SlideShare a Scribd company logo
1 of 1
Download to read offline
Pyroluria Questionaire
   Check if anwser is YES
__ 1. When you were young, did you sunburn easily? Do you have fair or pale skin?
__ 2. Do you have a reduced amount of head hair, eyebrows, or eyelashes, or do youhave prematurely gray hair?
__ 3. Do you have poor dream recall or nightmares?
__ 4. Are you becoming more of a loner as you age? Do you avoid outside stressbecause it upsets your emotional balance?
__ 5. Have you been anxious, fearful, or felt a lot of inner tension since childhood but mostly hide these inner feelings from
   others?
__ 6. Is it hard to clearly recall past events and people in your life?
__ 7. Do you have bouts of depression and/or nervous exhaustion?
__ 8. Do you have cluster headaches?
__ 9. Are your eyes sensitive to sunlight?
__ 10, Do you belong to an all-girl family, or have look-alike sisters?
__ 11. Do you get frequent colds or infections, or unexplained chills or fevers?
__ 12. Do you dislike eating protein? Have you ever been a vegetarian?
__ 13. Did you reach puberty later than normal?
__ 14. Are there white spots/flecks on your fingernails, or do you have opaquely or paper-thin nails?
__ 15. Are you prone to acne, eczema, or psoriasis?
__ 16. Do you prefer the company of one or two close friends rather than a gathering of friends?
__ 17. Do you have stretch marks on your skin?
__ 18. Have you noticed a sweet smell (fruity odor) to your breath or sweat when ill or stressed?
__ 19. Do you have or did you have, before braces crowded upper front teeth?
__ 20. Do you prefer not to eat breakfast, or even experience light nausea in themorning?
__ 21. Does your face sometimes look swollen while under a lot of stress?
__ 22. Do you have a poor appetite, or a poor sense of smell or taste?
__ 23. Do you have any upper abdominal, splenic pain? As a child, did you get a "twitch" in your side when you ran?
__ 24. Do you tend to focus internally (on yourself) rather than on the external world?
__ 25. Do you frequently experience fatigue?
__ 26. Do you feel uncomfortable with strangers?
__ 27. Do your knees crack or ache?
__ 28. Do you overreact to tranquilizers, barbiturates, alcohol, or other drugs? does a little produce a powerful response?
__ 29. Does it bother you to be seated in a restaurant in the middle of the room?
__ 30. Are you anemic?
__ 31. Do you have cold hands and/or feet?
__ 32. Are you easily upset (internally) by criticism?
__ 33. Do you have a tendency toward morning constipation?
__ 34. Do you have tingling sensations or muscle spasms in your legs or arms?
__ 35. Do changes in your routine (traveling, new situations) provoke stress?
__ 36. Do you tend to become dependent on one person whom you build your life around?
   Yes Score____
   If you scored 15 or more, it would be worth your while to be tested for pyroluria

   Contact Information
   Direct Healthcare Access II Inc.
   sommerfed@aol.com
   350 W Kensington Road Suite 107 Mount Prospect IL. 60056
   Phone 847-222-9546
   Fax 847-222-9547

More Related Content

Viewers also liked

Questionaire
QuestionaireQuestionaire
Questionaire
ASgroup9
 
Healthy eating questionnaire
Healthy eating questionnaireHealthy eating questionnaire
Healthy eating questionnaire
doragk
 

Viewers also liked (6)

Questionaire
QuestionaireQuestionaire
Questionaire
 
Eating questionnaire
Eating questionnaireEating questionnaire
Eating questionnaire
 
Questionaire
QuestionaireQuestionaire
Questionaire
 
Healthy eating questionnaire
Healthy eating questionnaireHealthy eating questionnaire
Healthy eating questionnaire
 
Nutritional Assessment
Nutritional AssessmentNutritional Assessment
Nutritional Assessment
 
