IJMDC. 2020; 4(6): 1022-1027

Alternative levothyroxine administrating time: a systematic review

Authors: Ibarhim Mahmoud Ajwah, Badr Mohammed Alsharif, Abdullah Noman Alatawi, Yousef Musallam Albalawi, Othman Musad Albalawi, Assem Hammad Altemani, Kholoud Abdullah Aljohani, Shelian Juweed Alnomsi, Kholud Eid Albalawi, Elhassan Asia A, Marwa Mamoun Suliman, Hyder Osman Marghani.

ABSTRACT

Studies justify prescribing levothyroxine (LT4) as the first-line treatment for patients with hypothyroidism. However, the strict administration requirements, since LT4 optimally absorbed during fasting state which mandates delaying of any food for at least 30 minutes. Consequently, the compliance with these instructions may be problematic for the patient's adherence. Therefore, we aimed to systematically assess the effects of bedtime LT4 administration on the degree of hypothyroidism clinical parameters. Several databases were systematically searched for relevant papers on alternative Levothyroxine administrating time. The papers published in the English language from the first available article up to March 2020 were approached. The terms hypothyroidism, LT4, and bed-time were used. Out of 316 papers retrieved, only seven fulfilled the inclusion and exclusion criteria. In the current review, seven full texts fulfilled the inclusion and exclusion criteria, of the two, showed a reduction in thyroid stimulating hormone (TSH) when thyroxine was administered at bedtime. Three studies showed that the bed-time administration is as effective as standard morning time administration. The last two studies examine the possibility of LT4 co-administration with meals and both show statistically significant higher TSH seen with non-fasting regimens. The review concluded that the medication adherence will be affected by the patient's preference. Therefore, if Levothyroxine administrating (30-60 minutes) before breakfast is not convenient, alternative regiment, such as bed-time or co-administration with the meal, may also be an option.

Keywords:
Bedtime, hypothyroidism, levothyroxine, review.


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Alternative levothyroxine administrating time: a systematic review


Authors
Ibarhim Mahmoud Ajwah
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Badr Mohammed Alsharif
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Abdullah Noman Alatawi
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Yousef Musallam Albalawi
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Othman Musad Albalawi
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Assem Hammad Altemani
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Kholoud Abdullah Aljohani
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Shelian Juweed Alnomsi
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Kholud Eid Albalawi
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Elhassan Asia A
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Marwa Mamoun Suliman
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Hyder Osman Marghani
Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.
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Correspondence to:
. King Salman Armed Forces Hospital, Tabuk, Saudi Arabia.; aj.wa@hotmail.com

Publication history
Received 02 May 2020
Accepted 18 May 2020
Published online 27 May 2020
Published in print 25 Jun 2020

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Pubmed Style

Ajwah IM, Alsharif BM, Alatawi AN, Albalawi YM, Albalawi OM, Altemani AH, Aljohani KA, Alnomsi SJ, Albalawi KE, A EA, Suliman MM, Marghani HO. Alternative levothyroxine administrating time: a systematic review. IJMDC. 2020; 4(6): 1022-1027. doi:10.24911/IJMDC.51-1588450423


Web Style

Ajwah IM, Alsharif BM, Alatawi AN, Albalawi YM, Albalawi OM, Altemani AH, Aljohani KA, Alnomsi SJ, Albalawi KE, A EA, Suliman MM, Marghani HO. Alternative levothyroxine administrating time: a systematic review. http://www.ijmdc.com/?mno=103970 [Access: July 14, 2020]. doi:10.24911/IJMDC.51-1588450423


AMA (American Medical Association) Style

Ajwah IM, Alsharif BM, Alatawi AN, Albalawi YM, Albalawi OM, Altemani AH, Aljohani KA, Alnomsi SJ, Albalawi KE, A EA, Suliman MM, Marghani HO. Alternative levothyroxine administrating time: a systematic review. IJMDC. 2020; 4(6): 1022-1027. doi:10.24911/IJMDC.51-1588450423


Vancouver/ICMJE Style

Ajwah IM, Alsharif BM, Alatawi AN, Albalawi YM, Albalawi OM, Altemani AH, Aljohani KA, Alnomsi SJ, Albalawi KE, A EA, Suliman MM, Marghani HO. Alternative levothyroxine administrating time: a systematic review. IJMDC. (2020), [cited July 14, 2020]; 4(6): 1022-1027. doi:10.24911/IJMDC.51-1588450423


Harvard Style

Ajwah, I. M., Alsharif, . B. M., Alatawi, . A. N., Albalawi, . Y. M., Albalawi, . O. M., Altemani, . A. H., Aljohani, . K. A., Alnomsi, . S. J., Albalawi, . K. E., A, . E. A., Suliman, . M. M. & Marghani, . H. O. (2020) Alternative levothyroxine administrating time: a systematic review. IJMDC, 4 (6), 1022-1027. doi:10.24911/IJMDC.51-1588450423


Turabian Style

Ajwah, Ibarhim Mahmoud, Badr Mohammed Alsharif, Abdullah Noman Alatawi, Yousef Musallam Albalawi, Othman Musad Albalawi, Assem Hammad Altemani, Kholoud Abdullah Aljohani, Shelian Juweed Alnomsi, Kholud Eid Albalawi, Elhassan Asia A, Marwa Mamoun Suliman, and Hyder Osman Marghani. 2020. Alternative levothyroxine administrating time: a systematic review. International Journal of Medicine in Developing Countries, 4 (6), 1022-1027. doi:10.24911/IJMDC.51-1588450423


Chicago Style

Ajwah, Ibarhim Mahmoud, Badr Mohammed Alsharif, Abdullah Noman Alatawi, Yousef Musallam Albalawi, Othman Musad Albalawi, Assem Hammad Altemani, Kholoud Abdullah Aljohani, Shelian Juweed Alnomsi, Kholud Eid Albalawi, Elhassan Asia A, Marwa Mamoun Suliman, and Hyder Osman Marghani. "Alternative levothyroxine administrating time: a systematic review." International Journal of Medicine in Developing Countries 4 (2020), 1022-1027. doi:10.24911/IJMDC.51-1588450423


MLA (The Modern Language Association) Style

Ajwah, Ibarhim Mahmoud, Badr Mohammed Alsharif, Abdullah Noman Alatawi, Yousef Musallam Albalawi, Othman Musad Albalawi, Assem Hammad Altemani, Kholoud Abdullah Aljohani, Shelian Juweed Alnomsi, Kholud Eid Albalawi, Elhassan Asia A, Marwa Mamoun Suliman, and Hyder Osman Marghani. "Alternative levothyroxine administrating time: a systematic review." International Journal of Medicine in Developing Countries 4.6 (2020), 1022-1027. Print. doi:10.24911/IJMDC.51-1588450423


APA (American Psychological Association) Style

Ajwah, I. M., Alsharif, . B. M., Alatawi, . A. N., Albalawi, . Y. M., Albalawi, . O. M., Altemani, . A. H., Aljohani, . K. A., Alnomsi, . S. J., Albalawi, . K. E., A, . E. A., Suliman, . M. M. & Marghani, . H. O. (2020) Alternative levothyroxine administrating time: a systematic review. International Journal of Medicine in Developing Countries, 4 (6), 1022-1027. doi:10.24911/IJMDC.51-1588450423


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