Created by Dr. Angela Goldstein, ND
Naturopathic doctor, 25+ years in practice, San Juan Capistrano, California.
What the Hormone Orchestra Quiz measures
The Hormone Orchestra Quiz is a free hormone imbalance quiz that checks the three systems Dr. Angela Goldstein sees break down most often: your stress response, your thyroid and your sex hormones. It takes about 3 minutes. Every question is built on a symptom that published clinical research uses to measure that system, and the result shows how your three systems line up against each other, not just one number.
Stress response
7 questions on tension, overload and running on empty, built on published stress research and lines from Dr. Angela's Master Class.
Thyroid
7 questions on the classic signs of a slow thyroid, from Zulewski's clinical score and the NIH.
Sex hormones
8 questions for women on the symptom areas of the Menopause Rating Scale, or for men on the Aging Males' Symptoms scale.
Why an orchestra? Dr. Goldstein's three-system model
“Think of your endocrine system like an orchestra. You have thyroid hormones, sex hormones, stress hormones, blood sugar hormones, and dozens more. When they're all playing together in harmony, you feel great. But if one instrument is out of tune, if one hormone system is off, the whole orchestra sounds terrible.”Dr. Angela Goldstein, ND, from her free Master Class
Most hormone tests look at one instrument at a time. Dr. Goldstein's point is that the three most common problem systems are interconnected, so a problem in one rarely stays there.
“When you're under chronic stress, your adrenals pump out cortisol constantly. High cortisol tells your thyroid to slow down because your body thinks there's a famine. Your thyroid slowing down disrupts your sex hormones because your body thinks it's not safe to reproduce.”Dr. Angela Goldstein, ND
Published research backs up each link in that chain:
- Stress slows the thyroid. Cortisol, the main stress hormone, turns down the signals your brain sends to tell the thyroid to work.
- The thyroid affects your sex hormones. Thyroid hormone helps control the brain signals that run the menstrual cycle and fertility.
- Stress affects your sex hormones directly. When the stress system is switched on, the body puts reproduction on hold.
That is why this quiz scores all three systems side by side.
What your result means
Each system gets one of four levels: in tune, slightly off, out of tune, or loudly out of tune. Your overall pattern depends on which systems land out of tune.
| Pattern | What it points to |
|---|---|
| The whole orchestra | All three of your systems are out of tune. A pattern like this is why treating one system at a time so often gives only partial relief. It is worth having all three read together, by someone who looks at how they interact. |
| Stress and thyroid | Your stress response and your thyroid are out of tune together. If you have been told your thyroid is normal, it is worth asking which markers were run, and whether anyone looked at your stress hormones alongside them. |
| Stress and sex hormones | Your stress response and your sex hormones are out of tune together. Before adding hormones, it helps to know what is pushing them out of balance. That means reading the stress response and the thyroid in the same visit. |
| Thyroid and sex hormones | Your thyroid and your sex hormones are out of tune together. If you have been told "it's just your age" or "your thyroid is fine," a combined read of thyroid, sex hormones and stress hormones is the next step. |
| Stress leading | Your stress response is leading the orchestra. This is the moment to look at what is keeping your stress response switched on, before it pulls the thyroid and sex hormones along with it. |
| Thyroid leading | Your thyroid is the loudest instrument. Ask which thyroid markers you have actually had. A fuller panel, read alongside stress and sex hormones, often explains more than TSH alone. |
| Sex hormones leading | Your sex hormones are the loudest instrument. Before deciding on any hormone treatment, it helps to see the whole system: sex hormones, thyroid and stress hormones, read together. |
| A few instruments drifting | Your orchestra is mostly in tune, with some drift. Keep an eye on which symptoms move together. If they build, a full evaluation looks at function, not only disease. |
| In tune | Your orchestra sounds in tune. If something still feels wrong, Dr. Angela's free Master Class explains what standard labs miss and what she looks at instead. |
Signs each system may be out of tune
| System | Common symptoms | What Dr. Goldstein looks at |
|---|---|---|
| Stress response | Trouble winding down, running at 40%, irritability, tension, feeling overloaded, holding it together on the outside while falling apart underneath, pushing through | Your stress history and timeline, and stress hormones read alongside the thyroid and sex hormones |
| Thyroid | Feeling cold, dry skin, thinning hair, weight gain, constipation, puffiness, sweating less | A fuller thyroid picture than TSH alone, read against stress hormones |
| Sex hormones (women) | Hot flashes and night sweats, sleep changes, mood swings, anxiety, heart palpitations, lower sex drive, dryness, joint aches | Where you are in the transition, and how estrogen and progesterone are moving as a system |
| Sex hormones (men) | Lower well-being and drive, losing muscle strength, lower sex drive, erection changes, sudden sweats, joint aches | Testosterone in context of stress, thyroid and metabolic health |
Thyroid or perimenopause? How the quiz tells them apart
Fatigue, weight change, poor sleep and low mood show up in both, which is why so many women are told it is one when it is the other, or both. The quiz scores each system with its own questions, so you can see whether one stands out or whether they are rising together. When both are raised, the answer is often not either-or. Our article on telling thyroid from perimenopause walks through the overlap.
