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Hotze Health & Wellness Center
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Hormone, Thyroid & Adrenals for Men
Do you have or experience any of the following?
(Check all that apply)
Does Not Apply
Difficulty losing weight?
Less than one bowel movement per day?
Restless sleep or difficulty sleeping?
Thinning of your eyebrows or eyelashes?
Body temperature below 98.6?
Decline in self-confidence?
Difficulty making decisions?
Loss of muscle mass, strength and/or tone?
Chronic emotional or physical stress?
Feeling as though you might pass out when you rise quickly?
Cold hands and feet?
Poor short term memory?
Recurrent headaches or migraine headaches?
Tired upon waking, even after a full night’s sleep?
Tingling or numbness in your hands and feet?
Muscle aches & joint pain?
Puffy, pasty or pale skin?
Low blood pressure?
Lack of drive or initiative?
Difficulty setting goals?
Decreased stamina and endurance?
Increased body fat around your waist?
Decline in sexual ability?
Low pulse rate (less than 70 beats per minute with no exercise)?
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