Will Ozempic Affect Your Thyroid? Navigating Semaglutide with Hypothyroidism

For millions, the daily battle with weight isn’t just about diet and exercise; it’s a deeply personal struggle often intertwined with complex health conditions. Imagine dedicating yourself to healthier eating and consistent movement, only to be met with a stubborn scale and persistent fatigue—a reality many individuals living with hypothyroidism face. This small, butterfly-shaped gland located at the front of your neck orchestrates your body’s metabolism and energy use, and when its function is impaired, it can feel like an uphill battle to manage weight effectively.

At the same time, a new class of medications known as GLP-1 receptor agonists, including popular options like Ozempic, Wegovy, Mounjaro, and Zepbound, has emerged, revolutionizing the landscape of weight management and Type 2 diabetes treatment. As their efficacy in promoting significant weight loss becomes more widely recognized, a natural and critical question arises for those navigating both weight challenges and thyroid conditions: “Can I take Ozempic with hypothyroidism?” or more broadly, how do these powerful medications interact with thyroid health?

This post is designed to provide comprehensive, evidence-based insights into this important intersection. We will delve into the mechanisms of hypothyroidism and GLP-1 medications, clarify the safety considerations, explore potential interactions with thyroid hormone replacement, and underscore the critical importance of a medically supervised and personalized approach to weight loss. If you’ve found yourself wrestling with these questions, or wondering how these innovative treatments might fit into your unique health journey, you’re certainly not alone.

Our journey at TrimRx began with a shared vision: to help individuals embrace healthier lifestyles by merging cutting-edge telehealth innovations with effective weight loss solutions. We believe that sustainable weight loss should be achieved through science, empathy, and a transparent approach. Through this article, we aim to offer clarity and guidance, drawing on the latest research and our commitment to individualized care. By the end, you’ll have a clearer understanding of how Ozempic and similar medications can potentially be part of your weight loss strategy, especially when coupled with the comprehensive support we provide at TrimRx. We’ll explore the basics of hypothyroidism, the role of GLP-1s, critical safety information, medication interactions, and how a truly comprehensive program can support your unique needs.

Understanding Hypothyroidism and Its Impact on Weight

Hypothyroidism, often referred to as an underactive thyroid, is a condition where your thyroid gland doesn’t produce enough thyroid hormones. These hormones—primarily thyroxine (T4) and triiodothyronine (T3)—are vital for regulating your body’s metabolism, energy production, and nearly every bodily function, from heart rate to digestion. According to the American Thyroid Association, an estimated 20 million Americans are living with some form of thyroid disorder, with hypothyroidism being the most common.

The Mechanism of an Underactive Thyroid

When your thyroid doesn’t produce enough hormones, your body’s processes slow down. This metabolic slowdown is directly linked to many of the hallmark symptoms of hypothyroidism, which can include:

• Weight Gain: Despite maintaining usual eating habits, many individuals with hypothyroidism experience unexplained weight gain. This isn’t just about fat accumulation; it can also involve fluid retention due to slower metabolism and changes in how the body processes salt and water.
• Fatigue: A persistent feeling of tiredness, even after adequate rest, is a common complaint. This low energy level can naturally lead to decreased physical activity, further complicating weight management efforts.
• Cold Sensitivity: Feeling cold even in moderate temperatures.
• Dry Skin and Hair: Hormonal imbalances can affect skin and hair health.
• Constipation: Slower digestive motility is a frequent gastrointestinal symptom.
• Brain Fog: Difficulty concentrating, memory issues, and a general mental sluggishness.

The connection between hypothyroidism and weight gain is complex. While studies show that starting thyroid replacement medication (like levothyroxine) can lead to some initial weight loss, this is often attributed to the excretion of excess water rather than a significant reduction in body fat. The underlying metabolic changes make it harder for the body to burn calories efficiently, store fat differently, and regulate appetite effectively. This intricate interplay highlights why losing weight with hypothyroidism can feel uniquely challenging, often requiring more than just conventional diet and exercise adjustments. It’s a struggle we deeply understand and are committed to addressing through personalized care.

Introducing GLP-1 Receptor Agonists: A Modern Approach to Weight Management

In recent years, GLP-1 receptor agonists have emerged as a significant advancement in the treatment of Type 2 diabetes and, more recently, chronic weight management. These medications, which include active ingredients like semaglutide and tirzepatide, work by mimicking the action of a natural hormone in your body called glucagon-like peptide-1 (GLP-1).

