Questionnaire for Low Thyroid

Here is a great thyroid questionnaire, modified from the Hotze Health and Wellness Center. If the question addresses a concern that applies to you, record the number. When done, total the numbers. 1. Do you experience fatigue (4)? 2. Is your cholesterol elevated (4)? 3. Do you have difficulty losing weight (2)? 4. Do you have cold hands and feet (2)? 5. Are you sensitive to cold (2)? 6. Do you have difficulty thinking (2)? 7. Do you find it hard to concentrate (2)? 8. Do you have poor short-term memory (2)? 9. Are your moods depressed (2)? 10. Are you experiencing hair loss (2)? 11. Do you have fewer that one BM per day (2)? 12. Do you have dry skin (2)? 13. Do you have itchy skin in winter (1)? 14. Do you have fluid retention (2)? 15. Do you have recurrent headaches (1)? 16. Do you sleep restlessly (1)? 17. Do you experience afternoon fatigue (2)? 18. Are you tired when you awaken (2)? 19. Do you experience tingling in hands or feet (2)? 20. Have you had infertility or miscarriages (2)? 21. Do you have decreased sweating (2)? 22. Do you have muscle aches (2)? 23. Have you had recurrent infections (2)? 24. Do you have joint pain (2)? 25. Do you have thinning of your eyebrows or eyelashes (2)? Score < 11? You are unlikely to have a thyroid problem. Score 11-30? Low thyroid function is a possibility. Score >30? Low thyroid function is probable. Get tested if your score is > 11, including a free T3 and TSH.