Integrative Medicine Dallas5330 Alpha Road, Suite 100 Dallas TX 75420

Thyroid Questionnaire for Men & Women

Check the symptoms you are experiencing to find out if your thyroid hormone levels are out of balance.

Thyroid Deficiency

 "Crash" every day around 3:00 PM Bone, Muscle, strength loss Cold Body Temperature Cold hands and feet Decreased sex drive Decreased sweating Dry, Breaking, Brittle nails Edema with puffy face and eyes Family history of thyroid problems Fatigue - Feeling "Burned Out" Hair Loss, Dry, Breaking brittle hair Heart Palpitations Inability to focus or concentrate Low blood pressure Malaise or fatigue Memory Lapses – forgetfull Outer third of eyebrows thinning Poor Concentration Retaining fluid Sad or Depressed without cause Thinning papery skin Vertical ridges on fingernails Weight Gain - Can't lose weight

Thyroid Excess

 Anxiety Bulging or protruding eyes Decreased concentration Erratic behavior Insomnia Irritability Neck mass Panic Attacks Rapid Heart Rate Rapid weight loss Tremor Unusual sweating
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Integrative Medicine Dallas
5330 Alpha Road, Suite 100
Dallas, TX 75420
Phone: 214-205-0012
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