Health Questionnaires

The questionnaires on this page are designed to find out if you have a particular health issue, or it is likely the issue is related to your signs and symptoms. Do one or do them all, depending on what you want to find out about your health.

Please contact us with your results (the total number of each section).

Then, depending on your needs, we send you to a link that takes you through a much more comprehensive online questionnaire. If you want the link now click here. Then we analyse your results and recommend appropriate measures.

Please note these questionnaires are not a complete diagnosis in and of themselves, and are not intended to diagnose any type of illness.

Detox questionnaireButterfly

Thyroid questionnaire

Candida questionnaire

Digestion questionnaire

Gluten questionnaire

Liver questionnaire

 


TIME FOR A DETOX?

Answer the following list of questions to determine if you need to do a detox program. Your body is sending out a cry for help with even one of these symptoms. Always feeling tired even after a good sleep is a major sign that your body needs detoxifying.
Whatever your score, you will definitely need to stimulate your body’s ability to eliminate waste.
Send us your total score from this questionnaire.

Do you:

boxoften feel tired and lacking in energy?
boxfind it hard to concentrate or have fuzzy thinking?
boxoften feel moody, anxious, irritable or just plain stressed-out?
boxfrequently get a blocked nose or sinuses, and have a lot of post-nasal drip?
boxseem to be more prone to getting colds and flu?
boxhave bad breath or body odour?
boxhave a coated tongue?
boxhave sore muscles or joints or frequent backache?
boxhave eczema, hayfever or other allergies?
boxhave frequent headaches?
boxhave constipation or diarrhoea?
boxhave foul smelling stools or undigested food particles in stools?
boxhave wind, bloating, indigestion or nausea?
boxhave abdominal discomfort or fullness?
boxhave digestive disorders?
boxhave multiple food allergies, or chemical sensitivities?
boxgain weight easily and tend to have food cravings?
boxfeel like you’re not as healthy or fit as people your own age?
boxhave parasites, worms or yeast infections?

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THYROID QUESTIONNAIRE

Answer the following questions to determine if your health issues are related to thyroid problems. Answering yes to more than 9 is likely you have a low thyroid. The higher your score the more likely you have low thyroid. Send us your total score from this questionnaire.

Do you:

boxexperience hair loss or hair is coarse, dry, brittle?
boxhave dry skin, or does your skin itch in winter?
boxexperience decreased sweating?
boxhave fluid retention?
boxget jumpy/tics in eyes, eyes sensitive to light, or gritty eyes?
boxget dizzy or have vertigo?
boxhave tinnitus?
boxhave a hoarse voice?
boxget recurrent headaches?
boxhave thinning of eyebrows or eye lashes?
boxexperience forgetfulness, or poor short term memory?
boxhave elevated cholesterol?
boxhave difficulty losing weight?
boxget cold hands and feet, or senstivity to cold?
boxhave difficulty thinking, or experience brain fog?
boxhave constipation (less than 1 bowel movement a day)?
boxfeel moody, depressed, anxious?
boxhave achey mucles/sore joints?
boxhave low sex drive?
boxhave history of infertility or miscarriages?
boxhave irregular, or painful menstraul cycles?
boxexperience more recurrent infections?
boxhave a previous diagnosis of goitre/nodules?
boxhave history of treatment for hypothyroidism?
boxhave history of treatment for hyperthyroidism?
boxhave a slow pulse?
boxhave low blood pressure?
boxhave sleep apnea?
boxsleep restlessly, or tired when you awake

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CANDIDA QUESTIONNAIRE

Are your health problems yeast connected?
Answer the following questions to determine if your health issues have a yeast connection. Answering yes to more than 5 means candida possibly plays a role. Over 8 is highly probable. The higher your score the more likely it is chronic candida infection. Send us your total score from this questionnaire.

Do you have:

boxfatigue or lethargy?
boxfeeling of being drained of energy?
boxfeeling mental fog, poor concentration?
boxdepression, moodiness or changeable moods?
boxheadaches?
boxcravings for sweets, bread or alcohol?
boxnumbness, burning or tingling anywhere?
boxmuscle aches, weakness?
boxpainful joints or swelling in joints?
boxabdominal pain, digestive problems?
boxconstipation or diarrhoea?
boxbloating or indigestion?
boxtroublesome vaginal discharge?
boxpersistant vaginal burning or itching?
box“jock itch” or prostatitis?
boxhistory of athlete’s foot, ringworm or other chronic fungus infections?
boximpotence, or history of infertility?
boxlack of sexual desire?
boxmenstrual irregularity or cramps/pain during menstruation?
boxPMT?
boxspots in front of eyes?
boxpoor or erratic vision?
boxAntibiotic useage within the past two years?
boxFeeling of “bad all over” but the cause hasn’t been found?

