Hypothyroid versus Hyperthyroid

Hypothyroid

In each box below enter the number that corresponds with your choice. (0 = Never, 1 = Occasionally, 2 = Often, 3 = Regularly)

Tired or sluggish

Feel cold (hands, feet, or your whole body

Require an excessive amount of sleep to function properly

Gain weight easily

Difficult, infrequent bowel movements

Depression or lack of motivation

Thinning of outer third of eyebrows

Thinning of hair on scalp, face, or genitals, or excessive hair loss

Dry skin and/or scalp

Slow brain processing

Lack of or diminished sex drive

Infertility or impotency (N=0, Y=4)

Heavy or profuse menstrual bleeding (women only)

Hypothyroid Total:________

Risk for hypothyroidism:

Low = 0-11 , Medium= 12-22, High =23-40

Hyperthyroid

In each box below enter the number that corresponds with your choice. (0 = Never, 1 = Occasionally, 2 = Often, 3 = Regularly)

Heart palpitations

Inward trembling

Increased pulse, even at rest

Nervous or emotional

Insomnia

Night sweats

Eyes appear bulging or swollen

Difficulty gaining weight

Hyperthyroid Total_________

Risk for hyperthyroidism:

Low = 0-5, Medium = 6-10, High =11-24

Precision nutrition