Part I: Gastrointestinal
Section A: Gastric Function
- Indigestion, food repeats on you after you eat
- Excessive burping, belching and/or bloating following meals
- Stomach spasms and cramping during or after eating
- A sensation that food just sits in your stomach creating uncomfortable fullness, pressure and bloating during or after a meal.
- Bad taste in your mouth
- Small amounts of food fill you up immediately
- Skip meals or eat erratically because you have no appetite
Section B: GI Inflammation
- Strong emotions, or the thought or smell of food aggravates your stomach or make it hurt
- Feel hungry an hour or two after eating a good-sized meal
- Stomach pain, burning and/or aching over a period of 1-4 hours after eating
- Stomach pain, burning and/or aching relieved by eating food; drinking carbonated beverages, cream or milk; or taking antacids
- Burning sensation in the lower part of your chest, especially when lying down or bending forward
- Digestive problems that subside with rest and relaxation
- Eating spicy and fatty (fried) foods, chocolate, coffee, alcohol, citrus or hot peppers causes your stomach to burn or ache
- Feel a sense of nausea when you eat
- Difficulty or pain when swallowing food or beverage
Section C: Small Intestine & Pancreas
- Whenmassaging under your rib cage on your left side, there is pain, tenderness or soreness
- Indigestion, fullness or tension in your abdomen is delayed, occurring 2-4 hours after eating a meal
- Lower abdominal discomfort is relieved with the passage of gas or with a bowel movement
- Specific foods/beverages aggravate indigestion
- The consistency or form of your stool changes (e.g., from narrow to loose) within the course of a day
- Stool odor is embarrassing
- Undigested food in your stool
- Three or more large bowel movements daily
- Diarrhea (frequent loose, watery stool)
- Bowel movements shortly after eating (within 1 hour)
Section D: Colon
- Discomfort, pain or cramps in your colon (lower abdominal area)
- Emotional stress and/or eating raw fruits and vegetables cause abdominal bloating, pain, cramps or gas
- Generally constipated (or straining during bowel movements)
- Stool is small, hard and dry
- Pass mucus in your stool
- Alternate between constipation and diarrhea
- Rectal pain, itching or cramping
- No urge to have a bowel movement
- An almost continual need to have a bowel movement
Part II: Liver/Gal Bladder - Hepatobiliary Function
- When massaging under your rib cage on your right side, there is pain, tenderness or soreness
- Abdominal pain worsens with deep breathing
- Pain at night that may move to your back or right shoulder
- Bitter fluid repeats after eating
- Feel abdominal discomfort or nausea when eating rich, fatty or fried foods
- Throbbing temples and/or dull pain in forehead associated with overeating
- Unexplained itchy skin that's worse at night
- Stool color alternates from clay colored to normal brown
- General feeling of poor health
- Aching muscles not due to exercise
- Retain fluid and feel swollen around the abdominal area
- Reddened skin, especially palms
- Very strong body odor
- Are you embarrassed by your breath?
- Bruise easily
- Yellowish cast to eyes
PART III: Endocrine
Section A: Thyroid
- Feel cold or chilled--hands, feet or all over-- for no apparent reason
- Your upper eyelids look swollen
- Muscles are weak, cramp and/or tremble
- Are you forgetful?
- Do you feel like your heart beats slowly?
- Reaction time seems slowed down
- In general, are you disinterested in sex because your desire is low?
- Feel sluggish
- Dryness, discoloration of skin and/or hair
- Have you noticed recently that your voice is deepening?
- Thick, brittle nails
- Weight gain for no apparent reason
- Outer third of your eyebrow is thinning or disappearing
- Swelling of the neck
Section B: Adrenal
- Lingering mild fatigue after exertion or stress
- Do you find that you get tired and exhaust easily?
- Craving for salty foods
- Sensitive to minor changes in weather and surroundings
- Dizzy when rising or standing up from a kneeling position
- Dark bluish or black circles under your eyes
- Have bouts of nausea with or without vomiting
- Catch colds or infections easily
- Wounds heal slowly
- Your body or parts of your body feel tender, sore, sensitive to the touch, hot and/or painful
- Feel puffy and swollen all over your body
- Skin is gradually tanning without exposure to the sun or the ingestion of high levels of carotene-rich foods or supplements
PART IV: Glucose Regulation
Section A: Dysglycemia-L
When you miss meals or go without food for extended periods of time, do you experience any of the following symptoms?