How GLP-1s Work

GLP-1 is an incretin hormone that plays several crucial roles in metabolic regulation:

• Appetite Regulation and Satiety: GLP-1s act on receptors in the brain to reduce appetite and increase feelings of fullness, leading to decreased food intake. This can be particularly beneficial for those who struggle with persistent hunger or cravings, a common challenge in weight loss journeys.
• Slowed Gastric Emptying: These medications slow down how quickly food leaves your stomach. This not only contributes to prolonged feelings of fullness but also helps stabilize blood sugar levels by preventing rapid glucose spikes after meals.
• Blood Sugar Control: For individuals with Type 2 diabetes, GLP-1s stimulate insulin release when blood sugar levels are high and suppress glucagon secretion, which helps lower blood glucose.

The efficacy of GLP-1 medications in promoting substantial weight loss has been well-documented. Studies have shown participants achieving significant reductions in body weight, often exceeding 15% of their initial body weight over a period of months. This makes them a powerful tool for individuals who have found traditional weight loss methods insufficient.

Our Comprehensive Approach to GLP-1 Therapies

At TrimRx, we are proud to offer a range of clinically proven GLP-1 receptor agonists as part of our personalized weight loss programs. Our offerings include leading branded medications and expertly compounded options:

• Branded Medications: We offer Ozempic®, Wegovy®, Mounjaro®, and Zepbound®, all of which are FDA-approved for their respective indications.
• Compounded Medications: We also provide Compounded Semaglutide and Compounded Tirzepatide. It is important to clarify that compounded medications are not FDA-approved. However, we ensure that these medications are provided through FDA-registered, inspected, and approved pharmacies, upholding our unwavering commitment to safety and quality.

To determine eligibility and receive a personalized treatment plan for any of these prescription medications, we invite you to take our free assessment quiz. This initial step helps our medical team understand your unique health profile and determine the most appropriate path forward.

Navigating Ozempic and Hypothyroidism: Safety and Considerations

For individuals with hypothyroidism considering GLP-1 medications like Ozempic, safety is a primary concern. Understanding how these medications interact with an underactive thyroid is crucial for making informed decisions about your weight loss journey.

General Safety for Common Thyroid Conditions

The good news is that for most people with common thyroid conditions such as hypothyroidism or hyperthyroidism, Ozempic and other semaglutide-based medications are generally considered safe to use. As experts in the field note, there aren’t direct drug interactions between semaglutide injections and standard thyroid medications like levothyroxine (Synthroid) or desiccated thyroid hormone (Armour Thyroid). This means that having an underactive thyroid typically doesn’t automatically preclude you from utilizing these effective weight management tools.

In fact, there can even be potential benefits. The weight loss achieved with GLP-1s may positively impact individuals with hypothyroidism. Significant weight reduction can lead to decreases in thyroid-stimulating hormone (TSH) levels, suggesting an improvement in thyroid function and potentially reducing the dosage requirements for thyroid replacement therapy. A compelling case study, for instance, followed a patient with diabetes who, after losing 31 pounds on semaglutide, subsequently required 25% less levothyroxine to maintain her thyroid hormone levels. This illustrates the profound systemic benefits that sustained weight loss can have on overall metabolic health, including thyroid regulation.

Understanding the Thyroid Cancer Warning

While GLP-1 medications are generally safe for common thyroid disorders, there is a specific and critical warning that individuals must be aware of, prominently featured as a boxed warning on the prescribing information for these drugs.

The warning is based on animal studies that found an association between semaglutide and thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in rodents. However, it is crucial to understand that there is no proven risk of MTC in humans from GLP-1 receptor agonists. Researchers continue to monitor for any long-term associations, and current human data has not established a causal link between these medications and MTC.

Therefore, Ozempic and similar GLP-1 medications are contraindicated for individuals with:

• A personal or family history of medullary thyroid carcinoma (MTC).
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). This is a rare genetic disorder that significantly increases the risk of MTC.

