Test for Low Thyroid (Hypothyroidism)
This thyroid questionnaire lists symptoms and other factors most commonly found in people suffering from low thyroid, or hypothyroidism. By answering this questionnaire, your scores will determine whether or not you might have low thyroid.
Do you have fatigue?
Do you have elevated cholesterol?
Do you have difficulty losing weight?
Do you have cold hands and feet?
Are you sensitive to the cold?
Do you have difficulty thinking?
Do you find it hard to concentrate?
Do you experience brain fog?
Do you have poor short term memory?
Are your moods depressed?
Are you experiencing hair loss?
Do you have less than one bowel movement a day?
Do you have dry skin?
Does your skin itch in the winter?
Do you have fluid retention?
Do you have recurrent headaches?
Do you sleep restlessly?
Are you tired when you awaken?
Do you have afternoon fatigue?
Do you experience tingling or numbness in your hands or feet?
Do you have decreased sweating?
Have you had problems with infertility or miscarriages?
Do you have recurrent infections?
Do your muscles ache?
Do you have joint pain?
Do you have thinning of your eyebrows or eyelashes?
Is your tongue enlarged with teeth indentations?
Is your skin pasty, puffy or pale?
Do you have decreased body hair?
Is your voice hoarse?
Do you have a slow pulse?
Do you have low blood pressure?
Does your body temperature run below the normal 98.6º?
Do you have sleep apnea?
Total:____
Each question/symptom is 1 point
Scoring less than 10 points, it is not likely that you have low thyroid
Scoring between 11-30 points indicates low thyroid as a possibility
Scoring above 30 points would suggest that low thyroid is very likely
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This thyroid questionnaire lists symptoms and other factors most commonly found in people suffering from low thyroid, or hypothyroidism. By answering this questionnaire, your scores will determine whether or not you might have low thyroid.
Do you have fatigue?
Do you have elevated cholesterol?
Do you have difficulty losing weight?
Do you have cold hands and feet?
Are you sensitive to the cold?
Do you have difficulty thinking?
Do you find it hard to concentrate?
Do you experience brain fog?
Do you have poor short term memory?
Are your moods depressed?
Are you experiencing hair loss?
Do you have less than one bowel movement a day?
Do you have dry skin?
Does your skin itch in the winter?
Do you have fluid retention?
Do you have recurrent headaches?
Do you sleep restlessly?
Are you tired when you awaken?
Do you have afternoon fatigue?
Do you experience tingling or numbness in your hands or feet?
Do you have decreased sweating?
Have you had problems with infertility or miscarriages?
Do you have recurrent infections?
Do your muscles ache?
Do you have joint pain?
Do you have thinning of your eyebrows or eyelashes?
Is your tongue enlarged with teeth indentations?
Is your skin pasty, puffy or pale?
Do you have decreased body hair?
Is your voice hoarse?
Do you have a slow pulse?
Do you have low blood pressure?
Does your body temperature run below the normal 98.6º?
Do you have sleep apnea?
Total:____
Each question/symptom is 1 point
Scoring less than 10 points, it is not likely that you have low thyroid
Scoring between 11-30 points indicates low thyroid as a possibility
Scoring above 30 points would suggest that low thyroid is very likely
Back to Wellness Plans
Back to Questionnaires
