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For Hashimoto's patients, this discontinuation requires careful planning because: Thyroid hormone requirements increase significantly during pregnancy (typically 25-50% higher) Weight regain after GLP-1 discontinuation will change levothyroxine requirements again Optimal thyroid function before conception is critical for fetal brain development If you discover you are pregnant while on a GLP-1 medication , stop the medication immediately and contact your healthcare provider for urgent thyroid function testing and levothyroxine dose adjustment

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Oral semaglutide tablets (Rybelsus) is a modified form of semaglutide with the addition of a carrier sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC).30,31 Due to the degradation of peptide-based drugs by proteolytic enzymes, the low permeability of intestinal epithelium, and the low pH of the gastrointestinal tract, oral administration of semaglutide is challenging