Skip to content
Optimal Health Insights: Advanced Blood Test for Personalized Care
Home
Shop
Accuracy
Blog
Example Report
Cart
Meet Dr. Zamir
Menu
Home
Shop
Accuracy
Blog
Example Report
Cart
Meet Dr. Zamir
Thank You
We will be in touch shortly
Form is successfully submitted. Thank you!
Thyroid Check
Step1
Step2
Step2
Full Name
*
Phone
Email
*
History & Health Status
Put a check by the following statements that apply to your family history, your personal history, and the symptoms that you may have
History
My family (parent, sibling, child) has a history of thyroid disease
I've had a thyroid problem in the past
A member of my family or I have currently or in the past been diagnosed with an autoimmune disease
Women: I have a history of infertility or miscarriage
I have been told I have high cholesterol
history of high blood pressure
I have been told I have high blood sugar
I have carpal tunnel syndrome, tendonitis, or plantar fasciitis (present or in the past)
Do you have any of below signs and symptoms
I am gaining weight for no clear reason or am unable to lose weight with a diet and exercise program
My hands and feet are cold to the touch and I frequently feel cold when others do not
I feel fatigued or exhausted more than normal
I have been told I have high cholesterol
My hair is rough, coarse dry, breaking, brittle, or falling out
My skin is rough, coarse, dry, scaly, itchy, and thick
My nails have been dry and brittle, and break more easily
My eyebrows appear to be thinning, particularly the outer portion
My eyebrows appear to be thinning, particularly the outer portion
My voice has become hoarse and/or ‘gravelly’
I have pains, aches, stiffness, or tingling in joints, muscles, hands and/or feet
I am constipated (less than 1 bowel movement daily)
I feel depressed, restless, moody, sad
I have difficulty concentrating or remembering things
I have a low sex drive
My eyes feel gritty, dry, light-sensitive
My neck or throat feels full, with pressure, or larger than usual, and/or I have difficulty swallowing
I have puffiness and swelling around the eyes, eyelids, face, feet, hands and feet
Women: I am having irregular menstrual cycles (longer, or heavier, or more frequent)
Current Weight
Height
Your true gender?
Male
Female
We need this to process your tests — we respect that your identifying gender might be different.
How many hours of sleep do you have on average?
7-8
5-6
Less than 5
Are you a smoker?
Yes, I smoke at least a pack a day
Yes, I smoke around half a pack a day
I’m a social smoker
No
How often do you exercise every week?
I don't exercise much
< 120 minutes/week
120 - 150 minutes/week
>150 minutes/week
At least 5 minutes a day
Submit
