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The Toxicity Questionnaire

For the “before” part of the questionnaire, rate each of the following symptoms based upon your health profile for the past 30 days. Youʼll take this quiz again after your 10-Day Detox, but itʼs especially important that you take the time to complete and score it now, before you embark on the program. Without that baseline score, 10 days from now you may have a hard time believing just how different your “after” results really are.

Empty fields are treated as "0 = Never or almost never have the symptom".

Based on
Please, answer the questions/give estimates on attributes
Digestive tract: Nausea or vomiting
Digestive tract: Diarrhea
Digestive tract: Constipation
Digestive tract: Bloated feeling
Digestive tract: Belching, or passing gas
Digestive tract: Heartburn
Digestive tract: Intestinal/stomach pain
Ears: Itchy ears
Ears: Earaches, ear infections
Ears: Drainage from ear
Ears: Ringing in ears, hearing loss
Emotions: Mood swings
Emotions: Anxiety, fear or nervousness
Emotions: Anger, irritability, or aggressiveness
Emotions: Depression
Energy/activity: Fatigue, sluggishness
Energy/activity: Apathy, lethargy
Energy/activity: Hyperactivity
Energy/activity: Restlessness
Eyes: Watery or itchy eyes
Eyes: Swollen, reddened, or sticky eyelids
Eyes: Bags or dark circles under eyes
Eyes: Blurred or tunnel vision (does not include near- or far-sightedness)
Head: Headaches
Head: Faintness
Head: Dizziness
Head: Insomnia
Heart: Irregular or skipped heartbeat
Heart: Rapid or pounding heartbeat
Heart: Chest pain
Joints/muscles: Pain or aches in joints
Joints/muscles: Arthritis
Joints/muscles: Stiffness or limitation of movement
Joints/muscles: Pain or aches in muscles
Joints/muscles: Feeling of weakness or tiredness
Lungs: Chest congestion
Lungs: Asthma, bronchitis
Lungs: Shortness of breath
Lungs: Difficulty breathing
Mind: Poor memory
Mind: Confusion, poor comprehension
Mind: Poor concentration
Mind: Poor physical coordination
Mind: Difficulty in making decisions
Mind: Stuttering or stammering
Mind: Slurred speech
Mind: Learning disabilities
Mouth/throat: Chronic coughing
Mouth/throat: Gagging, frequent need to clear throat
Mouth/throat: Sore throat, hoarseness, loss of voice
Mouth/throat: Swollen or discolored tongue, gums, or lips
Mouth/throat: Canker sores
Nose: Stuffy nose
Nose: Sinus problems
Nose: Hay fever
Nose: Excessive mucus formation
Nose: Sneezing attacks
Skin: Acne
Skin: Hives, rashes, or dry skin
Skin: Hair loss
Skin: Flushing or hot flushes
Skin: Excessive sweating
Weight: Binge eating/drinking
Weight: Craving certain foods
Weight: Excessive weight
Weight: Compulsive eating
Weight: Water retention
Weight: Underweight
Other: Frequent illness
Other: Frequent or urgent urination
Other: Genital itch or discharge
No solution (probably the solver needs more information)
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