- A sense of weakness
- A sudden sense of anxiety when you get hungry
- Tingling sensation in your hands
- A sensation of your heart beating too quickly or forcefully
- Shaky, jittery, trembling hands
- Sudden profuse sweating and/or your skin feels clammy
- Nightmares possibly associated with going to be on an empty stomach
- Wake up at night feeling restless
- Agitation, easily upset, nervous
- Poor memory, forgetful
- Confused or disoriented
- Dizzy, faint
- Cold or numb
- Mild headaches or head pounding
- Blurred vision or double vision
- Feel clumsy and uncoordinated
Section B: Dysglycemia-E
- Frequent urination during the day and night
- Unusual thirst -- feeling like you can't drink enough water
- Unusual hunger -- eating all the time
- Vision blurs
- Feel itchy all over
- Tingling or numbness in your feet
- Sense of drowsiness, lethargy during the day not associated with missing meals or not sleeping
- Eating starchy foods, even if they are healthy and unprocessed (like rice, corn, beans, whole wheat or oats), causes you to gain weight or prevents you from losing weight
- Sores heal slowly
- Loss of hair on your legs
PART V: Cardiovascular
Section A: Heart
- Feel jittery
- First effort of the day causes pain, pressure, tightness or heaviness around the chest
- Exhaustion with minor exertion
- Heavy sweating (no exertion, no hot flashes)
- Difficulty catching breath, especially during exercise
- Heart pounding, sensation of heart beating too quickly, too slowly or irregularly
- Swelling in feet, ankles and/or legs comes and goes for no apparent reason
Section B: Circulation
- Muscle pain at rest
- Cramp-like pains in your ankles, calves or legs
- Numbness, tingling and prickling sensation in hands and feet
- Cold feet and/or toes appear blue
- Brief moments of hearing loss
- Nausea comes and goes quickly (unrelated to eating)
- Feel worse standing: legs get heavy and fatigued
- Fingers and toes get numb in cold weather even when protected
PART VI: Mood
Section A: Depression
- Family, friends, work, hobbies or activities you hold dear are no longer of interest
- Do you cry?
- Does life look entirely hopeless?
- Would you describe yourself as feeling miserable and sad, unhappy or blue?
- Do you find it hard to make the best of difficult situations?
- Sleep problems -- too much or too little?
- Changes in your appetite and weight
- Lately you've noticed an inability to think clearly or concentrate
- Difficulty making decisions and/or clarifying and achieving your goals
Section B: Anxiety
- Does worrying get you down?
- Does every little thing get on your nerves and wear you out?
- Would you consider yourself a nervous person?
- Do you feel easily agitated?
- Do you shake and tremble?
- Are you keyed up and jittery?
- Do you tremble or feel weak when someone shouts at you?
- Do you become scared at sudden movements or noises at night?
- Do you find yourself sighing a lot?
- Are you awakened out of your sleep by frightening dreams?
- Do frightening thoughts keep coming back in your mind?
- Do you become suddenly scared for no reason?
- Do you break out in a cold sweat?
- "Butterflies in your stomach," nausea and/or diarrhea
Section C: Anger
- Do you feel pent up and ready to explode?
- Are you prone to noisy and emotional outbursts?
- Do you do things on impulse?
- Are you easily upset or irritated?
- Do you go to pieces if you don't control yourself?
- Do little annoyances get on your nerves and make you angry?
- Does it make you angry to have anyone tell you what to do?
- Do you flare up in anger if you can't have what you want right away?
PART VII: Immune System - Eyes, Ears, Nose, Throat & Lungs
- Eyes water or tear
- Mucus discharge from the eyes
- Ears ache, itch, feel congested or sore
- Discharge from the ears
- Is your nose continually congested?
- Are you prone to loud snoring?
- Does your nose run?
- Hoarse voice
- Do you have to clear your throat?
- Do you feel a choking lump in your throat?
- Do you suffer from severe colds?
- Do frequent colds keep you miserable all winter?
- Flu symptoms last longer than 5 days?
- Do infections settle in your lungs?
- Chest discomfort or pain
- Do you experience sudden breathing difficulties?
- Do you struggle with shortness of breath?
- Difficulty exhaling (breathing out)
- Breathlessness followed by coughing during exertion, no matter how slight
- Inability to breath comfortably while lying down
- Do you cough up lots of phlegm?
- Can you hear noisy rattling sounds when breathing in and out?
- Are you troubled with coughing?
- Do you wheeze?
- Do you have severe soaking sweats at night?
- Do your lips and/or nails have a bluish hue?
- Are you sleepy during the day?
- Do you have difficulty concentrating?
