Thyroid

THYROID

About

The thyroid gland is a tiny gland, located in front of the windpipe (Trachea), that regulates every organ in the body through its hormones. When it’s not functioning properly you know something is wrong.

Unfortunately, you may not know you have a thyroid disorder.

Often the signs and symptoms of thyroid disease can mimic many other conditions.

Take this quiz and see if you have some of the symptoms of Thyroid Disease.

Thyroid Questions

	Symptom List:
_____	Cold Hands and /or Feet	_____	Inability to Concentrate
_____	Cold Intolerance	_____	Infertility
_____	Constipation	_____	Irritability depression moodiness
_____	Difficulty in Verbal expression	_____	Menstrual pain, Menstrual irregularities
_____	Dry Skin, Brittle Nails	_____	Muscle weakness
_____	Elevated Cholesterol	_____	Slow heart rate
_____	Swollen Eyelids, ankles	_____	Weight Gain
_____	Fatigue	_____	Nervousness
_____	Hair loss	_____	Poor Memory

Do you have any family members with diagnosed thyroid disease? Yes No Unsure

Have you ever been diagnosed with a thyroid disease? Yes No

If yes, please indicate.
Overactive thyroid
Underactive thyroid gland
Nodule or enlarged thyroid gland
Thyroid cancer
Other

Are you currently being treated for a thyroid disease? Yes No

If yes, please indicate.
Thyroid hormone therapy (eg. Synthroid, Eltroxin, Cytomel)
Antithyroid drug therapy (eg. PTU, Tapazole)
Other

Were you ever treated for a thyroid disease in the past? Yes No

If yes, please indicate all that apply.
Thyroid hormone therapy (eg. Synthroid, Eltroxin, Cytomel)
Thyroid surgery
Radioiodine therapy (not the diagnostic scan)
Antithyroid drug therapy (eg. PTU, Tapazole)
Other

Do you currently take any herbal remedies or dietary supplements specifically to benefit
your thyroid? Yes No

If yes, please list.

Do you have any of the following medical problems? High blood pressure: Yes No High cholesterol: Yes No Heart disease or angina (chest pain): Yes No

Do you take any of the following? Cholestyramine: Yes No Amiodarone: Yes No Lithium: Yes No

Treatment: At our office we prefer to use natural and/or glandular support to treat Thyroid. In addition, we use Bio-Identical hormones if necessary.