Wellness Assessment

Understand Your Stress Response

This assessment identifies your unique stress pattern and recommends targeted nutritional support tailored to your biology.

0 = Never true1 = Seldom true2 = Sometimes true3 = Often true

Section A

Sympathetic Arousal & Physical Stress Signs

/45

1.Get wound up when I get tired and have trouble calming down

2.Feel driven, appear energetic but feel "burned out" and exhausted

3.Feel restless, agitated, anxious, and uneasy

4.Feel easily overwhelmed by emotion

5.Feel emotional — cry easily or laugh inappropriately

6.Experience heart palpitations or a pounding in my chest

7.Am short of breath

8.Am constipated

9.Feel warm, over-heated, and dry all over

10.Get mouth sores or sore tongue

11.Get hot flashes

12.Sleep less than seven hours a night

13.Have trouble falling asleep and staying asleep

14.Worry about high blood pressure, cholesterol, and triglycerides

15.Forget to eat and feel little hunger

Section A Score0 /45

Section B

Anxiety, Worry & Cognitive Overload

/30

1.Find myself worrying about things big and small

2.Feel like I can't stop worrying, even though I want to

3.Feel impulsive, pent up, and ready to explode

4.Get muscle spasms

5.Feel aggressive, unyielding, or inflexible when pressed for time

6.See, hear, and smell things that others do not

7.Stay awake replaying the events of the day or planning for tomorrow

8.Have upsetting thoughts or images enter my mind again and again

9.Have a hard time stopping myself from doing things again and again like checking on things or rearranging objects over and over

10.Worry a lot about terrible things that could happen if I'm not careful

Section B Score0 /30

Section C

Physical Pain & Adrenal Signs

/30

1.Have muscle and joint pains

2.Have muscle weakness

3.Crave salt or salty things

4.Have multiple points on my body that when touched are tender or painful

5.Have dark circles under my eyes

6.Feel a sudden sense of anxiety when I get hungry

7.Use medications to manage pain

8.Get dizzy when rising or standing up from a kneeling or sitting position

9.Have diarrhea or bouts of nausea with or without vomiting for no apparent reason

10.Have headaches

Section C Score0 /30

Section D

Mental Fatigue & Cognitive Decline

/30

1.Have trouble organizing my thoughts

2.Get easily distracted and lose focus

3.Have difficulty making decisions and mistrust my judgment

4.Feel depressed and apathetic

5.Lack the motivation and energy to stay on task and pay attention

6.Am forgetful

7.Feel unsettled, restless, and anxious

8.Wake up tired and unrefreshed

9.Experience heartburn and indigestion

10.Catch colds or infections easily

Section D Score0 /30

Section E

Energy Depletion & Physical Fatigue

/45

1.Feel tired for no apparent reason

2.Experience lingering mild fatigue after exertion or physical activity

3.Find it difficult to concentrate and complete tasks

4.Feel depressed and apathetic

5.Feel cold or chilled – hands, feet, or all over – for no apparent reason

6.Have little or no interest in sex

7.Sweat spontaneously during the day

8.Feel puffy and retain fluids

9.Sleep more than nine hours a night

10.Have poor muscle tone

11.Have trouble losing weight

12.Wake up tired even though I seem to get plenty of sleep

13.Have no energy and feel physically weak

14.Am susceptible to colds and the flu

15.Feel dragged down by multiple symptoms, such as poor digestion and body aches

Section E Score0 /45

60 questions remaining