Hypothyroid Review

Hypothyroidism is a condition where the Thyroid gland in your neck does not make enough thyroid hormone or thyroxine.

If your level of thyroid hormone is too low or causing you to have symptoms then you will need replacement hormone. The replacement hormone is called Levothyroxine.

This review form should only be used if you have a formal diagnosis of Hypothyroidism and you are taking a stable dose of Levothyroxine.

The answers you give on this form are part of your Annual Hypothyroidism Review.

When you submit this form it will be reviewed by a GP and we will generate you a blood form to collect from the surgery to check your Thyroid Function Test and any other review test which might be relevant or needed. E.g a cholesterol check.

We try and ask that your annual hypothyroidism review happens around the month of your birth.

If you feel you have problems with your thyroid medication or symptoms at any other time please book a triage call with a GP

If you have concerns about any other issues which you feel may relate to your thyroid, but you do not have a formal diagnosis please book a triage call with a GP instead of using this form.

Hypothyroid Self Assessment

Hypothyroid Self Assessment

Please use this date format: DD/MM/YYYY.