- Eyes, ears, nose, throat and lung symptoms seem associated with specific foods like dairy or wheat products
- Eyes, ears, nose, throat and lung symptoms are associated with seasonal changes
PART VIII: Urological - Kidney & Bladder
- Involuntary loss of urine when you cough, lift something or strain during an activity
- Mild lower back ache or pain
- Abdominal achiness or pain
- Pain or burning when urinating
- Rarely feel the urge to urinate
- Feel the need to urinate less than every two hours during the day or night
- Strong smelling urine
- Back or leg pains are associated with dripping after urination
- Sore or painful genitals
- Urine is a rose color
- Sudden urge to void causes involuntary loss of urine
- Generalized sense of water retention throughout your body
PART IX: Musculoskeletal
Section A: Bone Integrity
- Bones throughout your entire body ache, feel tender or sore
- Localized bone pain
- Hands, feet or throat get tight, spasm or feel numb
- Difficulty sitting straight
- Upper back pain
- Lower back pain
- Pain when sitting down or walking
- Find yourself limping or favoring one leg
- Shins hurt during or after exercise
Section B: Connective Tissue
- Are you stiff in the morning when you wake up?
- Difficulty bending down and picking up clothing or anything form the floor?
- Joint swelling, pain or stiffness involving one or more areas (fingers, hands, wrists, elbows, shoulders, toes, arches, feet, ankles, knees or ankles)
- Joints hurt when moving or when carrying weight
- A routine exercise program, like daily walking, causes your knees to swell or hurt
- Difficulty opening jars that were previously easy to open
- Discomfort, numbness, prickling or tingling sensation, or pain in neck, shoulder or arm
- Intermittent pain or ache on one side of head spreading to cheek, temple, lower jaw, ear, neck and shoulder
- Difficulty chewing good or opening mouth
- Difficulty standing up from a sitting position
- Shooting, aching, tingling pain down the back of leg
- Is it difficult to reach up and get a 5-pound object like a bag of flout from just above your head?
- Injure, strain or sprain easily
Section C: Muscle & Nerves
- Muscles stiff, sore, tense and/or achy
- Burning, throbbing, shooting or stabbing muscle pain
- Muscle cramps or spasms (involuntary or after exertion/exercise)
- Is muscle pain or stiffness greater in the morning than other times of the day?
- Specific points on body feel sore when pressed
- Feel unrefreshed upon awakening
- Pain at the sides of your head or in your face especially when awakening
- Your jaw clicks or pops
- Muscle twitch or tremor -- eyelids, thumb, calf muscle
- Irresistible urge to move legs
- Legs move during sleep
- Unpleasant crawling sensation inside calves when lying down
- Hand and wrist numbness or pain (e.g. , interferes with writing or with buttoning or unbuttoning your clothes)
- Feeling of "pins and needles? In your thumb and first three fingers
- Pain in forearm and sometimes in shoulder
PART X: CNS & Brain
Section A: Central Nervous Sytem
- Head feels heavy
- Difficulty bending over, standing up from sitting, rolling over in bed and/or turning your head from side to side
- Your hands tremble, ever so slightly, for no apparent reason
- You feel like you're wearing heavy weights on your feet when walking
- Bump into things, trip, stumble and feel clumsy
- Difficulty breathing
- Difficulty swallowing
- People tell you to speak up because they have trouble hearing you
- Speaking and forming words does not feel automatic
- Need 10-12 hours of sleep to feel rested
- Lack of strength (your grip is weak, holding your head or picking your arms up takes effort)
- Hands get tired when you write and your handwriting is less legible and smaller than it used to be
- Muscles in arms and legs seem softer and smaller
- Is your eyesight, sense of smell and taste or ability to hear not as sharp as it used to be?
- Do you find yourself moving slower than you used to?
Section B: Cognition
- Difficulty absorbing new information
- Tend to forget things
- Trouble thinking or concentrating
- Easily distracted
- Do you have a tendency to become frustrated quickly?
- Inability to sit still for any length of time, even at mealtime
- Finishing tasks is easier said than done
- Do you have more trouble solving problems or managing your time than usual?
- Low tolerance for stress and otherwise ordinary problems
PART XI -- MEN ONLY
- Sensation of not emptying your bladder completely
- Need to urinate less than 2 hours after you have finished urinating
- Find yourself needing to stop and start again several times while urinating
- Find it difficult to postpone urination
- Have a weak urinary stream
- Need to push or strain to begin urinating
- Dripping after urination
- Urge to urinate several times at night