• Comprehensive Health Evaluation

  • Serotonin

  • 1. Feel depressed, unhappy, or sad
  • 2. You can’t stay asleep and/or lack of deep restorative sleep
  • 3. Compulsive behavior, unprovoked anger and/or unexplained crying

  • Dopamine

  • 4. Feel anxious or have social phobia
  • 5. Have addictive personality; Past/present troubles with alcohol, food, pharmaceutical and recreational drugs.
  • 6. Have troubles staying focused on one particular task
  • 7. Life seems less fun, colorful or flavorful, lack pleasure

  • Acetylcholine

  • 8. Lapses in memory
  • 9. Difficulty comprehending verbal instructions

  • Gaba

  • 10. Feel tense and/or have troubles turning your mind off when you want to relax
  • 11. Feel irritable, crabby or short tempered
  • 12. You often use alcohol or other sedatives to calm down

  • Stress

  • 13. Feelings of hopelessness
  • 14. Feelings of being overwhelmed
  • 15. Events from the past cause you pain, resentment or anger
  • 16. Worry about the future or current situation you are in (finances, health, work, family, lack of purpose, lack of certainty)
  • 17. Current level of stress

  • Adrenal Glands

  • 18. Stress seems to easily cause noticeable symptoms like flushing or heart palpitations
  • 19. Brain fog, forgetting basic things, a sense of mild confusion Stress seems to easily cause noticeable symptoms like flushing or heart palpitations
  • 20. Unexplained anxiety
  • 21. Low or high blood pressure
  • 22. Troubles falling asleep and/or wakes up after 2-4 hours of sleep and unable to fall back asleep within 30 minutes
  • 23. Alternating areas of pain, tenderness, hot, sore, and sensitive to the touch or diagnosed with chronic fatigue syndrome or fibromyalgia

  • Thyroid Gland

  • 24. Hands and feet frequently feel cold or chilled
  • 25. Constantly feeling sleepy
  • 26. Feel slow-moving, sluggish
  • 27. Constipated regularly
  • 28. Dry or scaly skin
  • 29. Hair feels coarse and/or brittle
  • 30. Losing hair and/or outer third of eyebrow
  • 31. Heavy menstrual periods (men answer no)
  • 32. Weight gain despite changes in diet
  • 33. Take thyroid medication

  • Male Hormones

  • 34. Decrease in muscle mass, with an increase in body fat
  • 35. Loss of sex drive
  • 36. Suffer from erectile dysfunction
  • 37. After 35 years of age started having troubles concentrating and/or lack of feeling sharp
  • 38. Unexplained depression and decreased since of wellbeing after 35 years of age

  • Stomach Function

  • 39. Indigestion, taste or burp food hours after eating
  • 40. Low iron/anemia
  • 41. Use antacids or take medications for digestion

  • Gastrointestinal Inflammation

  • 42. Feel a sense of nausea when you eat or before you eat
  • 43. Stomach pain relieved by eating food, drinking carbo-nated beverages, milk, or taking antacids
  • 44. Indigestion after eating may be 30 to 90 minutes after eating
  • 45. Muscle twitching

  • Small Intestines and Pancreas

  • 46. Pain under your rib cage on your left side
  • 47. Indigestion is delayed, occurring 2-4 hours after eating a meal
  • 48. The consistency or form of your stool changes (e.g., from narrow to loose) within the course of a day
  • 49. Excessive odor with bowel movements
  • 50. Undigested food in your bowel movements
  • 51. Diarrhea or frequently loose stools

  • Large intestines

  • 52. Discomfort, pain or cramps in your lower abdominal area
  • 53. Eating raw fruits and vegetables causes gas, bloating, and pain in lower abdomen
  • 54. Anal itch

  • Gallbladder

  • 55. Bowel movements alternate from normal to clay colored
  • 56. Sporadic pains in the middle of the upper abdomen, or just below the ribs on the right side
  • 57. History of gallstones or attacks, had gallbladder removed (if yes answer severe)

  • Nutritional Deficiency

  • 58. Muscle cramping
  • 59. Ridges on nails, longitudinal
  • 60. Gingivitis, gums bleeding
  • 61. Anorexia or bulimia
  • 62. Cracking/peeling/brittle/splitting fingernails or fingertips (i.e. hang nails)
  • 63. Small bumps on back of upper arms and/or thighs

  • Immune Function

  • 64. Suffer from eczema, psoriasis, lupus, MS, RA, Crohn’s or any other autoimmune condition
  • 65. Recurrent thrush or fungal infections
  • 66. Used intravenous antibiotics to clear infection or taken antibiotics for more than 30 days continuously
  • 67. Frequency of sinus, ear, yeast, kidney, bladder, skin and lung infections
  • 68. Frequent colds or flu
  • 69. Suffer from allergies

  • Detoxification system

  • 70. Currently taking statin medication or history/currently elevated cholesterol
  • 71. Suffer from acne, liver spots, or other skin lesions
  • 72. Suffer migraines and/or headaches frequently
  • 73. Bitter or metallic taste
  • 74. Difficulty recalling commonly used words
  • 75. Excessively strong body odor
  • 76. Yellowish tint of the whites of your eyes
  • 77. Dark circles around your eyes

  • Please list your top 5 complaints. If you don’t have 5 that is okay.

  • Contact Information

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