Predawn Versus Preiftar Timing of Levothyroxine Administration During Ramadan Intermittent Fasting: A Multicenter Randomized Controlled Trial
Authors' conclusion
Both preiftar and predawn LT4 regimens maintained thyroid stability during Ramadan. Either can be safely adopted according to patient preference.
Study context
- Population
- Adults with primary hypothyroidism (thyroid cancer excluded), 3 Saudi cities; mean age 49 ± 12 years, 87% femalecompleted the study
- Participants
- 303 adults
- Comparison
- Preiftar vs predawn levothyroxine (LT4) dosing during Ramadan
- Preiftarn = 156
- Predawnn = 147
Methodological detailsmulticenter, open-label
- Multicenter
- Open-label
Primary result
As reported in the abstract
4 to 6 weeks after Ramadan
- Within-group post-Ramadan changes were nonsignificant
- Preiftar vs Predawn: P = 0.47
- Preiftar vs Predawn: P = 0.81
Further findings
Weekly LT4 dose
P = 0.001
- Thyroid-stimulating hormone (TSH), pre-Ramadan
- P = 0.3
- Free thyroxine (FT4), pre-Ramadan
- P = 0.16
- TSH, post-Ramadan
- P = 0.78
- FT4, post-Ramadan
- P = 0.003
Within-group post-Ramadan changes
- Within-group post-Ramadan changes were nonsignificant
Compliance and satisfaction
- Compliance and satisfaction were comparable
Original publication
Predawn Versus Preiftar Timing of Levothyroxine Administration During Ramadan Intermittent Fasting: A Multicenter Randomized Controlled Trial. Endocr Pract. Published 31 January 2026. doi:10.
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