Questionnaire on consumer behaviour on cosmetic product
Questionnaire on consumer behaviour on cosmetic productQuestionnaire on consumer behaviour on cosmetic product
Questionnaire on consumer behaviour on cosmetic product
 

More from Direct Healthcare Access II

More from Direct Healthcare Access II (20)

Wellness Promotional Testing Card
Wellness Promotional Testing CardWellness Promotional Testing Card
Wellness Promotional Testing Card
 
Kyptopyrrole Stress Management Card
Kyptopyrrole Stress Management Card Kyptopyrrole Stress Management Card
Kyptopyrrole Stress Management Card
 
DRUG TESTING PROMOTIONAL CARD
DRUG TESTING PROMOTIONAL CARDDRUG TESTING PROMOTIONAL CARD
DRUG TESTING PROMOTIONAL CARD
 
DNA MARKETING CARDS
DNA MARKETING CARDSDNA MARKETING CARDS
DNA MARKETING CARDS
 
DIRECT HEALTHCARE LEGAL DNA QUESTIONS
DIRECT HEALTHCARE LEGAL DNA QUESTIONSDIRECT HEALTHCARE LEGAL DNA QUESTIONS
DIRECT HEALTHCARE LEGAL DNA QUESTIONS
 
Ancestry testing services
Ancestry testing servicesAncestry testing services
Ancestry testing services
 
Updated Mental Health Parity Defined by the Federal Goverment
Updated Mental Health Parity Defined by the Federal GovermentUpdated Mental Health Parity Defined by the Federal Goverment
Updated Mental Health Parity Defined by the Federal Goverment
 
Community providers presentation__june_16,_2010 non profit
Community providers presentation__june_16,_2010 non profitCommunity providers presentation__june_16,_2010 non profit
Community providers presentation__june_16,_2010 non profit
 
American overview ecf_2010 nursing home
American overview ecf_2010 nursing homeAmerican overview ecf_2010 nursing home
American overview ecf_2010 nursing home
 
American overview m_ds_psychiatrists_march_1,_2010
American overview m_ds_psychiatrists_march_1,_2010American overview m_ds_psychiatrists_march_1,_2010
American overview m_ds_psychiatrists_march_1,_2010
 
Press release dha bio chem
Press release dha bio chemPress release dha bio chem
Press release dha bio chem
 
Naturopathic doctors
Naturopathic doctorsNaturopathic doctors
Naturopathic doctors
 
Follow up testing-protocol for Bio-Chemcial Balancing
Follow up testing-protocol for Bio-Chemcial BalancingFollow up testing-protocol for Bio-Chemcial Balancing
Follow up testing-protocol for Bio-Chemcial Balancing
 
Mauve factor 2.ai
Mauve factor 2.aiMauve factor 2.ai
Mauve factor 2.ai
 
DNA Testing Description
DNA Testing DescriptionDNA Testing Description
DNA Testing Description
 
Vitamins treatments
Vitamins treatmentsVitamins treatments
Vitamins treatments
 
Direct healthcare access ii agenda
Direct healthcare access ii agendaDirect healthcare access ii agenda
Direct healthcare access ii agenda
 
Dha and vitamin opportunity
Dha and vitamin opportunityDha and vitamin opportunity
Dha and vitamin opportunity
 
Dha new marketing document
Dha new marketing documentDha new marketing document
Dha new marketing document
 
LAB TESTING PRICING
LAB TESTING PRICINGLAB TESTING PRICING
LAB TESTING PRICING
 

Recently uploaded

Sonia Journal club presentation (2).pptx
Sonia Journal club presentation (2).pptxSonia Journal club presentation (2).pptx
Sonia Journal club presentation (2).pptx
palsonia139
 
Circulation through Special Regions -characteristics and regulation
Circulation through Special Regions -characteristics and regulationCirculation through Special Regions -characteristics and regulation
Circulation through Special Regions -characteristics and regulation
MedicoseAcademics
 
