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Others

Rate any condition that applies to you using the following scale:

0 = Not Present  1 = Weak  2 = Mild  3 = Moderate  4 = Strong  5 = Severe

0%

1 / 42

crave salt

2 / 42

constipation

3 / 42

Best sleep between 7-9 am

4 / 42

vaginal dryness

5 / 42

like to compete and work hard, often feeling rushed and impatient?

6 / 42

tooth fractures

7 / 42

tender or enlarged breat tissue - men

8 / 42

tender breasts - women

9 / 42

slow to get going in a.m. and/or like to sleep late

10 / 42

sensitivity to light

11 / 42

seasonal depression (during darker, colder months)

12 / 42

overweight

13 / 42

oily skin

14 / 42

often awake between 2-3 a.m. (not because I’m hungry)

15 / 42

obessive/ circular thinking

16 / 42

night sweats

17 / 42

nails brittle, break easily

18 / 42

menstrual irregularities

19 / 42

male fertility issues

20 / 42

loss of muscle mass/ inability to keep muscle

21 / 42

loss of bone density

22 / 42

lack of motivation

23 / 42

irritable/ short-tempered

24 / 42

increased or excessive facial or body hair

25 / 42

increased effort to perform daily tasks

26 / 42

incontinence

27 / 42

impotence

28 / 42

heavy menstrual bleeding

29 / 42

headaches

30 / 42

hard to calm down

31 / 42

hair loss/ thinning hair

32 / 42

gets tearful easily

33 / 42

female fertility issues

34 / 42

fatigue not relieved by sleep

35 / 42

exercise exhausts, makes me feel worse

36 / 42

energy dips in the afternoon

37 / 42

drowsy during the day

38 / 42

do not wake feeling refreshed

39 / 42

diminished sex drive, low libido

40 / 42

difficulty concentrating/ learning new things

41 / 42

delicate joints or cartilage

42 / 42

crepey skin at neck and/or eyelids

  • Please provide the same name and email you will use (or have used) for other assessments.
  • This allows me to consolidate, evaluate, and send recommendations accordingly.
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