If you have a history of other types of thyroid cancer (e.g., papillary or follicular thyroid carcinoma), it is essential to have a thorough discussion with your healthcare provider about the potential risks and benefits before starting treatment. Our medical professionals at TrimRx prioritize your safety above all else. During your initial consultation, we meticulously review your entire medical history, including any personal or family history of thyroid cancers or endocrine disorders, to ensure that any prescribed treatment is unequivocally appropriate and safe for you. We believe in transparency and comprehensive care, making sure every aspect of your health is considered.

Other Thyroid Conditions

Beyond MTC, concerns might arise about GLP-1s impacting other benign thyroid conditions. Current research, including meta-analyses of numerous clinical trials, has indicated that semaglutide does not appear to increase the likelihood of developing conditions such as:

• Goiter: Enlargement of the thyroid gland.
• Thyroiditis: Inflammation of the thyroid.
• Noncancerous thyroid masses or growths.

While continuous research is always valuable for deepening our understanding, the existing data suggests that GLP-1 receptor agonists do not negatively affect thyroid function or hormone levels in individuals without pre-existing thyroid issues. Our commitment at TrimRx extends to working exclusively with FDA-registered and inspected pharmacies for the shipping of all weight loss medications, upholding the highest standards of safety and quality for your care.

The Interplay Between Semaglutide, Weight Loss, and Thyroid Medication

Understanding how GLP-1 medications interact with your existing thyroid medication, particularly levothyroxine, is key to a successful and safe weight loss journey. The relationship is not one of direct drug interaction but rather an indirect influence through changes in absorption and the physiological impact of weight loss itself.

Impact on Levothyroxine Absorption

One of the primary mechanisms of GLP-1 receptor agonists is to slow gastric emptying, meaning food and medications remain in the stomach for a longer period. This deliberate slowdown, which typically lasts for about 4–5 hours after an injection, can affect how other oral medications, including levothyroxine, are absorbed. If levothyroxine absorption is delayed or reduced, it could potentially lead to sub-optimal thyroid hormone levels, impacting your thyroid control. An open-label study in healthy adults, for example, demonstrated a 33% increase in total T4 exposure when oral semaglutide and levothyroxine were taken together, underscoring the need to reassess thyroid dosing when starting GLP-1 therapy due to potential absorption changes.

To mitigate this, clinicians advise strategic timing:

• Stagger Dosing: It is recommended to take your levothyroxine on an empty stomach, as usual (typically 30–60 minutes before food). Then, administer your GLP-1 medication later in the day, well after you’ve taken your thyroid hormone. This separation allows the levothyroxine to be absorbed effectively before the gastric-emptying effects of the GLP-1 medication become fully active.
• Consistent Injection Day: Maintaining a consistent day for your weekly GLP-1 injection helps stabilize the gastric emptying pattern, making it easier for you and your healthcare provider to interpret any changes in your TSH levels and adjust your levothyroxine dosage if necessary.
• Separate Supplements: If you take other supplements like calcium or iron, remember they can also chelate (bind to) thyroid hormone, further impeding absorption. Space these supplements at least 4 hours away from both your levothyroxine and your GLP-1 medication to avoid double malabsorption.

Levothyroxine Dose Adjustments

Perhaps one of the most significant considerations when combining Ozempic with levothyroxine is the potential for dose adjustments. As you experience substantial weight loss, your body’s need for thyroid replacement therapy may change. Thyroid hormone dosages are often weight-based, and a significant drop in body weight (e.g., a 10 kg weight loss) can reduce your daily T4 replacement requirement by roughly 12 µg.

This means close monitoring of your thyroid-stimulating hormone (TSH) levels is paramount. While some providers might recommend re-testing TSH every three to six months during the first year of significant weight loss, others suggest monitoring every 6-8 weeks, especially during the initial phases of GLP-1 therapy or after each dose escalation. Regular lab work is crucial to prevent over-replacement, which can lead to symptoms of hyperthyroidism.

Pay close attention to symptoms that might indicate your thyroid medication needs changing, such as:

• Increased fatigue
• Heart palpitations or a racing heart rate
• Increased anxiety or nervousness
• Changes in your energy levels (either feeling excessively energetic or still unusually tired)
• Unexplained weight changes (further loss or gain despite medication)

Our comprehensive programs at TrimRx include doctor consultations, necessary lab work, and unlimited support to ensure these adjustments are handled smoothly and safely. After completing our free assessment quiz, if you qualify for our personalized weight loss programs, our dedicated medical team will work with you to meticulously track your progress, monitor your thyroid levels, and adjust your treatment plan as needed. We believe in transparent service, ensuring our approach remains consistent regardless of dosage changes, and prioritizing your well-being every step of the way.