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DIGESTION/Low Stomach Acid

Many of our health problems come back to how food is digested.
Basic Naturopathic philosophy states that all disease begins in the gut. The quality of food we ingest is one thing, but the ability to assimilate and take up all the nutrients is really the key to better health.
As we age, our production of digestive enzymes and stomach acid decreases. Most people suffer from poor digestion and the answer is not antacids or Losec (omeprazole), but improving the digestion and getting rid of Helicobacter pylori, the bacterium that causes much stomach disease. Answer these questions as best you can. A yes to any one of these questions is likely you have problems in this area.
Send us your total score to these questions.

Do you have:

boxfrequent gas, belching, or flatulence an hour after eating?
boxfood that seems to sit in your stomach?
boxa sense of fullness even after only a few bites?
boxunexplained loss of appetite?
boxfrequent nausea or vomiting?
boxfrequent burning sensation in stomach or heartburn?
boxheartburn so severe it wakes you from sleep?
boxchronically irritated throat, or hoarseness and need to clear throat?
boxhoarseness worse in morning?
boxdifficulty swallowing?
boxwaterbrash or reflux or a sour taste in your mouth?
boxbad breath?
boxinflamed gums?
boxchronic candida or parasite infections?
boxrosacea? (dilated blood vessels in cheeks or nose that looks red and or rosy)
boxrectal itching?
boxweak, brittle or ridged nails?
boxdifficulty gaining weight, anemia, malnourishment?

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GLUTEN QUESTIONNAIRE

Are your health problems gluten related?
Do you have a gluten sensitivity? Often over looked as a major contributor to poor health. Gluten is highest in wheat products, particularly bread, sauces and thickeners. A total gluten allergy is called Celiacs disease, but a large portion of us (up to 30%) may have a sensitivity to gluten producing the following symptoms.
Send us your total score from this questionnaire.

Do you have:

boxdigestive problems, upset tummy?
boxbloating and gas?
boxgastric reflux or heartburn?
boxdiarrhoea or constipation?
boxpoor weight control?
boxnot growing well?
boxeating disorders, lack of appetite?
boxexhaustion, weakness, or feel tired all the time?
boxany symptoms that seem to worsen after eating bread or other wheat based foods?
boxrunny nose and sinus problems?
boxchronic iron deficiency or anaemia?
boxosteoporosis, or growing pains?
boxdermatitis, eczema or skin rashes?
boxinfertility?
boxheadaches or migraine?
boxdepression or moodiness?
boxdifficulty thinking clearly?
boxAttention Deficit Hyperactivity Disorder (ADHD)?
boxautism?
boxhyperactivity or irritability?
boxmental health issues?

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LIVER QUESTIONNAIRE

Answer the following questions to determine if your health issues are related to poor detox capacity and a sluggish or toxic liver. Regardless of whether you have one or ten of these symptoms, your body is trying to send you an SOS. Answering yes to more than 9 is likely you have liver issues. The higher your score the more the likelihood.
Send us your total score from this questionnaire.

Do you have:

boxacne, blemishes hives or itchy skin?
boxdiscolouration in eyes (particularly yellowish blips)?
boxhaemorrhoids or varicose veins?
boxhormonal imbalances (PMS, menstraul or menopauseal concerns)
boxheat in upper body such as warm face or hot eyes?
boxlight coloured stools?
boxgas, bloating, nausea, especially after eating fatty foods?
boxdifficulty digesting fats?
boxtiredness or sleepiness after eating?
boxweak tendons, ligaments or muscles?
boxmild frontal headaches?
boxtendency to loss of appetite or other eating disorder?
boxweight gain, or difficulty controlling your weight?
boxtendency to wake around 1am to 3am?
boxpain under right shoulder blade?
boxoutbursts of anger, irritability or rage?
boxdepression that isn’t necessarily related to life events?
boxhi bilirubin levels?
boxelevated liver enzymes (SGOT, SGPT)?

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