Allergy Evaluation & Treatment
Are you feeling sick but can't find the reason why?
Have you ever been tested for the link between what you eat and how you feel? Many times perfectly good foods may not be good for you and cause or aggravate your nagging symptoms. A simple blood test and the resulting diet modification will relieve symptoms such as arthritis, IBS, headache, overweight/underweight, hypertension, diabetes, chronic fatigue, asthma, & sinusitis to name a few.
Evaluate yourself below. Rate each of your symptoms based upon how you have been feeling during the past 30 days. Use the following point scale:
- 0 = never or almost never have the symptom
- 1 = occasionally have it, effect is not severe
- 2 = occasionally have it, effect is severe
- 3 = frequently have it, effect is not severe
- 4 = frequently have it, effect is severe
If your overall total score exceeds 10, then an IgG Delayed Food Allergy test is recommended.
Joints & Muscles
- ___ Pains or aches in joints
- ___ Arthritis
- ___ Stiffness, limited movement
- ___ Pain or aches in muscles
- ___ Feeling weak or tired
- ___ Swollen, tender joints
- ___ Growing pains in legs
- ___ Total
Emotions
- ___ Mood swings
- ___ Anxiety, fear, nervousness
- ___ Angry, irritable, aggressive
- ___ Argumentative
- ___ Frustrated, cries often
- ___ Depression
- ___ Total
Weight
- ___ Binge eating/drinking
- ___ Craving certain foods
- ___ Excessive weight
- ___ Compulsive eating
- ___ Water retention
- ___ Total
Other
- ___ Frequent illness
- ___ Frequent or urgent urination
- ___ Genital itch or discharge
- ___ Anal itching
- ___ Total
Digestive Tract
- ___ Nausea & Vomiting
- ___ Diarrhea
- ___ Constipation
- ___ Bloated feeling
- ___ Belching or passing gas
- ___ Stomach pains or cramps
- ___ Heartburn
- ___ Blood or mucous in stools
- ___ Total
Energy & Activity
- ___ Apathy, lethargy
- ___ Attention deficit
- ___ Fatigue
- ___ Hyperactivity
- ___ Restlessness
- ___ Poor physical coordination
- ___ Stuttering or stammering
- ___ Slurred speech
- ___ Total
Mind
- ___ Poor memory
- ___ Difficulty completing projects
- ___ Difficulty with mathematics
- ___ Underachiever in school
- ___ Poor/short attention span
- ___ Confusion
- ___ Easily distracted
- ___ Making decisions
- ___ Learning disabilities
- ___ Total
Total of All Sections: ____
If your grand total is higher than 10, please call us to schedule a personal consultation today. You don't need to suffer any longer!
Mention "Toxic Food Syndrome" and receive that book as a gift from us at your next appointment.
© 2009 Harmony Chiropractic Center, Inc. | 419.517.5055