For each question CIRCLE the number that best applies to your experience with that symptom over the past 3 months.
0 - Never or rarely – It is rare to experience this symptom.
1 - Occasionally – Once in awhile you may experience this – maybe once or twice a month.
2 - Often – You experience this 1-2 times a week, enough that it bothers you.
3 - Regularly – You are constantly aware of this as it occurs almost every day or weekly.
GROUP 5: Endocrine System
78. Headaches
79. Hot flashes
80. High blood pressure
81. Insomnia
82. Ringing in the ears
83. Difficulty Swallowing
84. Very round face and/or excess upper body weight
85. Dizziness
86. Extreme Exhaustion
87. Weakness or dizziness when standing up
88. Tired all day, most energetic in the evening
89. Low blood pressure
90. Nails weak, ridged
91. Sensitive to cold
92. Arthritic tendencies
93. Perspiration increase
94. Bowel disorders – irritable or hyperactive
95. Crave salt
96. Brown patches or bronzing of skin
97. Allergies – environmental and/or food
98. Slow to recover from injury, illness, or stress
99. Respiratory disorders
100. Poor focus and concentration – brain fog
101. Pain on inside lower part of knees
102. Insomnia
103. Nervous and/or Irritable
104. Sudden weight loss or increased appetite without weight gain
105. Intolerance to heat
Total Score for Group 5
