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Determine whether you have symptoms that commonly arise in those having sensitivities.

The greater the number of yes responses, the greater the likelihood that at least some of your symptoms are reactions to sensitivities.

1. Do any of your blood relatives suffer from sensitivity syndromes (hay fever, asthma, skin rashes, or severe reactions to drugs or insect stings), food sensitivities addictive disorders (alcohol or drug abuse or compulsive eating, diabetes or low blood sugar, arthritis, headaches, or digestive disorders? Were any blood relatives hyperactive, learning- disabled, or bedwetters as children?

2. Did your mother experience severe stress during her pregnancy with you? Was your birth difficult or complicated?

3. As an infant, did you have any problems tolerating bottle formula or breast milk? Did you have difficulty gaining weight or have colic.

4. As an infant, did you suffer from frequent digestive, respiratory, or skin problems?

5. Were you difficult in infancy and/or childhood, often crying or irritable? Were you overactive or under-active? Did you have problems sleeping or trouble learning or paying attention at school?

6. As a child, were you often sick, plagued by ear infections, sore throats, swollen glands, colds, bronchitis, croup, stomach aches, constipation, diarrhea, or headaches?

7. As an adult, are you always tired, even though you get enough sleep?

8. Do you frequently have puffy eyes or baggy, swollen eyelids, wrinkles or dark circles under you eyes, or itchy, red, watery, burning, painful, or light sensitive eyes? Do you have blurred vision

9. Do you often have a stuffy, watery, and/or runny nose? Do you sneeze several times in a row, or do you rub your nose upward or wiggle your nose? Do you have one cold after another, even without feeling sick, or do you get nosebleeds? Do you have excessive formation of mucus?

10. Do you have asthma or wheezing? Do you cough or wheeze with laughter, with exercise, with cold air, with cold drinks, or atnight when it is damp outside?

11. Do you have skin rashes such as eczema or atopic dermatitis or itchy rashes or hives, especially in the creases of your arms or
legs? Do you have cracked toenails or fingernails, acne, dandruff, or loss of hair?

12. Do you have swelling or soreness of your face and lips, itchiness of the roof of your mouth, cancer sores, bleeding gums, or bad breath? Do you suffer from digestive problems, including nausea or stomachaches, excess gas, diarrhea and/or constipation, belching, ulcers, colitis, or rectal itching?

13. Do you have recurrent earaches, fluid behind your eardrum(s), intermittent trouble with your hearing, ear poppingor ringing, flushed or red earlobes, dizziness, itchy ears, or drainage from your ear(s)?

14. Do you have difficulty gaining or losing weight?

15. Do you have repeated bladder infections, difficulty urinating, and/or water retention?

16. Is your pulse or heartbeat irregular after eating?

17. Have you ever had seizures, convulsions, or fainting spells?

18. Do you have a history of sinus problems, earaches, or sore throats?

19. Do you suffer from headaches, insomnia, leg or muscle aches, back pain, stiff or swollen joints, or arthritis?

20. Do you have constant low-grade fever, a feeling of being flushed or chilled, or excessive sweating?

21. Are you a picky eater? Do you indulge in binge eating?

22. Do you feel like you are high one moment and low the next, with depression appearing for no reason?

23. Do you have trouble concentrating, sometimes feeling confused and spacey? Are you sometimes hyperactive, overly nervous, frequently anxious, and/or quick to anger?

24. Does a change in your surroundings or the seasons affect how you feel?


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