Do you experience any of these head-based symptoms?
Headaches/Migraines
Dizziness/Faintness
Neck Tension
Cloudy Head
None of the above
Do you experience any of these sinus-based symptoms?
Nasal Congestion (Stuffy Nose)
Allergies (Seasonal or Daily)
Mucus
Sneezing
Nose Blowing
None of the above
Do you experience any of these eye-based symptoms?
Dark circles under eyes
Bags under eyes
Itchy Eyes
Discharge or Watery Eyes
Blurred vision
Crusted eyes upon waking
None of the above
Do you experience any of these ear-based symptoms?
Itchy ears
Discharge or drainage from ears
Ringing in ears (Tinnitus)
Excessive wax buildup
Blocked or muffled hearing
None of the above
Do you experience any of these teeth-based symptons?
Pain in gums or teeth
Bleeding gums
Silver fillings
None of the above
Do you experience any of these mouth-based symptoms?
Canker sores
Cold sores (Herpes Virus)
Cracking on lips
Discolored lips
White film on lips upon waking or after eating
None of the above
Do you experience any of these tongue-based symptoms?
Red dots on tongue
Side of tongue has dents (Scalloping)
White, yellow, or brown coating on tongue
Cracks or lines on tongue
None of the above
Do you experience any of these glands-based symptoms?
Swollen lymph nodes (neck, armpits, or groin)
Difficulty swallowing
Loss of voice
Swollen ankles or hands/wrists/fingers
None of the above
Do you experience any of these breathing-based symptoms?
Chest tension
Inability to get enough air in
Chest congestion
Chronic cough
Clearing throat a lot
Voice hoarseness
None of the above
Do you experience any of these weight-based symptoms?
Difficulty losing weight
Gaining weight easily
Feeling swollen or puffy
Retaining water
Binge or compulsive eating
None of the above
Do you experience any of these joint/muscle-based symptoms?
Pain in joints
Muscle stiffness
Limited range of motion
Muscle weakness
Arthritis
None of the above
Do you experience any of these skin-based symptoms?
Acne
Hairloss
Flushing/Hot flashes
Dry, flaky skin
Excessive sweating
Hives or itchiness
Psoriasis, eczema, ringworm or skin rashes
None of the above
Do you experience any of these sleep-based symptoms?
Inability to fall asleep
Can't stay asleep / Wake up frequently
Nightmares
Heart racing at night
Night sweats
None of the above
Do you experience any of these energy-based symptoms?
Tired upon waking
Daytime or afternoon fatigue
General lack of energy
Apathy
Lack of ambition or drive
None of the above
Hyperactivity (Can't sit still)
Restlessness (Feeling uncomfortable with quiet)
Tapping feet or shaking legs when seated
Decreased libido or sexual function
Do you experience any of these digestive-based symptoms?
Feeling tired after meals (especially lunch)
Gas
Belching/Burping
Heartburn or indigestion
Diarrhea
Constipation
Stomach or intestinal pain
Nausea or vomiting
Stomach sticking out more as day progresses
Do you experience any of these mind-based symptoms?
Lack of concentration
Easily distracted or lose train of thought
Difficulty making decisions
Brain fog
Stuttering or difficulty putting sentences together
Uncoordination or dropping things
ADD/ADHD or learning disabilities
Do you experience any of these emotion-based symptoms?
Anxiety
Overwhelm
Irritability
Anger or rage
Dark thoughts
Sad for no reason
Mood swings
Depression
High strung
Seasonal Affective Disorder (SAD)
Do you experience any of these immunity-based symptoms?
Frequent colds (more than 2-3 illnesses per year)
Allergies (environmental or non-fatal food sensitivities)
Pneumonia in the last 12 months
Diagnosed disease
Unexplained illness
None of the above
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