Q: I have thyroid problem. Following are my test results T3 0.76 ng/ml(Normal 0.7 to 2.1) T4 40 ng/ml (Normal 42 to 120) TSH 5.65 micro/ml(Normal .2 to 5) Now I am 3 months pregnant. I am taking Eltroxin(1-0-0). Though I was asked to take 1 tablet every morning at 8 Oclock, I am not able to take it every day at the same time but take it between 8 A.M. and 10 A.M. Will it affect my baby in anyway and is it compulsory to take the tablet at the same time?

A:In answer to your question: there is nothing sacred about 8 am, and I am not sure why your doctor has specified that time: we usually recommend that thyroxin be taken first thing in the morning on an empty stomach (basically as soon as you wake up), so that nothing interferes with its absorption. It is a good idea to take it at that time because then the chances of forgetting are minimal, and it is important to be regular in taking the medication. Independent of your question, I notice your TSH is marginally high and T4 low. You have not mentioned when this test was done, and whether the eltroxin was being taken before pregnancy, or if it was started in response to this test. If the test was done while you were already on thyroxin, you need to increase the dose marginally, and repeat thyroid tests after 6 weeks to confirm that the reports are in the normal range. If the tablet was started in response to these values, you need to repeat thyroid tests 6 weeks after starting the tablet to confirm that the reports are in the normal range. During pregnancy, the need for thyroxin increases, so the thyroid tests must be done in each trimester. Also, you must take care that any iron containing preparation you take is spaced 8 hours away from thyroxin intake. Preferably the calcium tablets should also be a few hours away.