Hotze Health and Wellness Center


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Free Consultation with a health and wellness consultant, please call 281-698-8698 or 1-877.698.8698

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Do you have low thyroid function (Hypothyroidism)?

This thyroid questionnaire lists symptoms and other factors most commonly found in people suffering from low thyroid, or hypothyroidism. Read each question carefully and check the box if it applies to you. When you finish, the form will automatically calculate your score.

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?
Do you have depressed moods?
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?
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 98.6°?
Do you have sleep apnea?
Total Score
  • < 9 — It is not likely that you have low thyroid function.
  • 9-28 — Low thyroid function is a possibility.
  • > 28 — Low thyroid function is very likely.

For a FREE Hypothyroidism CONSULTATION conducted by one of our health and wellness consultants, Contact or Call 877-698-8698 Today.

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