Thyroid Assessment Questionnaire

Thyroid Assessment Questionnaire.

Section 1 - Feelings*

	No or Rarely 0	Sometimes 3	Often 5
I am more moody than I used to be.
I have chronic or recurring muscle/joint pain.
I notice puffiness in my hands, feet or face.
I’m gaining weight for no reason.
I have or have had carpal tunnel syndrome or tendonitis.
My sex drive is lower than it used to be.
I have cold hands and feet.
More than a few hairs fall out in the shower or on my hairbrush.
I have a high level of stress in my life.
My brain feels foggy, I’m forgetful, or am thinking more slowly.
My hair is brittle and dry.
My eyebrows are thinning, especially the outer third.