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23

Do you experience weakness or increased fatigue?

No Sometimes Constantly

22

Is there palpitations or tachycardia?

No Under load Even at rest

21

Do you notice paleness of the skin or mucous membranes?

No Insignificant Expressed

20

Are there cracks in the corners of the lips or frequent stomatitis?

No Sometimes Often

19

Have the nails become wavy, thin, brittle, or depleted?

No Moderately Expressed

18

Is there a decrease in attention span or a deterioration in memory?

No Sometimes Constantly

17

Do your hands and feet get cold?

No Sometimes Constantly

16

Is there irritability or excessive emotionality?

No Sometimes Expressed

15

Do you notice dryness of the skin (especially on the elbows and feet)?

No Moderate Strong

14

Is there hair loss?

No Moderate Strong

13

Is there a craving for sweets despite a balanced diet?

No Sometimes Constantly

12

Do you notice decreased or selective appetite?

No Sometimes Expressed

11

Is there heaviness or pain in the lower back at the end of the workday?

No Sometimes Constantly

10

Does an involuntary urge to move your legs occur before falling asleep?

No Sometimes Often

9

Is there a predisposition to infections (herpes, ARVI, boils)?

I rarely get sick. Sometimes Often

8

Are heavy periods common?

No / not relevant Sometimes Yes

7

Is there low blood pressure?

No Sometimes Constantly

6

Do shortness of breath and palpitations occur during normal physical activity?

No Sometimes Constantly

5

Is there itching?

No Sometimes Often

4

Are there difficulties in swallowing large tablets or capsules?

No Sometimes Constantly

3

Do you notice a decrease in muscle tone, strength, and overall performance?

No Moderately Expressed

2

Is there an unstable stool or a tendency to constipation?

No Sometimes Constantly

1

Is there atrophy or flattening of the papillae on the tongue?

No Slightly Expressed