Online Questionnaire for Thyroid Function (Hypothyroidism)

The following are all some of the major symptoms and signs associated with an under active thyroid. Some symptoms are more significant than others. Read each line carefully. Click the box next to the symptom if it applies to you. Your score will be tallied up below.


  Weight gain

  Difficulty losing weight

  Low energy – fatigue

  Cold natured

  Ice-cold hands or feet

  Dry skin

  Hair loss (alopecia)

  Slowed thinking, poor concentration

  Brain fog

  Memory problems

  Insomnia, poor sleep

  Waking up exhausted

  Tingling in hands and feet

  Muscle pain

  Edema (swelling in ankles)


  Slow heart rate

  Low blood pressure

  Elevated cholesterol

  Thickened tongue


  Thinned eyebrows

  Muscle cramps at night

  Slow reflexes

  Your skin itches in the winter

  Recurrent headaches

  Decreased sweating

  Multiple miscarriages and infertility

  Pale, puffy, pasty skin

  Decreased body hair

  Vertigo (dizziness)

  Hoarse voice

  Fibrocystic breasts

  Low body temperature (below 98.6 degrees)

  Total Score

  • 0 – 9        Unlikely you are hypothyroid
  • 10 – 19   Mild hypothyroidism
  • 20 – 29   Moderate hypothyroidism
  • 30 – 49   Profound hypothyroidism
  • 50 – 69   Severe hypothyroidism
  • 70+          Hypothyroidism so bad that blood tests may be abnormal

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