She's Got Guts® -Lifestyle Analysis

She's Got Guts® -Lifestyle Analysis

Tick yes or no for all questions below. Submit the form to receive information on the results of the lifestyle analysis to understand how your gut microbiome is effecting your inner health and outer wellbeing.
Would you like more energy?

YESNO
Do you have frequent ill health? i.e. a flu bug or a bad cold or illness once or twice a year?

YESNO
Do you have any body odour and/or bad breath including smelly feet?

YESNO
Do you have difficulty digesting certain foods? If there are certain foods that you avoid because of how they make you feel (eg bloated, windy, indigestion) then please tick the box.

YESNO
Do you eat red meat at least twice a week? eg Beef, pork, (ham, bacon) lamb

YESNO
Ladies - Any problems with your monthly cycle? ie any PMT/PMS symptoms

YESNO
Have you had any antibiotic or other medication in the last three years? This includes birth control, HRT, antibiotics and prescribed medication.

YESNO
Do you have regular alcohol consumption? E.g. every other night or bingeing at weekends

YESNO
Do you have mood swings? Up and down moods – even if it is PMT related?

YESNO
Do you have any food allergies or intolerances? Are there certain foods that you avoid because of how they make you feel? (eg sick, bloated, windy, indigestion) If yes, please tick the box.

YESNO
Do you have dark circles under the eyes?

YESNO
Smoking (including passive)

YESNO
Do you have poor concentration, memory or brain fog? Please tick the box if you feel any of these are not as good as they could be.

YESNO
Do you have poor resistance to unhealthy conditions? ie if there is a lurgy going round do you catch it?

YESNO
Do you have any discomfort after eating? E.g. bloating or if there are certain foods that you avoid because of how they make you feel.

YESNO
Do you have a stressful lifestyle? Are you stressed or always on the go?

YESNO
Do you have skin problems?

YESNO
Do you crave sweets or processed foods including crisps, chocolates, cakes, biscuits, bread and pastries?

YESNO
Do you consume dairy products? - even if it’s just a splash of milk in tea or coffee, a smear of butter or a tiny bit of yoghurt or cheese?

YESNO
Do you feel low or have apathy? Do you feel down or like you can’t be bothered?

YESNO
Do you have inadequate or restless sleep?

YESNO
Ladies – do you have any menopausal concerns? (even if you are on HRT)

YESNO
Do you have any urination problems (including going to the loo during the night)

YESNO
Do you have brittle fingernails? Do your nails shatter or break often?

YESNO
Do you have any noticeable hair loss?

YESNO
Do you have any bad fats or cholesterol issues? Do you regularly eat fried food or ready meals?

YESNO
Do you have difficulty in maintaining your ideal weight? (either losing or gaining to be your ideal weight)

YESNO
Do you have a lack of stamina?

YESNO
Do you have poor eating habits? I.e. Do you eat the wrong type of food or at the wrong times?

YESNO
Do you have slow recovery from poor health? Does it take you a while to get rid of an illness?

YESNO
Do you have irregular or infrequent bowel activity? Do you suffer from diarrhoea or constipation?

YESNO
Are you edgy, unable to relax or tense? Are you a nervous character or do you suffer with tension?

YESNO
Do you have a low fibre diet? (ie less than 30g a day. Most people do. As a guide 100g of broccoli is only 5g of fibre or a loaf and a half of wholemeal bread or 16 weetabix!)

YESNO
Do you experience muscle tension or discomfort?

YESNO
Do you have dry/damaged/dull hair?

YESNO
Exposure to air pollution (if you breathe then you tick the box!)

YESNO
Do you have sleepiness when sitting? When you sit down do you start to feel tired and sleepy or feel like you could nod off?

YESNO
Do you have a lack of appetite? – Are you often not hungry at mealtimes?

YESNO
Do you drink two or more (in any combination) cups of tea, coffee or cola a day?

YESNO
Do you have any feeling out of control or like you just can’t cope?

YESNO
Do you have any food or chemical sensitivities? If there are certain foods that you avoid because of how they make you feel (e.g bloated, windy, indigestion) or soaps/washing powders,chemicals or perfume that affect you then please tick the box.

YESNO
Do you have any problems with yeast or fungus?i.e. fungal nails, thrush, athletes foot, candida.

YESNO
Do you have any muscle or joint discomfort or weakness?

YESNO
Do you have excessive worry? ie do you worry a lot or over think things?

YESNO
Are you easily irritated or angered?

YESNO
Do you have insufficient exercise? i.e a minimum of 20 minutes aerobic exercise at least 3 x per week

YESNO
Do you have problems with congestion or mucus? Do you often experience congestion or have a nasal drip?

YESNO
Name*

First NameLast Name
Email*
example@example.com
Please tick that you consent to me holding your data and that I can contact you in the future with relevent emails.

TICK TO AGREE

When I have plotted your results I will send you an email with a summary and an invitation for a free 20 minute zoom consultation. I will explain your full results and recommend ways to support your microbiome. Allow up to two working days before receiving results. Thank you. N.B. Throughout August allow longer to receive the results as I am away from my desk for a majority of the month. Thank you for your patience.
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