Recognizing Warning Signs and When to Seek Medical Attention

While GLP-1 medications are generally safe for individuals with common thyroid conditions, it’s vital to be aware of certain warning signs that may indicate a need for immediate medical attention. These symptoms could either signal an underlying issue that needs to be addressed or, in rare cases, point to a more serious concern related to your thyroid health.

It’s important to differentiate between common, mild side effects (like nausea or constipation) and symptoms that warrant prompt evaluation. Your safety is our paramount concern, and knowing when to seek help is a critical component of responsible health management.

Key Warning Signs to Monitor:

• Rapidly Enlarging Neck Mass: Any new lump or swelling in your neck that grows noticeably over weeks warrants immediate medical evaluation, including an ultrasound. While GLP-1 medications are rarely linked to C-cell tumors in rodents, any such change needs to be investigated thoroughly in humans.
• Persistent Hoarseness or Voice Changes: If you experience hoarseness that lasts longer than two weeks and cannot be attributed to a cold or other obvious cause, it requires a medical assessment, possibly including a laryngoscopy. Voice changes can sometimes signal vocal cord paralysis, which could be associated with thyroid enlargement or, in very rare cases, a tumor.
• Unexplained Diarrhea Combined with Weight Loss: While GLP-1s can cause gastrointestinal side effects, a combination of persistent, unexplained diarrhea and weight loss could potentially mask or indicate hyperthyroidism. A full thyroid panel can help determine if there’s an issue with levothyroxine over-replacement or an underlying hyperthyroid state.
• Severe Fatigue Despite Normal Glucose Levels: Up to 18% of patients on GLP-1 agonists report fatigue as a side effect. However, if you experience severe fatigue, especially when your blood sugar is well-controlled, it’s essential to have your TSH levels re-checked. Overlapping hypothyroid symptoms can sometimes be masked by the general feeling of being unwell, or the fatigue could be a sign of inadequate thyroid hormone levels.
• New Shortness of Breath Without a Lung Cause: The Ozempic safety page lists unexplained shortness of breath as one of the key symptoms that should prompt patients to stop the drug and seek immediate thyroid evaluation. This can be a red flag for thyroid enlargement affecting the airway.

If any of these red flag symptoms appear, it is crucial to stop your GLP-1 medication and contact your healthcare provider immediately. Your safety is our priority, and our supportive care model ensures you have unlimited support to discuss any concerns promptly. We offer compassionate care that respects every individual’s unique journey, combining advanced medical science with modern technology.

Optimizing Your Journey: Lifestyle and Support with TrimRx

Integrating GLP-1 medications like Ozempic into your weight loss strategy, especially with hypothyroidism, is most effective when combined with a holistic approach that includes lifestyle adjustments and continuous support. At TrimRx, we believe in empowering you with the tools and guidance to achieve sustainable weight loss and overall well-being.

Dietary Considerations for Enhanced Outcomes

While GLP-1 medications significantly impact appetite and satiety, strategic dietary choices remain foundational. For those managing hypothyroidism, diet plays an even more crucial role in supporting thyroid health and optimizing weight loss.

• Prioritize Protein: Higher protein intake is essential. Aim for 1.0–1.2 grams of protein per kilogram of your ideal body weight. GLP-1s can reduce overall appetite, potentially leading to insufficient protein intake, which can result in muscle loss. Adequate protein helps preserve lean muscle mass, which is vital for maintaining metabolism, and counters hypothyroid-related muscle loss.
• Stay Hydrated: GLP-1s can sometimes cause gastrointestinal side effects like constipation. Drinking at least 2 liters of water daily is crucial for digestive health and can significantly reduce the likelihood and severity of constipation.
• Focus on Nutrient-Dense Foods: A whole-foods-based diet rich in fruits, vegetables, lean proteins, and healthy fats supports overall health, reduces inflammation, and can be particularly beneficial for individuals with autoimmune thyroid conditions like Hashimoto’s. Addressing food sensitivities and digestive issues through diet can further enhance weight loss efforts for those with hypothyroidism.

The Role of Exercise

Exercise, particularly resistance training, is a powerful complement to GLP-1 therapy.

