I'm on thyroid tablets. Does my dose need to change while trying to conceive, and how should I take them?

Thyroid hormone is important for ovulation and for a healthy early pregnancy. In women with hypothyroidism who are trying to conceive, many doctors aim to keep TSH in the lower part of the normal range, often below about 2.5, though targets vary between guidelines and doctors. Your doctor may adjust your dose based on your result. When pregnancy happens, the body's need for thyroid hormone increases, often in the first few weeks. Many doctors advise women on thyroid tablets to contact them as soon as pregnancy is confirmed, as the dose often needs to go up and TSH is rechecked regularly through pregnancy. Never adjust the dose on your own. How you take it matters. Thyroid tablets are best taken on an empty stomach, usually first thing in the morning with water, about 30–60 minutes before breakfast or tea. Calcium, iron, some antacids and soy can reduce absorption, so keep these at least four hours apart. Prenatal vitamins often contain iron and calcium, so ask your doctor how to space them. Taking the tablet at the same time every day keeps levels steady. Discuss your TSH result and the target for conception with your doctor or endocrinologist. Get checked sooner if you have symptoms like a racing heart, extreme tiredness, weight changes or hair loss.