Thyroid History

Question 1

Have you had any change in body weight?

Answer 1

Hyperthyroidism: decreased (despite increased appetite)

Hypothyroidism: increased

Question 2

Have you had any change in appetite? Any associated dysphagia?

Answer 2

Hyperthyroidism: increased

Hypothyroidism: decreased

Question 3

Have you noticed any change in your voice?

Answer 3

Hyperthyroidism: no

Hypothyroidism: hoarseness

Question 4

Has there been any change when you go to the toilet, has your poo changed at all?

Answer 4

Hyperthyroidism: Increased frequency of defecation or diarrhoea

Hypothyroidism: Constipation

Question 5

Have you noticed any change in your energy levels?

Answer 5

Hyperthyroidism: increase or decrease, muscle weakness

Hypothyroidism: decrease, somnolent, slower movements, muscle weakness

Question 6

Have you noticed a change in your mood?

Answer 6

Hyperthyroidism: anxious, irritable, emotionally labile

Hypothyroidism: lethargy, depression

Question 7

Has your concentration got worse?

Answer 7

Hyperthyroidism + Hypothyroidism: yes

Question 8

Have you noticed you are more sensitive to the heat or the cold?

Answer 8

Hyperthyroidism: prefers the cold, wears fewer clothes

Hypothyroidism: prefers the warmth, wears extra clothes

Question 9

Have you noticed a change to your skin, nails or hair?

Answer 9

Hyperthyroidism: increased sweating, fine hair, hair loss, clubbing, separating of the nail from the nailbed (onycholysis)

Hypothyroidism: dry flaky skin, coarse thinning hair, brittle nails

Question 10

Have you noticed a change in heart rate or rhythm?

Answer 10

Hyperthyroidism: tachycardia, palpitations, atrial fibrillation

Hypothyroidism: bradycardia

Question 11

Are you currently pregnant or have you recently been pregnant? (No)

• Has there been any change to your menstrual cycle?

Answer 11

Hyperthyroidism: infrequent menses, fertility problems

Hypothyroidism: heavy, prolonged or irregular menses, fertility problems, increased risk of miscarriage

Question 12

Other Qs:
Previous thyroid disease, surgery or treatment?
Onset and duration of symptoms?
Any associated pain or discomfort?

Answer 12

Note: Previously hyperthyroid patients may become hypothyroid after treatment

Question 13

Drug history

Answer 13

Thyroxine
Lithium
Amiodarone
Glucocorticoids

Question 14

Social history

Answer 14

Smoking
Alcohol
Diet (sufficient iodine?)
Effect on activities of daily living

Question 15

Family history

Answer 15

Thyroid disease can be familial