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Practical timing strategies include: For oral semaglutide users: Take Rybelsus first upon waking with 4 oz water, wait at least 30 minutes, then take levothyroxine, and wait an additional 30-60 minutes before eating Alternatively, consider consistent bedtime levothyroxine dosing (3-4 hours after the last meal) Weight Loss Considerations : Significant weight reduction from semaglutide therapy can alter thyroid hormone requirements

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