• Resistance Training: Incorporate strength training at least twice a week. Rapid weight reduction, which can occur with GLP-1s, sometimes leads to a disproportionate loss of lean muscle mass alongside fat. Resistance training helps offset this by preserving and even building muscle, which is essential for boosting metabolism and maintaining functional strength. Studies suggest that patients who pair semaglutide with a structured strength program can retain significantly more lean mass.
• Cardiovascular Activity: Regular cardio, even moderate walking, supports cardiovascular health, energy levels, and overall well-being, complementing the metabolic benefits of GLP-1s.

Monitoring Beyond Lab Work

While lab tests are indispensable, self-monitoring also plays a critical role in your journey:

• Track Resting Heart Rate: A rising resting heart rate can sometimes be an early indicator of levothyroxine overtreatment, even before lab results are due. Monitoring this weekly can give you valuable insights.
• Symptom Diary: Keep a record of any symptoms, especially gastrointestinal ones, and note their correlation with your GLP-1 injection day and meal timing. This can help you and your provider adjust routines and minimize side effects.

The TrimRx Advantage: Your Personalized Path to Sustainable Weight Loss

At TrimRx, we understand that true wellness is a personalized journey, especially when navigating conditions like hypothyroidism alongside weight management goals. Our platform is a user-friendly and supportive space where individuals receive personalized, medically supervised care—all designed to make sustainable weight loss attainable and tailored to the individual.

• Personalized Weight Loss Programs: Our approach begins with a comprehensive assessment. By taking our free assessment quiz, you embark on a path to a treatment plan specifically designed for you. This includes doctor consultations, necessary lab work to establish baseline health and monitor progress, medication tailored to your needs (which may include Compounded Semaglutide, Oral Semaglutide, Ozempic®, Compounded Tirzepatide, Oral Tirzepatide, Mounjaro®, Zepbound®, or Wegovy®), unlimited support from our medical team, and discreet shipping—all with no hidden fees. We partner with FDA-registered and inspected pharmacies for the shipping of weight loss medications.
• Our Brand Values in Action: Our brand is empathetic, innovative, trustworthy, supportive, results-oriented, and personalized. We offer compassionate care that respects every individual’s unique journey by combining advanced medical science with modern technology. We believe in empowering you with choice and clarity, ensuring our comprehensive service remains consistent.
• Immediate Support for Overall Wellness: For those who are not yet ready for prescription medication or are looking for immediate support for their wellness journey, we offer quick-access supplements that do not require a quiz. Our GLP-1 Daily Support is designed to assist with appetite management and metabolic health, while our Weight Loss Boost offers additional nutritional support to complement your healthy lifestyle. These can be purchased directly to provide a valuable layer of assistance.

We are dedicated to safe, effective weight loss and individualized care. Our integrated approach ensures that your journey is not just about losing weight, but about fostering lasting health and well-being, with consistent, expert guidance every step of the way.

Beyond Ozempic: A Look at Other GLP-1 Options and Quick-Access Support

While Ozempic (semaglutide) is a widely recognized GLP-1 medication, it’s part of a broader family of advanced weight loss solutions. At TrimRx, we are committed to providing a diverse range of options, ensuring that your personalized plan aligns perfectly with your unique health needs and goals.

Exploring the Full Spectrum of Prescription GLP-1s

Our personalized weight loss program offers a selection of powerful prescription medications, each carefully considered by our medical team based on your assessment:

• Semaglutide-Based Options: This includes Ozempic®, Wegovy®, as well as Compounded Semaglutide and Oral Semaglutide. These medications primarily target GLP-1 receptors to regulate appetite and blood sugar.
• Tirzepatide-Based Options: For a dual-action approach, we also offer medications containing tirzepatide, such as Mounjaro®, Zepbound®, Compounded Tirzepatide, and Oral Tirzepatide. Tirzepatide uniquely acts on both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors, which may lead to even more pronounced weight loss for some individuals.

To discover which of these powerful medications may be right for you, we encourage you to take our free assessment quiz. Our medical experts will review your health profile and recommend a tailored plan that considers your individual physiology, medical history, and weight loss objectives.

