This questionnaire is designed to help you determine if you may have symptoms of hyperthyroid. Give each question a value ranging from 0-5 with “0″ representing on symptoms at all and “5″ severe symptoms.
Hypothyroid (Underactive)
You experience noticeable WEIGHT GAIN
Your appetite DECREASED
You are EASILY FATIGUE
You hear RINGING IN YOUR EARS
You are SLEEPY DURING A DAY
You are SENSITIVE TO COLD
You have DRY OR SCALY SKIN
You have CONSTIPATION
You are experiencing MENTAL SLUGGISHNESS
Your HAIR IS COARSE AND FALLS OUT
You have HEADACHES UPON ARISING-WEARS OFF DURING A DAY
Your PULSE IS SLOW BELLOW 65
You URINATE FREQUENTLY
You have IMPAIRED HEARING
TOTAL:
0- 10 = No/ Very slight symptoms of hypothyroid 11 – 22 = Mild symptoms of hypothyroid 23 – 33 = Moderate symptoms of hypothyroid 34 and above symptoms of hypothyroid.
If you are concern about your symptoms and are ready to address them personalize, nutritional evaluation and programs customized to your health needs are available. To schedule your appointment, contact our office at (214) 783-8721 or e-mail: info@womananew.com
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