Hypothyroidism Risk/Symptoms Checklist

Help in Diagnosis and Finetuning Your Treatment

You can use this checklist to bring to your doctor to help aid in getting a proper diagnosis of hypothyroidism, or as background information in your discussions regarding finetuning your dosage so you are at the optimal TSH level for your own level of wellness.

My risk factors for hypothyroidism include:

____ I have a family history of thyroid disease
____ I have had my thyroid "monitored" in the past to watch for changes
____ I had a previous diagnosis of goiters/nodules
____ I currently have a goiter
____ I was treated for hypothyroidism in the past
____ I had post-partum thyroiditis in the past
____ I had a temporary thyroiditis in the past
____ I have another autoimmune disease
____ I have had a baby in the past nine months
____ I have a history of miscarriage
____ I have had part/all of my thyroid removed due to cancer
____ I have had part/all of my thyroid removed due to nodules
____ I have had part/all of my thyroid removed due to Graves' Disease/hyperthyroidism
____ I have had radioactive iodine due to Graves' Disease/hyperthyroidism
____ I have had anti-thyroid drugs due to Graves' Disease/hyperthyroidism

I have the following symptoms of hypothyroidism, as detailed by the Merck Manual, the American Association of Clinical Endocrinologists, and the Thyroid Foundation of America

____ I am gaining weight inappropriately
____ I'm unable to lose weight with diet/exercise
____ I am constipated, sometimes severely
____ I have hypothermia/low body temperature (I feel cold when others feel hot, I need extra sweaters, etc.)
____ I feel fatigued, exhausted
____ Feeling run down, sluggish, lethargic
____ My hair is coarse and dry, breaking, brittle, falling out
____ My skin is coarse, dry, scaly, and thick
____ I have a hoarse or gravely voice
____ I have puffiness and swelling around the eyes and face
____ I have pains, aches in joints, hands and feet
____ I have developed carpal-tunnel syndrome, or it's getting worse
____ I am having irregular menstrual cycles (longer, or heavier, or more frequent)
____ I am having trouble conceiving a baby
____ I feel depressed
____ I feel restless
____ My moods change easily
____ I have feelings of worthlessness
____ I have difficulty concentrating
____ I have more feelings of sadness
____ I seem to be losing interest in normal daily activities
____ I'm more forgetful lately

I also have the following additional symptoms, which have been reported more frequently in people with hypothyroidism:

____ My hair is falling out
____ I can't seem to remember things
____ I have no sex drive
____ I am getting more frequent infections, that last longer
____ I'm snoring more lately
____ I have/may have sleep apnea
____ I feel shortness of breath and tightness in the chest
____ I feel the need to yawn to get oxygen
____ My eyes feel gritty and dry
____ My eyes feel sensitive to light
____ My eyes get jumpy/tics in eyes, which makes me dizzy/vertigo and have headaches
____ I have strange feelings in neck or throat
____ I have tinnitus (ringing in ears)
____ I get recurrent sinus infections
____ I have vertigo
____ I feel some lightheadedness
____ I have severe menstrual cramps