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Take Dr. Hotze’s Low Thyroid Questionnaire

Sara Gottfried, SaraGottfriedMD
Thyroid Nation

Dr. Gottfried on Dr. Hotze’s Thyroid Questionnaire:

I love this questionnaire from Dr. Hotze, another integrative physician. It gets to the heart of whether you should be tested for thyroid dysregulation, even if your conventional doc has dismissed your concerns. I also like to use these questions to build a tracker for how you improve with different therapies, as trial-and-error continues to be the best route for choosing the best thyroid optimization.

If the question addresses a concern that applies to you, record the number. When done, total the numbers to see if you have low thyroid function.

Hotze1. Do you experience fatigue (4)?
2. Is your cholesterol elevated (4)?
3. Do you have difficulty losing weight (2)?
4. Do you have cold hands and feet (2)?
5. Are you sensitive to cold (2)?
6. Do you have difficulty thinking (2)?
7. Do you find it hard to concentrate (2)?
8. Do you have poor short-term memory (2)?
9. Are your moods depressed (2)?
10. Are you experiencing hair loss (2)?
11. Do you have fewer that one BM per day (2)?
12. Do you have dry skin (2)?
13. Do you have itchy skin in winter (1)?
14. Do you have fluid retention (2)?
15. Do you have recurrent headaches (1)?
16. Do you sleep restlessly (1)?
17. Do you experience afternoon fatigue (2)?
18. Are you tired when you awaken (2)?

19. Do you experience tingling in hands or feet (2)?
20. Have you had infertility or miscarriages (2)?
21. Do you have decreased sweating (2)?
22. Do you have muscle aches (2)?
23. Have you had recurrent infections (2)?
24. Do you have joint pain (2)?
25. Do you have thinning of your eyebrows or eyelashes (2)?

Score < 11? You are unlikely to have a thyroid problem.
Score 11-30? Low thyroid function is a possibility.
Score >30? Low thyroid function is probable.
Get tested if your score is > 11, including a free T3 and TSH.



**This questionnaire, by Dr. Hotze, originally featured at**

About the Author

sara-gottfriedDr. Sara Gottfried, for the last twenty years, Harvard-educated physician, speaker and author of the forthcoming book, The Hormone Cure, Dr. Sara Gottfried has been dedicated to practicing and helping women feel at home in their bodies. After graduating from the physician-scientist training program at Harvard Medical School and MIT, Dr. Gottfried completed her residency at the University of California at San Francisco, where she still serves on the faculty. She is board-certified in Obstetrics and Gynecology, a teacher of the adjunct faculty at Touro University College of Osteopathic Medicine, and a mentor to medical students in her integrative medicine practice, The Gottfried Center for Organic Gynecology. Dr. Gottfried has a disruptive model of how to deliver cutting-edge women’s health to as many women as possible by using technology – including teleseminars, group coaching, webinars, and Facebook – to raise oxytocin and reduce stress among today’s overly busy women, while teaching them how to balance their hormones naturally, regardless of age and location. As a result, her innovative methods for sharing medical information make her a popular keynote speaker. Feeatured in publications such as Cosmopolitan, Glamour, Family Circle, Natural Health, Women’s World, Redbook and Yoga Journal.

Questions or anything to ask about your thyroid results? We want your thoughts in the comments section–Please! 

Help Thyroid Nation create awareness for thyroid disease and share the links below…



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  5. I am sorry, but from personal experience and other things I have read, as well as my ND telling me, free T3 and TSH, doesnt really tell the story. Maybe your gland is producing enough hormones, but the question is, are they making the right conections once they enter the cells.

    This is the tests that should be done. Also using the scoring of .3 to 3.5 is better over .5 to 5.5.

    Most people fall between 3.5 and 5.5. Using the later scoring .5 to 5.5 isn’t telling the right story.

    Also many toxins that make it into our bodies and into the cells will compete with thyroid hormones and the connections in the cells. Most of the time, if not all of the time, the toxins win.

    But because the blood work shows you have enough hormones floating around in your blood stream, then hay, your just fine….and the doctor sends you away with fatigue, depression, dry skin, achy muscles and the list goes on.

    • Hi Randy,

      That is a great question, Randy. Actually, I think it means that you/we are considered ‘subclinical’ hypothyroidism. Meaning there are other things contributing to the symptoms as well as the thyroid. (Nutritional, vitamin deficiencies, hormones etc.) BUT, we will be discussing this very question LIVE on Sunday with Dr. Hotze himself. Tune in, if you can. Thanks for the comment and continued AMAZING support. I’ll probably say “a friend of mine, named RANDY, had a question”….. 🙂 ~Danna

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