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POINT SCALE

0 = Never or almost never have the symptom

1 = Occasionally have it, effect is not severe

2 = Occasionally have, effect is severe

3 = Frequently have it, effect is not severe

4 = Frequently have it, effect is severe

5E Tox Quiz-new
DIGESTIVE TRACT

1. Nausea or vomiting*

2. Diarrhea or loose stool*

3. Constipation*

4. Bloated feeling*

5. Belching/passing gas through anus*

6. Heartburn*

7. Intestinal/Stomach pain*

HEART

1. Irregular or skipped heartbeat*

2. Rapid or pounding heartbeat*

3. Chest pain*

JOINTS/MUSCLES

1. Pain or aches in joints*

2. Arthritis*

3. Stiffness or limitation of movement*

4. Pain or aches in muscles*

5. Feeling of weakness or tiredness*

LUNGS

1. Chest congestion*

2. Asthma, bronchitis*

3. Shortness of breath*

4. Difficult breathing*

MIND

1. Poor memory*

2. Confusion, poor comprehension*

3. Poor concentration*

4. Poor physical coordination*

5. Difficulty in making decisions*

6. Stuttering or stammering*

7. Slurred speech*

8. Learning disabilities*

MOUTH/THROAT

1. Chronic coughing*

2. Gagging, frequent need to clear throat*

3. Sore throat, hoarseness, loss of voice*

4. Swollen/discolored tongue, gum, lips*

5. Mouth Ulcer*

NOSE

1. Stuffy nose*

2. Sinus problems*

3. Hay fever*

4. Sneezing attacks*

5. Excessive mucus formation*

EARS

1. Itchy ears*

2. Earaches, ear infections*

3. Drainage from ear*

4. Ringing in ears*

5. Hearing loss*

HEAD

1. Headaches*

2. Faintness*

3. Dizziness*

4. Insomnia*

EMOTIONS

1. Mood swings*

2. Anxiety, fear or nervousness*

3. Anger, irritability, or aggressiveness*

4. Depression*

ENERGY/ACTIVITY

1. Fatigue, sluggishness*

2. Apathy, lethargy*

3. Hyperactivity*

4. Restlessness*

EYES

1. Watery or itchy eyes*

2. Swollen, reddened or sticky eyelids*

3. Bags or dark circles under eyes*

4. Blurred or tunnel vision (does not include near-or far-sightedness)*

SKIN

1. Acne*

2. Hives, rashes, or dry skin*

3. Hair loss*

4. Flushing or hot flushes*

5. Excessive sweating*

WEIGHT

1. Binge eating/drinking*

2. Craving certain foods*

3. Excessive weight*

4. Compulsive eating*

5. Water retention*

6. Underweight*

OTHER

1. Frequent illness*

2. Frequent or urgent urination*

3. Genital itch or discharge*