ProHealth health Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help

|
|
|
|

Trending News

The Most Powerful Natural Antioxidant Discovered to Date - Hydroxytyrosol

New Option For Chronic Fatigue Syndrome

How Lipoic Acid Preserves Critical Mitochondrial Function

Living Longer, Healthier Lives with Resveratrol

Iodine: The Forgotten Medicine

Stop Bacteria With Nature's Antibiotics

Lipoic Acid Reverses Mitochondrial Decay

Nutraceutical Update - Rhodiola

Strengthen Cell Function with Energy-Boosting Niagen

Coenzyme Q10 Helps Veterans Battle Gulf War Illness Symptoms

 
Print Page
Email Article

A Clinical Nutritionist’s Do-It-Yourself Health Questionnaire: Complete it and ‘See What Turns Up’

  [ 6 votes ]   [ 1 Comment ]
By Blake Graham, Clinical Nutritionist • www.ProHealth.com • March 1, 2011


Clinical Nutritionist Blake Graham, practicing in Perth, Western Australia, specializes in nutritional and environmental medicine therapies for those with chronic medical conditions, such as ME/CFS, fibromyalgia, and environmental illness. His website – www.nutritional-healing.com.au

Over the past 7 years Blake Graham has designed and refined a very detailed 16-page questionnaire to help assess the large array of potential factors which may be contributing to a person’s symptoms. As he states, “all illness is multi-factorial, and it is very logical to at least consider all of these variables when assessing a patient.”

To see a copy of this questionnaire, last updated Feb 13, 2011, click here (pdf file).

Print it off, carefully fill it in, and see what turns up. It may provide a much more complete and revealing health record for both you and your professional healthcare team – and perhaps new clues as to helpful tests and opportunities to improve your health support plan.

Factors Assessed Via This Questionnaire

1. Illness triggers or precipitating factors.

2. Family history / genetic predisposition.

3. Sleep.
• Lack of adequate sleep.
• Sleep apnea.
• Sleep disruption.
• Restless leg syndrome.
• Circadian rhythm imbalance.

4. Dietary inadequacies and excesses.

5. Post infectious state/chronic infection.

6. Blood sugar imbalances.
• Diabetes mellitus.
• Hypoglycemia.

7. Nutrient imbalances.
• Essential fatty acid deficiencies.
• Copper excess.
• Magnesium deficiency.
• Iron deficiency.
• Vitamin D deficiency.
• Zinc deficiency.

8. Pyroluria (stress-exacerbated genetic condition that causes anxiety, depression, withdrawal).

9. Impaired liver detoxification.

10. Gastrointestinal - intolerances/allergies/maladigestion.
• Celiac disease/gluten intolerance.
• Fat malabsorption.
• Stomach acid deficiency (hypochlorhydria).
• Food allergies/intolerances - general.
• Fructose malabsorption.
• Lactose intolerance.

11. Gastrointestinal - microbiology.
• Intestinal bacterial imbalance (dysbiosis).
• Intestinal yeast overgrowth.
• Intestinal parasites.

12. Environmental exposures.
• Electromagnetic radiation exposure.
• Environmental mold.
• Environmental chemicals.
• Heavy metals.

13. Neurotransmitter imbalances.
• Serotonin deficiency.
• Dopamine/noradrenaline deficiency and excess.
• Acetylcholine deficiency.
• Endorphin deficiency.
• GABA deficiency.

14. Psycho-social stress/emotional issues.

15. Hormone imbalances.
• Hypo-adrenal.
• Hypo-thyroid.
• Sex hormone imbalances.
- Women: Progesterone deficiency, estrogen excess, estrogen deficiency and androgen dominance.
- Men: Testosterone deficiency and estrogen excess.

Blake Graham, BSc (Honours), AACNEM
Clinical Nutritionist
Perth, Western Australia
Phone/Email: See Contact Page

To sign up for Blake Graham’s free Nutritional Healing e-newsletter, click here.



Please Discuss This Article:   Post a Comment 

An adjustment to the questionnaire
Posted by: uxordepp
Jun 17, 2009
Hi This looks like a very thorough questionnaire, but I wonder if the "Pollen Season" they suggest (October through January)should not be adjusted for the northern hemisphere to something like April to August?
Reply Reply
 
Free Chronic Fatigue Syndrome and Fibromyalgia Newsletters
Subscribe to
Our FREE
Newsletter
Subscribe Now!
Receive up-to-date ME/CFS & Fibromyalgia treatment and research news
 Privacy Guaranteed  |  View Archives

Save on Immune Support Supplements

Featured Products

Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get energized with malic acid & magnesium
FibroSleep™ by ProHealth FibroSleep™ by ProHealth
The All-in-One Natural Sleep Aid
Ultra EPA  - Fish Oil Ultra EPA - Fish Oil
Ultra concentrated source of essential fish oils
Optimized Curcumin Longvida® by ProHealth Optimized Curcumin Longvida® by ProHealth
Supports Cognition, Memory & Overall Health
Vitamin D3 Extreme™ by ProHealth Vitamin D3 Extreme™ by ProHealth
50,000 IU Vitamin D3 - Prescription Strength

Natural Remedies

Dreaming of a Good Night's Sleep? Dreaming of a Good Night's Sleep?
"It's Not Easy Being Green" - But It Is Healthy
Green Coffee Extract: Unique Obesity Intervention Green Coffee Extract: Unique Obesity Intervention
Natural Support for Mood, Sleep and Mental Focus? L-theanine Natural Support for Mood, Sleep and Mental Focus? L-theanine
Live Longer: Groundbreaking Research on Omega-3s Live Longer: Groundbreaking Research on Omega-3s

FIBROMYALGIA RESOURCES
What is Fibromyalgia?
Fibromyalgia 101
Fibromyalgia Symptoms
Fibromyalgia Treatments
| CFS RESOURCES
What is CFS?
ME/CFS 101
ME/CFS Symptoms
ME/CFS Treatments
| FORUMS
Fibromyalgia
ME/CFS
ADVANCED MEDICAL LABS
WHOLESALE  |  AFFILIATES
GUARANTEE
CONTACT US
PRIVACY
RSS
SITE MAP
ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus
Credit Card Processing