hiryanti Shahar, Mohammad Arif |
| author_facet |
Zakaria, Nurul Aulia Zakaria, Miza Hiryanti Shahar, Mohammad Arif |
| author_sort |
Zakaria, Nurul Aulia |
| title |
Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results |
| title_short |
Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results |
| title_full |
Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results |
| title_fullStr |
Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results |
| title_full_unstemmed |
Comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in Ramadan – a pilot randomized controlled trial: preliminary results |
| title_sort |
comparison of weekly vs daily dosing of levothyroxine for treatment of hypothyroidism in ramadan – a pilot randomized controlled trial: preliminary results |
| publishDate |
2018 |
| url |
http://irep.iium.edu.my/67895/ http://irep.iium.edu.my/67895/1/weekly%20vs%20daily%20thyroxine%20MAC9%202018.pdf |
| first_indexed |
2023-09-18T21:36:24Z |
| last_indexed |
2023-09-18T21:36:24Z |
| _version_ |
1777412849482596352 |