ADAM (Low Testosterone)

This basic questionnaire can be very useful for men to describe the kind

and severity of their low testosterone symptoms.

1. Do you have a decrease in libido (sex drive)? Yes No

2. Do you have a lack of energy? Yes No

3. Do you have a decrease in strength and/or endurance? Yes No

4. Have you lost height? Yes No

5. Have you noticed a decreased "enjoyment of life" Yes No

6. Are you sad and/or grumpy? Yes No

7. Are your erections less strong? Yes No

8. Have you noticed a recent deterioration in your ability to play sports? Yes No

9. Are you falling asleep after dinner? Yes No

10. Has there been a recent deterioration in your work performance? Yes No

If you Answer Yes to number 1 or 7 or if you answer Yes to more than 3 questions,

you may have low Testosterone.

Contact Healthy Solutions MD for free advice and treatment options.