Do you currently have palpitations (rapid or forceful heart beat)?

Do you have poor concentration?

Do you have memory loss?

Do you have difficulty sleeping?

Do you have an excessive need for sleep?

Do you regularly experience fatigue?

Do you experience weak muscles?

Do you experience agitation/anxiety?

Do you currently experience depression?

Do you have dry skin?

Do you have itchy skin?

Do you have unusual hair loss?

Do you have cracking nails?

Do you have infrequent bowel movements or hard stools?

Do you have frequent bowel movements or loose stools?

Do you have unexplained weight gain?

Do you have unexplained weight loss?

Do you have persistent pain or swelling at the front of the neck?

Do you have persistent hoarseness?

Do you have a sensation of a lump in your throat?

Do you have eye pain of double vision?

Are you experiencing swelling or protrusion of your eyes?

Have you had a change in facial appearance?

Are you experiencing abnormal sweating?

Do you have difficulty tolerating cold?

Do you have hand tremors?

For Women Before Menopause Only:

Have you experienced loss of menstrual periods?

For Women Before Menopause Only:

Do you experience irregular periods?

For Women Before Menopause Only:

Do you experience excessive menstrual flow?