Your Thyroid Function Quiz
Rating 1 being never and 5 being always
First Name
*
Last Name
*
Phone
*
Email
*
My hair is naturally coarse and dry, even without heat and styling.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I have experienced sudden weight gain or loss without changes to my diet or activity level.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I frequently feel cold, even in warmer environments or when others are comfortable.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I experience fatigue or exhaustion throughout the day, even after a full night sleep.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
My skin often feels dry, flaky, and doesn’t respond well to moisturizers.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
My nails tend to split easily or grow thin with waves.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I have a low sex drive or find it difficult to maintain interest in intimacy.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I often have digestive issues, such as constipation or irregular bowel movements.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I’ve noticed thinning or hair loss, particularly in my outer eyebrows or scalp.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I have trouble concentrating and often experience “brain fog.”
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
My mood swings are frequent, and I sometimes feel irritable or anxious without reason.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
My cholesterol levels are higher than usual, or I take medication to control them.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
My energy levels feel low, and I struggle to complete daily tasks.
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
I’ve been diagnosed with or suspect I have a thyroid condition (hypothyroidism or Hashimoto thyroiditis).
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always
My body temperature is consistently low (below 97.8°F or 36.6°C).
*
1 Never
2 Almost Never
3 Sometimes
4 Almost Always
5 Always