The following test is designed to show symptoms from the effects of environmental or internal toxicity. Of course, any subjective test based on symptoms alone needs to be correlated with other methods of diagnosis and is not designed to replace the advice or counsel of a licensed medical practitioner. 

Please rate each of the following symptoms according to severity based on your health in the past 30 days. 

Point Scale

0 = Never or almost never have the symptom 
1 = Occasionally have the symptom, and it is not severe 
2 = Occasionally have the symptom and the effect is severe 
3 = Frequently have the symptom and the effect is not severe 
4 = Frequently have the symptom and the effect is severe 


Digestive Symptoms

Nausea or Vomiting 

Diarrhea 

Constipation 

Bloated Feeling 

Belching, Passing Gas 

Heartburn 

Sub-total for this section: 

EARS 

Itchy Ears 

Earaches, Ear Infections 

Drainage from ears 

Ringing in ears, hearing loss 

Sub-total for this section: 

Emotions

Mood swings 

Anxiety, fear, nervousness 

Anger, irritability 

Depression 

Energy/Activity

Fatigue, sluggishness 

Apathy, lethargy 

Hyperactivity 

Restlessness 

Sub-total for this section: 

Eyes

Watery, itchy eyes 

Swollen, red or sticky eyelids 

Dark circles under eyes 
0
Blurred, tunnel vision 

Sub-total for this section: 

Head

Headaches 

Faintness 

Dizziness 

Insomnia 

Sub-total for this section: 

Lungs

Chest Congestion 

Asthma, bronchitis 

Shortness of breath 

Difficulty breathing 

Sub-total for this section: 

Mind

Poor Memory 

Confusion 

Poor concentration 

Poor coordination 

Difficulty making decisions 

Stuttering, stammering 

Slurred speech 

Learning disabilities 

Sub-total for this section: 

Mouth/Throat

Chronic coughing 

Frequent need to clear throat 

Sore throat, hoarseness 

Swollen or discolored tongue, gums, lips 

Canker sores 

Sub-total for this section: 

Nose

Stuffy nose 

Sinus Problems  

Hay Fever 

Sneezing attacks 

Excessive Mucus 

Sub-total for this section: 

Skin

Acne 

Hives, rashes, dry skin 

Flushing or hot flashes 

Excessive sweating 

Sub-total for this section: 

Heart

Skipped heart beats 

Rapid heart beats 

Chest pain 

Sub-total for this section: 

Joints, muscles

Pain or aching in joints 

Arthritis 

Stiffness, limited movement 

Pain, aches in muscles 

Feelings of weakness or tiredness 

Sub-total for this section: 

Weight changes

Binge eating/drinking 

Craving certain foods/drinks 

Excessive weight 

Compulsive eating 

Water retention 

Underweight/ undesired weight loss 

Sub-total for this section: 

Other Symptoms

Frequent illness 

Frequent or urgent urination 

Genital itch/discharge 

Sub-total for this section: 

Total for all Sections     

 


Congratulations, you finished. Now simply go back and add up all of the numbers. If you scored more than 10 in any one section, or more than 50 total points, you should be concerned with the possibility of toxicity and the need for an effective cleansing program. 

If you find yourself in this situation and would like coaching, you may contact me to set up an in-person or  telephone consultation. If you find yourself with a large number of the above symptoms, it is very likely that a comprehensive detoxification and natural anti-inflammatory life style will help restore your health, so do not despair. 

 

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