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27

Hair loss, including the outer third of the eyebrows and/or eyelashes?

Yes No

26

Dry skin?

Yes No

25

Dry, brittle, tangled hair?

Yes No

24

Thin, fragile nails?

Yes No

23

Swelling or fluid retention (for example, in the area of the ankles)?

Yes No

22

Excess weight that is hard to lose (about 9 kg)?

Yes No

21

High cholesterol level?

Yes No

20

Rare peristaltic movements of the intestine or the sensation of incomplete evacuation?

Yes No

19

Periodic headaches?

Yes No

18

Reduced sweating?

Yes No

17

Muscle or joint pain, poor muscle tone?

Yes No

16

Tingling in the hands or feet?

Yes No

15

Cold hands and feet, intolerance to cold or heat?

Yes No

14

Sensitivity to cold, do you get cold quickly?

Yes No

13

Slow speech, hoarse voice, or hesitations?

Yes No

12

Slow heart rate (less than 60 beats per minute, not in an athlete)?

Yes No

11

Lethargy, apathy?

Yes No

10

Fatigue, especially in the morning?

Yes No

9

Slow thinking, hard to concentrate?

Yes No

8

Lethargic reflexes, slowed reaction, apathy?

Yes No

7

Decreased libido without an obvious reason?

Yes No

6

Depression or moodiness?

Yes No

5

Taking antidepressants without improvement?

Yes No

4

Heavy periods or menstrual issues?

Yes No

3

Infertility, miscarriages, or preterm births?

Yes No

2

Enlarged thyroid gland, difficulty swallowing, enlarged tongue?

Yes No

1

Are there any cases of thyroid disease in the family?

Yes No