Failure to thrive in neonates and infants + pediatric case.pptx
Failure to thrive in neonates and infants  + pediatric case.pptxFailure to thrive in neonates and infants  + pediatric case.pptx
Failure to thrive in neonates and infants + pediatric case.pptx
claviclebrown44
 
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the HeartCardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
MedicoseAcademics
 
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
DR SETH JOTHAM
 

Recently uploaded (20)

Scleroderma: Treatment Options and a Look to the Future - Dr. Macklin
Scleroderma: Treatment Options and a Look to the Future - Dr. MacklinScleroderma: Treatment Options and a Look to the Future - Dr. Macklin
Scleroderma: Treatment Options and a Look to the Future - Dr. Macklin
 
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best supplerCas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
 
Hemodialysis: Chapter 1, Physiological Principles of Hemodialysis - Dr.Gawad
Hemodialysis: Chapter 1, Physiological Principles of Hemodialysis - Dr.GawadHemodialysis: Chapter 1, Physiological Principles of Hemodialysis - Dr.Gawad
Hemodialysis: Chapter 1, Physiological Principles of Hemodialysis - Dr.Gawad
 
Case presentation on Antibody screening- how to solve 3 cell and 11 cell panel?
Case presentation on Antibody screening- how to solve 3 cell and 11 cell panel?Case presentation on Antibody screening- how to solve 3 cell and 11 cell panel?
Case presentation on Antibody screening- how to solve 3 cell and 11 cell panel?
 
Sonia Journal club presentation (2).pptx
Sonia Journal club presentation (2).pptxSonia Journal club presentation (2).pptx
Sonia Journal club presentation (2).pptx
 
Dermatome and myotome test & pathology.pdf
Dermatome and myotome test & pathology.pdfDermatome and myotome test & pathology.pdf
Dermatome and myotome test & pathology.pdf
 
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS by Dr M.KARTHIK EMMANUEL
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS  by Dr M.KARTHIK EMMANUELCONGENITAL HYPERTROPHIC PYLORIC STENOSIS  by Dr M.KARTHIK EMMANUEL
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS by Dr M.KARTHIK EMMANUEL
 
Introducing VarSeq Dx as a Medical Device in the European Union
Introducing VarSeq Dx as a Medical Device in the European UnionIntroducing VarSeq Dx as a Medical Device in the European Union
Introducing VarSeq Dx as a Medical Device in the European Union
 
Gallbladder Double-Diverticular: A Case Report المرارة مزدوجة التج: تقرير حالة
Gallbladder Double-Diverticular: A Case Report  المرارة مزدوجة التج: تقرير حالةGallbladder Double-Diverticular: A Case Report  المرارة مزدوجة التج: تقرير حالة
Gallbladder Double-Diverticular: A Case Report المرارة مزدوجة التج: تقرير حالة
 
TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...
TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...
TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...
 
Cardiovascular Physiology - Regulation of Cardiac Pumping
Cardiovascular Physiology - Regulation of Cardiac PumpingCardiovascular Physiology - Regulation of Cardiac Pumping
Cardiovascular Physiology - Regulation of Cardiac Pumping
 
World Hypertension Day 17th may 2024 ppt
World Hypertension Day 17th may 2024 pptWorld Hypertension Day 17th may 2024 ppt
World Hypertension Day 17th may 2024 ppt
 
The Orbit & its contents by Dr. Rabia I. Gandapore.pptx
The Orbit & its contents by Dr. Rabia I. Gandapore.pptxThe Orbit & its contents by Dr. Rabia I. Gandapore.pptx
The Orbit & its contents by Dr. Rabia I. Gandapore.pptx
 
Circulation through Special Regions -characteristics and regulation
Circulation through Special Regions -characteristics and regulationCirculation through Special Regions -characteristics and regulation
Circulation through Special Regions -characteristics and regulation
 
Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...
Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...
Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...
 
