Toxicity Questionnaire Test

natural_resources_for_detox

“Every human being is the author of his own health or disease.”
 Buddha

Your overall health problems related to toxic accumulation in the body. Even if the toxic accumulation is not the cause of the problem, it is at least worsens the condition. You can continue to mask the symptoms with medication and it will raise the toxic accumulation even more, or you can choose to detoxify your body and have a much better chance of living healthier. Often people do not even realize how unhealthy they have become over the years until they regain a more youthful health.

Realize that no matter how clean a life we live, our planet is still very toxic. That’s why it is important to control the toxic attack on us whenever we can. The toxicity questionnaire is designed to aid you in assessing a potential need for a detoxification.


Take the Toxicity Test to determine how much toxins you have in your body.


How it Works

Step 1

Fill out Toxicity Questionnaire Test

Please, answer every question that applies to you as honestly as you can, to find out your toxicity score. Please check off question with mark. Please, leave blank if symptoms do not apply. Rate each of the following categories based upon your health profile for the past 90 days.


0 N/A (Not Applicable)
1 Occasionally, Effect is Not Severe
2 Occasionally, Effect is Severe
3 Frequently, Effect is Not Severe
4 Frequently, Effect is Severe


Section I: Symptoms


Group 1
0
1
2
3
4
Nausea and/or vomiting
Diarrhea
Constipation
Bloated feeling
Belching and/or passing gas
Heartburn

Group 2
0
1
2
3
4
Itchy ears
Earaches or ear infections
Drainage from ear
Ringing in ears or hearing loss

Group 3
0
1
2
3
4
Mood swings
Anxiety, fear, or nervousness
Anger, irritability
Depression
Sense of despair
Uncaring or disinterested

Group 4
0
1
2
3
4
Fatigue or sluggishness
Hyperactivity
Restlessness
Insomnia
Startled awake at night

Group 5
0
1
2
3
4
Watery or itchy eyes
Swollen, reddened, or sticky eyelids
Dark circles under eyes
Blurred or tunnel vision

Group 6
0
1
2
3
4
Headaches
Faintness
Dizziness
Pressure

Group 7
0
1
2
3
4
Chest congestion
Asthma or bronchitis
Shortness of breath
Difficulty breathing

Group 8
0
1
2
3
4
Poor memory
Confusion
Poor concentration
Poor coordination
Difficulty making decisions
Stuttering, stammering
Slurred speech
Learning disabilities

Group 9
0
1
2
3
4
Chronic coughing
Gagging or frequent need to clear throat
Swollen or discolored tongue, gums, lips
Canker sores

Group 10
0
1
2
3
4
Stuffy nose
Sinus problems
Hay fever
Sneezing attacks
Excessive mucous

Group 11
0
1
2
3
4
Acne
Hives, rashes, or dry skin
Hair loss
Flushing
Excessive sweating

Group 12
0
1
2
3
4
Skipped heartbeats
Rapid heartbeats
Chest pain

Group 13
0
1
2
3
4
Pain or aches in joints
Rheumatoid arthritis
Osteoarthritis
Stiffness or limited movement
Pain or aches in muscles
Recurrent back aches
Feeling of weakness or tiredness

Group 14
0
1
2
3
4
Binge eating or drinking
Craving certain foods
Excessive weight
Compulsive eating
Water retention
Underweight

Group 15
0
1
2
3
4
Frequent illness
Frequent or urgent urination
Leaky bladder
Genital itch, discharge

Section II: Risk of Exposure


1. How often are strong chemicals used in your home? (Disinfectants, bleaches, oven and drain cleaners, furniture polish, floor wax, window cleaners, etc.)
0 1 2 3 4
2. How often are pesticides used in your home?
0 1 2 3 4
3. How often do you have your home treated for insects?
0 1 2 3 4
4. How often are you exposed to dust, overstuffed furniture, tobacco smoke, mothballs, incense, or varnish in your home or office?
0 1 2 3 4
5. How often are you exposed to nail polish, perfume, hairspray, or other cosmetics?
0 1 2 3 4
6. How often are you exposed to diesel fumes, exhaust fumes, or gasoline fumes?
0 1 2 3 4
7. Have you noticed any negative change in your health since you moved into your home or apartment?
0 1 2 3 4
8. Have you noticed any change in your health since you started your new job?
0 1 2 3 4

Section III: Other


1. Do you have a water purification system in your home?
yes no
2. Do you have any indoor pets?
no yes
3. Do you have an air purification system in your home?
yes no
4. Are you a dentist, painter, farm worker, or construction worker?
no yes

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