This questionnaire is designed to help you determine if you may have symptoms of sugar and carbs intolerance. Give each question a value ranging from 0-5 with “0″ representing no symptoms at all and “5″ severe symptoms.
Do you EAT WHEN you are NERVOUS
Do you have EXCESSIVE APPETITE
Are you HUNGRY BETWEEN MEALS
Are you IRRITABLE BEFORE MEALS
Do you GET SHAKY IF HUNGRY
Do you FEEL FATIGUED often
Do you get LIGHTHEADED IF MEALS are DELAYED
Do you experience HEART PALPITATES IF MEALS MISSED/DELAYED
Do you experience AFTERNOON HEADACHES
Do you excessively EAT SWEETS when you feel UPSET
Do you Wakeup AFTER A FEW HOURS SLEEP
Do you have HARD time TO GET BACK TO SLEEP
Do you CRAVE CANDY OR COFFEE IN AFTERNOON
Do you experience MOODS OF DEPRESSION, MELANCHOLY
Do you Crave SWEETS/SNACKS
TOTAL:
0- 10 = No/ Very slight symptoms of Sugar and carbs intolerance 11- 20 = Mild symptoms of Sugar and carbs intolerance 21 – 30 = Moderate symptoms of Sugar and carbs intolerance 31 and above Sever symptoms of Sugar and carbs intolerance
If you are concern about your symptoms and are ready to address them personalize, nutritional evaluation and programs customized to your health needs are available. To schedule your appointment, contact our office at (214) 783-8721 or e-mail: info@womananew.com
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