Restore Your Health Online Cellular Inflammation Assessment

Restore Your Health Online Cellular Inflammation Assessment

*Please Note: The desktop version of this assessment is the easiest to navigate. As we perfect the mobile version, please try to complete this survey on your computer.
Name*

First NameLast Name
Email*
example@example.com
Date*

MonthDayYear
Inflammation is a normal part of the body's defense mechanism which activates your immune system and comes in two types, Acute and Chronic.

Acute Inflammation is short-term. Acute inflammation is necessary to "jump start" your immune system to repair and heal your cells. Cellular damage due to any injury, infection, or toxic insult can induce acute inflammation. It starts rapidly, becomes severe in a short period of time, and symptoms may last for a few days to a few months before resolving.

Chronic Inflammation, on the other hand, occurs when the offensive stimuli are gone but the acute inflammation does NOT turn off properly. It is long-term inflammation lasting from several months to several years, slowly eroding your health even though you may or may not actually feel it.

Chronic inflammation damages your cells and eventually leads to Chronic Cellular Dysfunction and ultimately Chronic Illness. Symptoms may sometimes be obvious, however, the majority of chronic inflammation is typically considered "silent" or "hidden" until such time that illness is finally diagnosed.

Chronic Cellular Dysfunction often leads to a condition called Metabolic Syndrome, which greatly raises the risk of developing diabetes, heart disease, stroke, or all three. Other chronic conditions related to Chronic Cellular Dysfunction are anxiety/depression, obesity, long-term digestive problems like IBS/IBD, chronic fatigue, insomnia, diabetes, dementia, and even all types of cancer.

The following questionnaire can help reveal if you may be suffering from "hidden" Chronic Cellular Dysfunction which is silently robbing you of your health OR if you are already suffering from obvious Chronic Illness related to this long-term inflammation.

Please simply answer YES or NO to the following questions, then compare your Grand Total to the Scoring Key to determine your likelihood to be suffering from Chronic Cellular Inflammation.

Section 1: Do you have...*

	Yes	No
Body pain, arthralgia (joint pain), or myalgia (muscle pain)
Chronic fatigue
Depression, anxiety, or mood disorders
Gastrointestinal complications like constipation, diarrhea, or acid reflux
Sustained unwanted weight gain or weight loss
Frequent infections
Frequent emotional stress
Sleep difficulty at night or Chronic Fatigue during the day
Smoking history
Hormone issues
Sexual dysfunction
Yo-Yo weight, meaning frequently losing and then gaining weight back
Problems with the strength or texture of your hair, skin, or nails
Obvious reactions to certain foods
Brain Fog, meaning you are unable to focus on something properly. Even though there are no distractions around you, you may find yourself spacing out.
Acanthosis Nigricans, meaning the folds of your skin are starting to turn brown. The browning is typically visible on your neck, armpits or groin and between your butt cheeks.

Section 1 Total

Section 2: Do you consume...*

	Yes	No
simple carbohydrates or sugar (cookies, cakes, pastas, breads, chips, etc) more than once per WEEK
fried foods, saturated fats, or trans fats (hydrogenated or partially hydrogenated oils) more than once per MONTH

Section 2 Total

Section 3: Have you been told you have...*

	Yes	No
Pre-diabetes or Diabetes
Pre-cancer or Cancer
Cardiovascular Disease (heart issues or stroke)
Dementia or Alzheimer's
An Autoimmune Condition
Thyroid Dysfunction
Allergies or Asthma
Frequent skin rashes, eczema, or Psoriasis
Nonalcoholic Fatty Liver Disease
Polycystic Ovary Syndrome
Abdominal Obesity - the weight concentrates in the middle part of your body. Measurement of the waist circumference (at the level of your belly button, NOT the belt line) is as follows: 40 or more inches in men, or 34 or more inches in women
High blood pressure (equal to or greater than 130/85 WITHOUT medication)

Section 3 Total

Section 4: Have you had any of these irregularities in your bloodwork in the past 6 months?*

	Yes	No
Increased C-reactive Protein (>1)
High Insulin (>17)
High Ferritin (men>337; women>307)
High Sedimentation (Sed) Rate (men>22; women>29)
High LDH (>280)
High Fasting Glucose (>100) or HbA1c (>5.5)
Atherogenic Dyslipidemia, which means WITHOUT medication you have elevated levels of "bad cholesterol" (LDL>100)
High Triglycerides (>150)
Low Levels of “Good Cholesterol” (HDL)

Section 4 Total
Final Total
Now that you've completed your cellular assessment, your next step is to schedule a "no strings attached" brief consultation with Dr. Wild to discuss your results, what impact they may have on your health and longevity, and what you can do to improve them. Simply click on the SUBMIT button below and a member of our team will reach out to you shortly to book your FREE 15-minute Discovery Call as soon as possible.
Should be Empty: