Do you suffer from tiredness or fatigue?

Never

1-2 times per month

Weekly

Daily

Do you experience weakness?

Never

1-2 times per month

Weekly

Daily

Do you suffer from constipation?

Never

1-2 times per month

Weekly

Daily

Do you experience loss of appetite?

Never

1-2 Times per Month

1-2 Times per Month

Daily

Do you suffer from weight loss or gain?

Never

1-2 times per month

Weekly

Daily

Do you experience numbness and tingling in the hands and feet?

Never

1-2 Times per Month

Weekly

Daily

Do you suffer from balance problems?

Never

1-2 times per month

Weekly

Daily

Do you experience confusion?

Never

1-2 times per month

Weekly

Daily

Do you suffer from poor memory?

Never

1-2 Times Per Month

Weekly

Weekly

Do you experience soreness of the mouth or tongue?

Never

1-2 times per month

Weekly

Daily

Do you suffer from Anemia?

Yes

No

Do you experience inflammation?

Never

1-2 times per month

Weekly

Daily

First Name *

Email *

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