As suggested by the forum I had more comprehensive tests done on my thyroid function following the hemithyroidectomy in April 21. These are my results from tests done early morning before eating and before taking my parkinson's medication which includes levadopa and a dopamine agonist (Ropinorole).
The test done in July just tested my TSH level which was 2.06miu/L ( 0.35 - 4.78) at 2pm in the afternoon with 2 doses of Parkinson's meds in me
The results today are
TSH 4.35 (0.35 - 4.78)
FreeT4 13.5 (10-20 pmo/L)
Free T3 4.7 (3.5-6.5 pmo/L)
Ferritin 55 (15-250ug/L)
Serum total vit D 72( 76-250 nmol/L) adequate or borderline deficient
My GP says everything is normal. But I am still very tired some days worse than others. Would a consultation with an endocrinologist be helpful ? Not sure if the fatigue is due to wearing off Parkinson's meds or my thyroid or both?
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Quiltyqueen
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Patently obvious your TSH is too high, your Free T4 and Free T3 too low.
I did a quick check on levadopa and Ropinorole and didn't see any obvious, published interactions with thyroid hormones.
You just might find the article below (and the full paper which you can access) interesting and/or useful.
The normal range: it is not normal and it is not a range
1. Martin Brunel Whyte
2. Philip Kelly
Abstract
The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.
By interaction, I meant primarily affecting your own thyroid hormone levels. Many medicines are known to affect how much thyroid hormone we have.
And I still say, TSH too high, FT4 and FT3 too low. And your doctor should be taking into account that you only have half a thyroid.
As TSH has risen, though I note issues which mean the tests are not fully comparable, it suggests your half thyroid is not increasing output adequately.
Your Vitamin D is not "borderline deficient", it is extremely deficient. Unfortunately, medical practice has not kept up with research. A truly adequate blood level of Vitamin D is sometimes twice what current medical practice thinks it should be. In the US they have it set at 20 ng/ml, when 40 ng/mL (or 100 nmol/L is what is required for optimal health. Here is a calculator where you can enter you weight, your current supplemental intake of Vitamin D3, and your desired level. (NOTE: I set my desired level to 60 ng/ml because research shows this reduces the odds of breast cancer by 80%). You can select whether your lab used ng/ML or nmol/L as the measuring stick. grassrootshealth.net/projec...
P.S. When taking a large dose of Vitamin D, you should also take Vitamin K2-MK7. Increasing your blood level of Vitamin D will increase the amount of calcium you get from food. Taking 90-100 mcg of Vitamin K2-MK7 will help to route the calcium where it does a body good -- bones and teeth -- instead of to soft tissues where it is harmful such as breasts and blood vessels. Also taking the co-factors of Magnesium and Zinc along with your D will help.
So, first and foremost I have no knowledge of the interactions of other medications but have read what has already been posted regarding same.
Your TSH is too high for someone who is already taking thyroid hormone replacement and you'll likely feel better with a dose increase in Levothyroxine as currently your T4 is only 35% through the range and we generally feel better when T4 sits up in or around the top quadrant of the range.
A higher T4 should in turn reflect in a higher T3 which is currently at just 40% through its range, as it is too low a T3 for you that gives you the symptoms of hypothyroidism just as too high a level of T3 for you may give you symptoms of hyperthyroidism.
A daily dose increase in Levothyroxine is generally at 25mcg increments and a further blood test in 6 - 8 weeks taken to review and see if your symptoms are resolved, and if not, likely a further dose increase in T4 needed, until your levels are high enough in the range to offer you relief of symptoms.
T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that runs the body. T3 is said to be about 4 time more powerful than T4 with the average person needing to find/utilise/convert around 50 T3 daily, just to function.
No thyroid hormone replacement works well until your vitamins and minerals, especially ferritin, folate, B12 and vitamin D are maintained at optimal levels and you may need to supplement these yourself as you will likely be in the NHS ranges, but for someone on thyroid hormone replacement we need good high levels :
I now maintain my ferritin at around 100 ; my folate at 20 ; active B12 75 ++ ( serum 500 )
and my vitamin D at 100 :
Normal is an opinion, and simply means that your levels fall within the NHS ranges :
Some ranges are too wide to be sensible :
We need optimal levels as we are not with a fully functioning thyroid and taking thyroid hormone replacement and it's where you feel at your best within these ranges that will help relieve your symptoms.
P.S, Thyroid UK the charity who support this forum have a list of " supportive " endos and specialist, NHS and private, and yes, you may well feel better seeking a doctor with knowledge of thyroid but first build up your core strength vitamins and minerals and just see if your doctor will support you with a dose increase and then take it one step at a time.
Sorry - I thought you were on thyroid hormone replacement :
However your T3 and T4 levels are low and your TSH rising :
Generally when a TSH rises to over 3 you are considered as having hypothyroidism and some doctors treat when TSH is at this number, however, the goal posts have moved and now some people find they can't get medicated until the TSH climbs up to over 10.
Considering you only have half a thyroid I would think a sensible option would be to start thyroid hormone replacement as you are experiencing debility symptoms.
Your TSH is higher then mine Im (thyroidless) and I can’t remember anything feels like I have dementia and Im exhausted just sitting and muscle fatigue is insane… so sorry you don’t look well to me based on your numbers and your doctor needs better glasses..
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Advice needed on serum ferritin level
Optimal serum levels for thyroid antibodies?
Serum vs. tissue T3 levels
Is this a dangerous tsh level? 
