Thyroid self-assessment Test

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.