Do you have a problem with histamine?

Do you have a problem with histamine?
Name

First NameLast Name
Email
example@example.com
Over the last 3-6 months have you experienced any of the following?
Please select all that apply:
Central Nervous System

HeadachesPremenstrual MigrainesCircadian rhythms issuesArousal issues (can’t get to sleep)VertigoBody temperature issues like flushingMotion sicknessProblems with learning and memory
Gastointestinal System

Increase in gastric acid (reflux like symptoms)DiarrhoeaStomach pain or crampingGas or abdominal distention (bloating)Do you suffer nausea?Do you vomit?Do you react to spicy foods, tomatoes, coffee, chocolate and high histamine foods?
Mast Cell Issues

MastocytosisHave you ever had exposure to mould?Do you regularly get yeast infections?Do you have enlarged liver, spleen or lymph nodes?Do you experience unexplained bruisingDo you get nosebleeds?
Uterus /Cycle issues

Do you suffer Period pain?Cramping before your period or when you get your period?Does your mood suffer before your period?Does your sleep get affected by your period?Are your symptoms also worse around ovulation?
Respiratory System

Increase in mucous secretionBronchoconstriction - tightness in chest, difficulty in breathingAsthmaBlocked NoseRunny NoseSneezingWheezingChest pain
Neurological issues

Do you have memory issues?Do you find it hard to concentrate?Do you have an unsteady gait?Do you get depressed?Do you get migraines regularly?Do you experience hallucinations?Do you suffer panic attacks?Do you suffer anxiety?
Cardiovascular System

AnaphylaxisLow Blood PressureHigh Blood PressureLow Muscle ToneVertigoAbnormal Heart RhythmPalpitations
Skin

ItchingRednessFlushingHives
Reprinted from: www.mthfrgenesupport.com
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