Self Evaluation

Use the following questionnaire to do a self evaluation. For diagnosis visit your healthcare provider.

Low Stomach Acid: Hypochlorydia

  • Excessive belching, burping or bloating
  • Gas immediately following a meal
  • Offensive breath
  • Difficult bowel movements
  • Sense of fullness during and after meals
  • Difficulty digesting fruits and vegetables
  • Undigested food found in stools

High Stomach Acid: Hyperacidity

  • Stomach pain, burning or aching 1-4 hours after eating
  • Frequently use of antacids
  • Feeling hungry an hour or two after eating
  • Heartburn when lying down or bending forward
  • Temporary relief from antacids, food, milk or carbonated beverages
  • Digestive problems subside with rest and relaxation
  • Heartburn due to spicy foods, chocolate, citrus, peppers, alcohol and caffeine

* If you have symptoms of both High and Low Stomach Acid, that indicates you have low stomach acid.

Biliary Insufficiency:

  • Greasy or high fat food cause distress
  • Lower bowel gas and or bloating several hours after eating
  • Bitter metallic taste in mouth, specially in the morning
  • Unexplained itchy skin
  • Yellowish cast to eyes
  • Stool color alternates between clay color to normal brown
  • Reddened skin, specially palms
  • Dry or flaky skin and / or hair
  • History of gallbladder attacks or stones
  • Has gallbladder been removed?

Hypoglycemia (low sugar)

  • Crave sweets during the day
  • Irritable if meals are missed
  • Depend on caffeine to keep yourself going or started
  • Get lightheaded if meals are missed
  • Eating relieves Fatigue
  • Feel shaky, jittery, tremors
  • Agitated, nervous, get upset easily
  • Poor memory, forgetful
  • Blurred vision

Insulin Resistance (High sugar)

  • Fatigue after meals
  • Crave sweets during the day
  • Eating sweets does not relieve cravings for sugar
  • Must have sweets after meals
  • Waist size is equal or larger than hip size
  • Frequent urination
  • Increase thirst & appetite
  • Difficulty losing weight

Small Intestine (Pancreas)

  • Roughage and fiber cause constipation
  • Indigestion and fullness lasts 2 to 4 hours after eating
  • Pain, tenderness, soreness on left side under rib cage
  • Excessive passage of gas
  • Nausea and / vomiting
  • Stool is undigested, foul smelling, mucous-like, greasy or poorly formed
  • Frequent Urination
  • Increased thirst and appetite
  • Difficulty losing weight

Large Intestines (Colon)

  • Feeling that bowels do not empty completely
  • Lower Abdominal pain relief by passing stool or gas
  • Alternating constipation & diarrhea
  • Diarrhea
  • Constipation
  • Hard dry or small stool
  • Coated tongue or “fuzzy” debris on tongue
  • Pass large amount of foul smelling gas
  • More than 3 bowel movements daily
  • Use laxative frequently

Adrenal Hyper-function (Stress)

  • Can not fall asleep
  • Perspire easily
  • Under high amounts of stress
  • Weight gain when under stress
  • Wake up tired even after 6 or more hours of sleep
  • Excessive perspiration or perspiration with little or no activity

Adrenal Hypo-function (Fatigue)

  • Can not stay asleep
  • Crave salt
  • Slow starter in the morning
  • Afternoon fatigue
  • Dizziness when standing up quickly
  • Afternoon headaches
  • Headaches with exertion or stress
  • Weak nails

Menstruation Related: (Females Only)

  • Alternating menstrual cycle lengths
  • Extended menstrual cycle, greater than 32 days
  • Shortened menses, less than 24 days
  • Pain and cramping during periods
  • Scanty blood flow
  • Heavy blood flow
  • Breast pain and / or swelling during menses
  • Pelvic pain during menses
  • Irritable and depressed during menses
  • Acne break outs
  • Facial hair growth
  • Hair loss / thinning

Menopause Related: (Females only)

  • Lack or menstruation
  • Hot flashes
  • Mental fogginess
  • Disinterest in sex
  • Mood swings
  • Depression
  • Painful intercourse
  • Shrinking breast
  • Facial hair growth
  • Acne
  • Increased vaginal pain, dryness or itching

Prostate Related (Male Only)

  • Difficulty urinating or dribbling
  • Urination frequent
  • Pain inside of legs or heels
  • Feeling of incomplete bowel evacuation
  • Leg nervousness at night

Male Menopause: Andropause

  • Decrease in sex drive
  • Decrease in spontaneous morning erections
  • Decrease in fullness of erections
  • Difficulty in maintaining morning erections
  • Spells of mental fatigue
  • Inability to concentrate
  • Episodes of depression
  • Muscle soreness
  • Decrease in physical stamina
  • Unexplained weight gain
  • Increase in fat distribution around chest and hips
  • Sweating attacks
  • More emotional than in the past

Pituitary

Hypo-function:

  • Diminished sex drive
  • Menstrual disorders or lack of menstruation
  • Increased ability to eat sugars without symptoms

Hyper-function:

  • Increased sex drive
  • Tolerance to sugars reduced
  • “Splitting” type headaches