Thyroid Function The thyroid gland regulates metabolism & hormone function and is important for numerous physiological functions in the body. Please indicate answers below:1. Do you have a family history of hypothyroidism or other thyroid problems?YesNo2. Is your skin dry without the use of lotion?YesNo3. Do you suffer from constipation?YesNo4. Are your menstrual cycles irregular?YesNo5. Do you have high cholesterol?YesNo6. Do you have low blood pressure?YesNo7. Is your hair dry?YesNo8. Are your nails brittle?YesNo9. Is your hair thinning?YesNo10. Is the outer third of your eyebrows missing or thinning?YesNo11. Does your skin have a yellow tint?YesNo12. Do you sometimes suffer from depression?YesNo13. Do you suffer from mood swings?YesNo14. Do you need caffeine and/or other stimulants to get you going?YesNo15. Do you have low energy levels?YesNo16. Do you have a low sex drive?YesNo17. Do you note any forgetfulness?YesNo18. Do you have difficulty losing weight?YesNo19. Is it easy for you to gain weight?YesNoName* First Last Email* PhoneThis field is for validation purposes and should be left unchanged.