Do you have fatigue (can be severe) or loss of energy?

1

Do you have difficulty losing weight?

1

Do you have depression or depressed moods?

1

Do you have afternoon fatigue?

1

Do you sleep more than average?

1

Do you have poor short term memory?

1

Do you have fuzzy thinking (brain fog) or difficulty following conversation?

1

Do you have cold hands or feet?

1

Do you have slowness or slurring of speech?

1

Do you have drooping eyelids?

1

Do you have poor circulation?

1

Do you have anxiety or panic attacks?

1

Do you have slow heart rate or slow pulse?

1

Do you have low blood pressure?

1

Do you have a puffy face?

1

Do you have menstrual irregularities?

1

Do you have sleep apnea?

1

Do you have brittle hair or fingernails or ridges on your nails?

1

Is your hair thinning or do you have hair loss?

1

Do you have dry skin?

1

Do you have fluid retention?

1

Do you have decreased sweating?

1

Do you have carpal tunnel syndrome, tingling or numbness in your hands/wrists?

1

Do you have elevated levels of LDL (“bad” cholesterol)?

1

Do you have thinning of the lateral (outer) 1/3 of the eyebrows?

1

Do you have problems with infertility or miscarriages?

1

Does your skin itch – especially in the winter?

1

Do you have recurrent headaches?

1

Do you have decreased body hair?

1

Do you have puffy, pasty or pale skin?

1

Do you have problems with bruising or clotting?

1

Do you have a low basal body temperature?

1

Are you sensitive to the cold?

1

Do you have less than one bowel movement a day?

1

Do you have allergies that suddenly appear or get worse?

1

Is your tongue enlarged (thick) with teeth indentations around the outside?

1

Do you sleep restlessly or have insomnia?

1

Are you tired when you awaken?

1

Do your muscles ache?

1

Do you have joint pain (fibromyalgia)?

1

Do you have a hoarse or husky voice?

1

Do you have diminished sex drive?

1

Do you have persistent cold sores, boils or breakouts?

1