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Parasite Questionnaire

PARASITE QUESTIONNAIRE: There are many causes for each symptom listed below.

Assign points to each symptom to see if a pattern develops.

A = symptom never occurs.

B = symptom occurs occasionally.

C = symptom occurs regularly.

D = symptoms occurs frequently.

A B C D
1. Restless sleep (toss, turn, wake often) 0 1 2 3
2. Skin problems, rashes, itches 0 1 2 3
3. Increased appetite, hungry after meals 0 1 2 3
4. Frequent diarrhea, loose stool 0 2 3 4
5. Grinding of teeth when asleep 0 2 4 6
6. Variable, changeable consistency of stool 0 1 2 3
7. Picking at nose, boring nose with finger 0 2 4 6
8. Abdominal pains 0 1 2 3
9. Vertical wrinkles around mouth 0 2 4 6
10. Rectal, anal itch 0 2 3 4
11. Parallel lines (tracks) in soles of feet 0 2 4 6
12. Intestinal cramps, burning 0 1 2 3
13. Irritable (no apparent reason) 0 1 2 3
14. Feel bloated, gaseous, no known cause 0 2 3 4
15. Diarrhea alternates with constipation 0 2 3 4
16. Bowel urgency, occasional accidents 0 1 2 3
17. Hyperactive tendency (nervous) 0 1 2 3
18. Dark circles under eyes 0 2 3 4
19. Need for extra sleep, wake unrefreshed 0 1 2 3
20. Allergies, food sensitivities 0 1 2 3
21. Fevers of unknown origin 0 1 2 3
22. Night sweats (not menopausal) 0 1 2 3
23. Kiss pets, allow pets to lick your face 0 2 3 4
24. Anemia 0 1 2 3
25. Frequent colds, flu, sore throats 0 1 2 3
26. Go barefoot in parks, public streets 0 2 3 4
27. Travel in 3rd world countries 0 2 4 6
28. Eat lightly cooked pork products 0 2 3 4
29. Eat sushi, sashimi 0 2 4 6
30. Sleep with pets on bed 0 2 3 4
31. Bed wetting 0 1 2 3
32. Men: sexual dysfunction 0 1 2 3
33. Forgetfulness 0 1 2 3
34. Slow reflexes 0 1 2 3
35. Loss of appetite 0 1 2 3
36. Yellowish face 0 1 2 3
37. Heart beat rapid 0 1 2 3
38. Heart pain 0 1 2 3
39. Pain in umbilicus 0 1 2 3
40. Blurry, unclear vision 0 1 2 3
41. Pain: back, thighs, shoulders 0 1 2 3
42. Lethargy, apathy 0 1 2 3
43. Numbness, tingling in hands, feet 0 1 2 3
44. Burning pains in the stomach, intestines 0 1 2 3
45. Menstrual problems 0 1 2 3
46. Dry lips during day, damp at night 0 1 2 3
47. Drooling while asleep 0 1 2 3
48. Occult blood in stool (from lab test) 0 1 2 3
49. History of giardia, pin worms, worms 0 2 3 4
50. Swim in creeks, rivers, lakes 0 1 2 3
TOTAL
TOTAL 10-14 points = maybe

15-20 points = suspect parasites

21-25 points = likely (further testing helpful)

25 or more points = parasite involvement probable

Want more info or to book an appointment for a parasite cleanse? Contact meĀ here: http://fitnhealthynutrition.com/contact-us/

 

Ā© 1996 Jack Tips, Apple a day press