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FBF Assessment
When it comes to our health, everything is integrated. What we do to the part we do to the whole. Inflammation and nutrition hit every part of our system. But we usually have a weak spot. Knowing where we are most vulnerable is important so we can give this our attention. But knowing where we are strong is helpful too. We can improve that area gently as well as feel good about the parts of our wellbeing that are solid. In our one to one calls I am going to help you work where you need the most support and attention. Please complete this quiz and we will go over it and set up a plan of action.
Enter Your Name
*
First
Last
Neurological
Are you more forgetful than usual?
*
Never
Rarely
Sometimes
Often
Always
Are you depressed for no reason? Have you lost motivation or interest in things that used to give you energy?
*
Never
Rarely
Sometimes
Often
Always
Are you more anxious and worried than normal?
*
Never
Rarely
Sometimes
Often
Always
Do you have brain fog or trouble remembering things or concentrating on your work?
*
Never
Rarely
Sometimes
Often
Always
Do you experience unexplained mood swings?
*
Never
Rarely
Sometimes
Often
Always
Do you say words you don’t mean to say or struggle to express yourself?
*
Never
Rarely
Sometimes
Often
Always
Do you have sensory issues: more reactions to light, sounds, your environment?
*
Never
Rarely
Sometimes
Often
Always
Digestive
Are you often bloated or gassy or is your stomach distended after meals?
*
Never
Rarely
Sometimes
Often
Always
Do you get constipated or go more than 24 hours without having a bowel movement? Do you have stools that resemble small pellets?
*
Never
Rarely
Sometimes
Often
Always
Do you have alternating diarrhea or constipation?
*
Never
Rarely
Sometimes
Often
Always
Do you have diarrhea or loose, watery stools that are difficult to control or comes on suddenly?
*
Never
Rarely
Sometimes
Often
Always
Do you experience heartburn or acid reflux after eating or at night?
*
Never
Rarely
Sometimes
Often
Always
Do you have a white coating on your tongue or chronic bad breath despite using good oral hygiene?
*
Never
Rarely
Sometimes
Often
Always
Does your stomach hurt or cramp after eating with or without a particular food?
*
Never
Rarely
Sometimes
Often
Always
Toxicity
Do you retain water easily, and/or feel like your body looks much larger on some days and much smaller and tighter on other days, in a way too extreme or sudden to be related to fat gain or loss?
*
Never
Rarely
Sometimes
Often
Always
Does your weight fluctuate more than five pounds from morning to evening or from one day to the next?
*
Never
Rarely
Sometimes
Often
Always
Do you have a vague feeling of “being toxic,” even if you can’t pin it on any particular symptom?
*
Never
Rarely
Sometimes
Often
Always
Does your urine tend to be dark yellow, and/or does your stool tend to float? Do you have constant headaches?
*
Never
Rarely
Sometimes
Often
Always
Do you have unexplained itching, flaking, or rashes on your hands and/or feet or body?
*
Never
Rarely
Sometimes
Often
Always
Insulin and Blood Sugar
Do you crave sugary or starchy foods even when you have already eaten enough or feel full (such as after a big meal or too soon between meals)
*
Never
Rarely
Sometimes
Often
Always
Have you noticed an increase in appetite and/or thirst and urination recently, or does your level of thirst/appetite and urine output seem higher than normal to you?
*
Never
Rarely
Sometimes
Often
Always
Do you feel light-headed, dizzy, shaky, jittery, irritable, or “hangry” (a combination of hungry and angry) when you haven’t eaten for a few hours or you skip a meal?
*
Never
Rarely
Sometimes
Often
Always
Are you unusually tired even if you got enough sleep, but notice that your fatigue is relieved by eating something?
*
Never
Rarely
Sometimes
Often
Always
Is your waist girth equal to or greater than your hip girth? Is your weight gain or fat mostly in your middle?
*
Never
Rarely
Sometimes
Often
Always
Do you have difficulty losing weight, even when cutting calories and/or exercising?
*
Never
Rarely
Sometimes
Often
Always
Have you had your fasting blood sugar tested, and it was 100 dl/ml or higher, and/or did you have a hemoglobin A1C test and it was 5.7 or above, and/or do you have a diagnosis of prediabetes, metabolic syndrome, or type 2 diabetes?
*
Never
Rarely
Sometimes
Often
Always
Hormone and Endocrine System
Do you tend to have fatigue and/or headaches in the afternoons, then get a second wind in the evening, which causes you to stay up late?
*
Never
Rarely
Sometimes
Often
Always
Do you feel dizzy when you stand up suddenly?
*
Never
Rarely
Sometimes
Often
Always
Do you often crave salty foods?
*
Never
Rarely
Sometimes
Often
Always
Are your hands and feet often cold, even when your environment is warm?
*
Never
Rarely
Sometimes
Often
Always
Do you sleep excessively, or feel as if you could sleep all day and still sleep at night?
*
Never
Rarely
Sometimes
Often
Always
Are the outer thirds of your eyebrows thinning, or missing? Are you losing lots of hair?
*
Never
Rarely
Sometimes
Often
Always
Are you experiencing irregular, painful, or unusually heavy menstrual periods?
*
Never
Rarely
Sometimes
Often
Always
Muscles and Skeletal system
Do your joints hurt periodically, constantly, or in flares, in random places, with the pain coming and going, seemingly unrelated to injuries?
*
Never
Rarely
Sometimes
Often
Always
Do you wake up with stiff and/or aching joints and/or muscles but can relieve the stiffness by movement, only to find that it returns at the end of an active day?
*
Never
Rarely
Sometimes
Often
Always
Do you have chronic neck or back pain, tightness, and tension?
*
Never
Rarely
Sometimes
Often
Always
Do you get pins and needles, random stabbing pains, and/or numbness in your hands and feet, or shooting pains down your arms or legs?
*
Never
Rarely
Sometimes
Often
Always
Is there anything else you need to tell me?
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