HYPOTHYROIDISM RISKS/SYMPTOMS CHECKLIST

9780738218670 (4)A PDF version of this checklist is available for you to print and bring to your doctor: Download the PDF now.

RISK FACTORS

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/enlargement in my thyroid and/or thyroid nodule.
____ I was treated for hypothyroidism or hyperthyroidism in the past.
____ I had postpartum thyroiditis in the past.
____ I had a temporary thyroiditis in the past.
____ I have a family history of autoimmune disease.
____ I have another autoimmune disease.
____ I am pregnant now, or 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 been prescribed antithyroid drugs due to Graves’ disease/hyperthyroidism.

SYMPTOMS

I have the following symptoms of hypothyroidism:
____ I am gaining weight inappropriately.
____ I am 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.
____ I feel 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 gravelly 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 am more forgetful lately.

ADDITIONAL SYMPTOMS

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 my 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 or have tics, which makes me dizzy (vertigo) and give me headaches.
____ I have strange feelings in my 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.

A PDF version of this checklist is available for you to print and bring to your doctor: Download the PDF now.

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