Failure to thrive in neonates and infants + pediatric case.pptx
Failure to thrive in neonates and infants  + pediatric case.pptxFailure to thrive in neonates and infants  + pediatric case.pptx
Failure to thrive in neonates and infants + pediatric case.pptx
 
hypo and hyper thyroidism final lecture.pptx
hypo and hyper thyroidism  final lecture.pptxhypo and hyper thyroidism  final lecture.pptx
hypo and hyper thyroidism final lecture.pptx
 
5CL-ADB powder supplier 5cl adb 5cladba 5cl raw materials vendor on sale now
5CL-ADB powder supplier 5cl adb 5cladba 5cl raw materials vendor on sale now5CL-ADB powder supplier 5cl adb 5cladba 5cl raw materials vendor on sale now
5CL-ADB powder supplier 5cl adb 5cladba 5cl raw materials vendor on sale now
 
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the HeartCardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
 
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
 

Kryptopyrrole Health Questionaire to define Nutritional Needs

  • 1. Pyroluria Questionaire Check if anwser is YES __ 1. When you were young, did you sunburn easily? Do you have fair or pale skin? __ 2. Do you have a reduced amount of head hair, eyebrows, or eyelashes, or do youhave prematurely gray hair? __ 3. Do you have poor dream recall or nightmares? __ 4. Are you becoming more of a loner as you age? Do you avoid outside stressbecause it upsets your emotional balance? __ 5. Have you been anxious, fearful, or felt a lot of inner tension since childhood but mostly hide these inner feelings from others? __ 6. Is it hard to clearly recall past events and people in your life? __ 7. Do you have bouts of depression and/or nervous exhaustion? __ 8. Do you have cluster headaches? __ 9. Are your eyes sensitive to sunlight? __ 10, Do you belong to an all-girl family, or have look-alike sisters? __ 11. Do you get frequent colds or infections, or unexplained chills or fevers? __ 12. Do you dislike eating protein? Have you ever been a vegetarian? __ 13. Did you reach puberty later than normal? __ 14. Are there white spots/flecks on your fingernails, or do you have opaquely or paper-thin nails? __ 15. Are you prone to acne, eczema, or psoriasis? __ 16. Do you prefer the company of one or two close friends rather than a gathering of friends? __ 17. Do you have stretch marks on your skin? __ 18. Have you noticed a sweet smell (fruity odor) to your breath or sweat when ill or stressed? __ 19. Do you have or did you have, before braces crowded upper front teeth? __ 20. Do you prefer not to eat breakfast, or even experience light nausea in themorning? __ 21. Does your face sometimes look swollen while under a lot of stress? __ 22. Do you have a poor appetite, or a poor sense of smell or taste? __ 23. Do you have any upper abdominal, splenic pain? As a child, did you get a "twitch" in your side when you ran? __ 24. Do you tend to focus internally (on yourself) rather than on the external world? __ 25. Do you frequently experience fatigue? __ 26. Do you feel uncomfortable with strangers? __ 27. Do your knees crack or ache? __ 28. Do you overreact to tranquilizers, barbiturates, alcohol, or other drugs? does a little produce a powerful response? __ 29. Does it bother you to be seated in a restaurant in the middle of the room? __ 30. Are you anemic? __ 31. Do you have cold hands and/or feet? __ 32. Are you easily upset (internally) by criticism? __ 33. Do you have a tendency toward morning constipation? __ 34. Do you have tingling sensations or muscle spasms in your legs or arms? __ 35. Do changes in your routine (traveling, new situations) provoke stress? __ 36. Do you tend to become dependent on one person whom you build your life around? Yes Score____ If you scored 15 or more, it would be worth your while to be tested for pyroluria Contact Information Direct Healthcare Access II Inc. sommerfed@aol.com 350 W Kensington Road Suite 107 Mount Prospect IL. 60056 Phone 847-222-9546 Fax 847-222-9547