Tag Archives: TSH

The test that was developed for the Book Thyroid Power: Ten Steps to Total Health [Paperback] by Dr. Richard L Shames, M.D. and Dr. Karilee Halo Shames, R.N., Ph.D.    This test is not a complete guide that you have a thyroid condition but can lead you in the direction of whether testing is necessary.

The following is a list of symptoms, conditions, and signs that could be indicators of low thyroid. Take this self-assessment to see if you should receive further testing, or a trial of thyroid hormone, regardless of test results.

I.  Symptoms
Give yourself 5 points for significant fatigue, and 1 point for each additional ‘yes’ answer.

• Significant fatigue, lethargy, sluggishness, or history of low thyroid at an earlier age (5 points)
• Hoarseness for no particular reason
• Chronic recurrent infection(s)
• Decreased sweating even with mild exercise
• Depression, to the point of being a bothersome problem
• A tendency to be slow to heat up, even in a sauna
• Constipation despite adequate fiber and liquids in diet
• Brittle nails that crack or peel easily
• High cholesterol despite good diet
• Frequent headaches (especially migraines)
• Irregular menses, PMS, ovarian cysts, endometriosis
• Unusually low sex drive
• Red face with exercise
• Accelerated worsening of eyesight or hearing
• Palpitations or uncomfortably noticeable heartbeat
• Difficulty in drawing a full breath, for no apparent reason
• Mood swings, especially anxiety, panic, or phobia
• Gum problems
• Mild choking sensation or difficulty swallowing
• Excessive menopause symptoms, not well relieved with estrogen
• Major weight gain
• Aches and pains of limbs, unrelated to exertion
• Skin problems of adult acne, eczema, or severe dry skin
• Vague and mildly annoying chest discomfort, unrelated to exercise
• Feeling off balance
• Infertility
• Annoying burning or tingling sensations that come and go
• The experience of being colder than other people around you
• Difficulty maintaining standard weight with a sensible food intake
• Problems with memory, focus, or concentration
• More than normal amounts of hair come out in the brush or shower
• Difficulty maintaining stamina throughout the day

II.   Related Conditions: Give yourself 5 points for autoimmune illness, and one point for each additional ‘yes’ answer.
Have you ever had:

• Any of these autoimmune disorders: rheumatoid arthritis, lupus, sarcoidosis, scleroderma, Sjogren’s syndrome, biliary cirrhosis, myasthenia gravis, multiple sclerosis, Crohn’s disease, ulcerative colitis, thrombocytopenia (decreased blood platelets) 5 points
• Prematurely gray hair
• Anemia, especially the B-12 deficiency type
• Dyslexia
• Persistent unusual visual changes
• Rapid cycle bipolar disorder (manic-depressive illness)
• Raynaud’s syndrome (white or blue discoloration of fingers or toes when cold)
• Mitral valve prolapse
• Carpal tunnel syndrome
• Persistent tendonitis or bursitis
• Atrial fibrillation
• Alopecia (losing hair, especially in discrete patches)
• Calcium deficiency
• Attention deficit disorder (ADD)
• Vitiligo (persistent large white patches on skin)
• Neck injury, such as whiplash or blunt trauma

III. Family History: give yourself 5 points for blood relatives ever having a thyroid problem, and 1 point for each additional ‘yes’ answer.
Have any of your blood relatives ever had:

• High or low thyroid, or thyroid goiter (5 points)
• Prematurely gray hair
• Complete or partial left-handedness
• Diabetes
• Rheumatoid arthritis
• Lupus
• Sarcoidosis
• Scleroderma
• Sjogren’s syndrome
• Biliary cirrhosis
• Myasthenia gravis
• Multiple sclerosis
• Crohn’s disease
• Ulcerative colitis
• Thrombocytopenia (decreased blood platelets)

IV.  Signs: give yourself 5 points for low basal temperature, and 1 point for each additional ‘yes’ answer.
Have you or your doctor observed any of the following:

• Low basal temperature in early morning (average of less than 97.6 degrees over 7 days)

• Slow movements, slow speech, slow reaction time
• Muscle weakness
• Thick tongue (seemingly too big for mouth)
• Swelling of feet
• Swelling of eyelids or bags under eyes
• Decreased color of lips or yellowing of skin
• Swelling at base of neck (enlarged thyroid gland)
• Asymmetry, lumpiness, or other irregularity of thyroid gland
• Swelling of face
• Excess ear wax
• Dry mouth and/or dry eyes
• Noticeably cool skin
• Excessively dry or excessively coarse skin
• Especially low blood pressure
• Decreased ankle reflexes or normal reflexes with slow recovery phase
• Noticeably slow pulse rate without having exercised regularly
• Loss of outer one-third of eyebrows

Score interpretation: Add up your grand total of points from all four categories above.

• 5 points: only mildly indicative of low thyroid
• 10 points: somewhat suspicious for low thyroid. Possible actions: obtain TSH level as first screening test.
• 15 points: very suspicious for low thyroid. Possible actions: obtain additional tests if TSH is normal
• 20 points: likely to be low thyroid. Possible action: obtain all possible blood testing to help confirm a diagnosis.
• 25 or more points: very likely to be low thyroid. Possible actions: obtain a trial of thyroid medicine, regardless of blood test results.