HEALTH
&
LIFESTYLE ANALYSIS
|
D
I
G
E
S
T
I
V
E |
I
N
T
E
S
T
I
N
A
L |
C
I
R
C
U
L
A
T
O
R
Y |
N
E
R
V
O
U
S |
I
M
M
U
N
E |
R
E
S
P
I
R
A
T
O
R
Y |
G
L
A
N
D
U
L
A
R |
U
R
I
N
A
R
Y |
S
T
R
U
C
T
U
R
A
L |
N
U
T
R
I
T
I
O
N |
| Group I Symptoms |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Select only the boxes on the left side |
(DO NOT manually check any of these boxes) |
|
Lack of Energy |
|
|
|
|
|
|
|
|
|
|
|
Frequent Illness (more than normal) |
|
|
|
|
|
|
|
|
|
|
|
Body Odor and/or Bad Breath |
|
|
|
|
|
|
|
|
|
|
|
Difficulty Digesting Certain Foods |
|
|
|
|
|
|
|
|
|
|
|
Frequent Consumption of Red Meats |
|
|
|
|
|
|
|
|
|
|
|
Female Concerns (P.M.S. Menopausal) |
|
|
|
|
|
|
|
|
|
|
|
Use of Antibiotics Within the Last Three Years |
|
|
|
|
|
|
|
|
|
|
|
Regular Alcohol Consumption |
|
|
|
|
|
|
|
|
|
|
|
Mood Swings |
|
|
|
|
|
|
|
|
|
|
|
Food Allergies |
|
|
|
|
|
|
|
|
|
|
|
Bags or Dark Circles Under the Eyes |
|
|
|
|
|
|
|
|
|
|
|
Smoking |
|
|
|
|
|
|
|
|
|
|
|
Poor Concentration or Mermory |
|
|
|
|
|
|
|
|
|
|
|
Poor Resistance to Disease |
|
|
|
|
|
|
|
|
|
|
|
Belching or Gas After Meals |
|
|
|
|
|
|
|
|
|
|
|
Stressful Lifestyle |
|
|
|
|
|
|
|
|
|
|
|
Skin/Compexion Problemsl |
|
|
|
|
|
|
|
|
|
|
|
Cravings for Sweets and Processed Foods |
|
|
|
|
|
|
|
|
|
|
| |
|
| Group II Symptoms |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Select only the boxes on the left side |
(DO NOT manually check any of these boxes) |
|
Regular Consumption of Dairy Products |
|
|
|
|
|
|
|
|
|
|
|
Feelings of Depression or Uninterest |
|
|
|
|
|
|
|
|
|
|
|
Too Little Sleep or Restless Sleep |
|
|
|
|
|
|
|
|
|
|
|
Menopausal Concerns |
|
|
|
|
|
|
|
|
|
|
|
Any Urinary Concerns |
|
|
|
|
|
|
|
|
|
|
|
Hair Loss |
|
|
|
|
|
|
|
|
|
|
|
Sore or Painful Joints |
|
|
|
|
|
|
|
|
|
|
|
Difficulty Maintaing Ideal Weight |
|
|
|
|
|
|
|
|
|
|
|
Low Endurance During Activity |
|
|
|
|
|
|
|
|
|
|
|
Poor Eating Habits |
|
|
|
|
|
|
|
|
|
|
|
Slow Recovery From Illness |
|
|
|
|
|
|
|
|
|
|
|
Bowel Activity Less Than Twice Daily |
|
|
|
|
|
|
|
|
|
|
|
Lack of Appetite |
|
|
|
|
|
|
|
|
|
|
|
Low Sex Drive |
|
|
|
|
|
|
|
|
|
|
|
Brittle or Easily Broken Finger Nails |
|
|
|
|
|
|
|
|
|
|
|
Dry, Damaged, or Dull Hair |
|
|
|
|
|
|
|
|
|
|
|
High-Fat Diet |
|
|
|
|
|
|
|
|
|
|
|
Feeling Unsettled, Apprehensive, or Pressured |
|
|
|
|
|
|
|
|
|
|
| |
|
| Group III Symptoms |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Select only the boxes on the left side |
(DO NOT manually check any of these boxes) |
|
Low-Fiber Diet |
|
|
|
|
|
|
|
|
|
|
|
Asthma, Hayfever, or Allergies |
|
|
|
|
|
|
|
|
|
|
|
Muscle Cramps or Spasms |
|
|
|
|
|
|
|
|
|
|
|
Exposure to Air Pollution (live in the city) |
|
|
|
|
|
|
|
|
|
|
|
Regular Caffeine Consumption |
|
|
|
|
|
|
|
|
|
|
|
Feeling Out of Control |
|
|
|
|
|
|
|
|
|
|
|
Food or CHemical Sensitives |
|
|
|
|
|
|
|
|
|
|
|
Problems With Yeast or Fungus |
|
|
|
|
|
|
|
|
|
|
|
Weakness in Joints, Muscles, or Bones |
|
|
|
|
|
|
|
|
|
|
|
Excessive Worry |
|
|
|
|
|
|
|
|
|
|
|
Easily Irritated or Angered |
|
|
|
|
|
|
|
|
|
|
|
Too Little Exercise |
|
|
|
|
|
|
|
|
|
|
|
Excessive Mucas or Congestion |
|
|
|
|
|
|
|
|
|
|
|
More Than 10lbs. Overweight |
|
|
|
|
|
|
|
|
|
|
|
Spells of Rapid or Skipping Heartbeat |
|
|
|
|
|
|
|
|
|
|
|
Blood Pressure Problems |
|
|
|
|
|
|
|
|
|
|
|
Cold Hands or Cold Feet |
|
|
|
|
|
|
|
|
|
|
|
Excessive Thirst |
|
|
|
|
|
|
|
|
|
|
| |
|
| Group IV Symptoms |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Select only the boxes on the left side |
(DO NOT manually check any of these boxes) |
|
Eczema, Psoriasis, or Cracking Skin |
|
|
|
|
|
|
|
|
|
|
|
Swollen Glands |
|
|
|
|
|
|
|
|
|
|
|
Post Nasal Drip |
|
|
|
|
|
|
|
|
|
|
|
Frequent Sinus Problems or Stiffness |
|
|
|
|
|
|
|
|
|
|
|
Feel Shaky When Hungry |
|
|
|
|
|
|
|
|
|
|
|
Poor Concentration |
|
|
|
|
|
|
|
|
|
|
|
History of Stomach Ulcers |
|
|
|
|
|
|
|
|
|
|
|
Diabetic or High Sugar Consumption |
|
|
|
|
|
|
|
|
|
|
|
Light-Headedness When Standing Up |
|
|
|
|
|
|
|
|
|
|