Can stress cause a hormone imbalance?
In Dr. Goldstein's model, chronic stress is what sets off the other two. Sustained cortisol can quiet the thyroid, and the stress response acts on the reproductive axis too. That is why the quiz opens with stress. If your stress score stands out, read how cortisol and the thyroid interact.
Can a hormone quiz replace a lab test?
No. A quiz measures symptoms, and symptoms are only half the picture. Labs are the other half, though standard panels are built to catch disease, not to show how well a system is working.
“Standard labs measure diseases, not function. They're checking to see if your engine is completely broken, not whether it's running at 40% capacity.”Dr. Angela Goldstein, ND
The most useful next step puts the two together: your symptom pattern, your history, and the labs you already have, read by someone looking at how the systems interact. If your labs came back normal but you do not feel normal, see why normal labs can still leave you tired.
Do men get hormone imbalance too?
Yes. Men answer the same stress and thyroid questions, and the sex hormone section switches to questions on the symptom areas of the Aging Males' Symptoms scale: well-being, drive, muscle strength, sweating and sexual changes.
How the quiz is built and scored
Every question is written in plain language by our team and mapped to a symptom area from published research, or to a line from Dr. Angela's Master Class. The quiz does not reproduce any licensed questionnaire, and its score is not a research-validated score. Each answer counts 0 to 3 points (not at all, a little, quite a bit, a lot).
- Stress response (21 points): 0 to 4: in tune; 5 to 8: slightly off; 9 to 14: out of tune; 15 to 21: loudly out of tune.
- Thyroid (21 points): 0 to 4: in tune; 5 to 8: slightly off; 9 to 14: out of tune; 15 to 21: loudly out of tune.
- Sex hormones (24 points): 0 to 4: in tune; 5 to 9: slightly off; 10 to 16: out of tune; 17 to 24: loudly out of tune.
A system counts as out of tune when it reaches the third band. The overall pattern names every system that does.
This quiz is educational and is not a diagnosis or a substitute for care from a licensed provider. Scores describe symptoms, not lab values. If you have severe or sudden symptoms, contact your doctor or call 911. Always talk with your doctor before changing any treatment.
One full hour, all three systems
Want your orchestra read by Dr. Angela?
Her Comprehensive Wellness Evaluation looks at your history, your symptoms and the labs you already have, together. By video anywhere in California or in person in San Juan Capistrano.
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- Lovibond PF, Lovibond SH. The structure of negative emotional states. Behav Res Ther 1995;33(3):335-43. Source
- Zulewski H et al. Estimation of tissue hypothyroidism by a new clinical score. J Clin Endocrinol Metab 1997;82(3):771-6. Source
- National Institute of Diabetes and Digestive and Kidney Diseases. Hypothyroidism (Underactive Thyroid). Source
- Heinemann K et al. The Menopause Rating Scale (MRS) scale: a methodological review. Health Qual Life Outcomes 2004;2:45. Source
- Heinemann LAJ et al. The Aging Males' Symptoms (AMS) scale: update and compilation of international versions. Health Qual Life Outcomes 2003;1:15. Source
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- Brown EDL et al. The thyroid hormone axis and female reproduction. Int J Mol Sci 2023;24(12):9815. Source
- Joseph DN, Whirledge S. Stress and the HPA axis: balancing homeostasis and fertility. Int J Mol Sci 2017. Source
- Whirledge S, Cidlowski JA. Glucocorticoids, stress, and fertility. Minerva Endocrinol 2010. Source