Endocrine History 

Yes / No

Any intolerance to hot or cold weather?
N
Do you ever have hot flashes?
Do you have excessive thirst?
N
Have you lost or gained more than 10 lbs? In the last 3 months? 
Y; My pants are a lot looser than they used to be.
Do you have thyroid problems?
 
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©1998,  Neal R. Chamberlain, Ph.D.. All rights reserved.