Quick-Access Supplements for Holistic Support

We understand that every step of a weight loss journey is valuable. For those seeking immediate support or complementary solutions, TrimRx offers quick-access supplements that do not require a personalized quiz:

• GLP-1 Daily Support: This supplement is formulated to support overall metabolic wellness and appetite management. It can be a beneficial addition to a healthy lifestyle, helping to naturally regulate hunger cues and support balanced blood sugar.
• Weight Loss Boost: Designed to provide additional nutritional assistance, this supplement offers targeted ingredients to help optimize your body’s fat-burning processes and energy levels, complementing your dietary and exercise efforts.

These quick-access supplements are available for immediate purchase and are crafted to support your overall wellness during the weight loss journey. Whether you’re considering a prescription medication or looking for immediate ways to enhance your efforts, TrimRx provides science-backed solutions to support you.

Conclusion

Navigating weight loss when you have hypothyroidism presents unique challenges, yet modern medical advancements, particularly GLP-1 receptor agonists like Ozempic, offer promising new avenues for success. As we’ve explored, the answer to “Can I take Ozempic with hypothyroidism?” is, for most individuals, a reassuring yes, provided specific safety considerations and careful monitoring are in place. These medications can offer significant benefits by aiding in weight loss, which in turn may even lead to improvements in thyroid function and adjusted levothyroxine dosages.

However, the journey is not one-size-fits-all. It requires a nuanced, personalized approach that meticulously considers your medical history, current health status, and any potential interactions, particularly regarding medullary thyroid carcinoma or MEN 2. Close collaboration with healthcare professionals, regular monitoring of thyroid levels, and adherence to specific medication timing are all crucial components of a safe and effective plan.

At TrimRx, our commitment is to provide you with a comprehensive, empathetic, and scientifically-backed path to sustainable weight loss. Our journey began with a vision to merge cutting-edge telehealth with effective solutions, creating a supportive space where personalized, medically supervised care is accessible. We believe that empowering you with knowledge and a robust support system is key to transforming your health.

Whether you’re ready to explore prescription weight loss medications or seeking immediate support for your wellness goals, TrimRx is here to guide you. We invite you to take our free assessment quiz to see if you qualify for our personalized programs, which include doctor consultations, medication, lab work, unlimited support, and shipping with no hidden fees. Alternatively, you can explore our immediate support supplements, such as GLP-1 Daily Support and Weight Loss Boost, available for direct purchase to support your overall wellness.

Your weight loss journey is unique, and you deserve a partner who understands and supports every step. Let us help you unlock your potential for a healthier, more vibrant life.

FAQ

Q1: Is it safe to take Ozempic if I have hypothyroidism?

Yes, for most individuals with common thyroid conditions like hypothyroidism, Ozempic (semaglutide) is generally considered safe. There are no direct drug interactions between semaglutide and standard thyroid medications like levothyroxine. In fact, the weight loss achieved with Ozempic may even lead to improvements in thyroid function and potentially a need for lower levothyroxine doses, but continuous monitoring by a healthcare provider is essential.

Q2: Can semaglutide affect my thyroid hormone levels?

While semaglutide does not directly regulate thyroid levels, it can indirectly affect them, particularly for those on thyroid replacement therapy. Significant weight loss can reduce your body’s requirement for levothyroxine. Therefore, close monitoring of your TSH levels is crucial, and your levothyroxine dosage may need to be adjusted by your doctor to prevent over- or under-replacement. Semaglutide also slows gastric emptying, which can affect the absorption of oral medications like levothyroxine, making staggered dosing important.

Q3: Are there any thyroid conditions that would prevent me from taking Ozempic?

Yes, there are specific contraindications. You should not take Ozempic or other GLP-1 medications if you have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). These warnings are based on animal studies linking semaglutide to thyroid C-cell tumors. If you have a history of other types of thyroid cancer, a thorough discussion with your healthcare provider is necessary to weigh the potential risks and benefits.

Q4: What are the key things I should discuss with my doctor before starting Ozempic if I have hypothyroidism?

Before starting Ozempic, discuss your full medical history, including any personal or family history of thyroid cancer or MEN 2. Review all current medications, including your levothyroxine dosage and any supplements, to anticipate potential absorption issues. Establish a plan for regular thyroid function monitoring (TSH, T4), especially during initial dose titration and periods of significant weight loss. Discuss how to time your medications and what specific symptoms to watch for that might indicate a need for dose adjustment or immediate medical attention.