Is My Colon Toxic Questionnaire

Listed in this questionnaire are symptoms. Your answer comes up at the top of the page when you have finished.

A= symptom never occurs

B= symptom occurs often

C= symptom occurs occasionally

D= symptom occurs most of the time

Name	B	C	D
1.Unable to Mentally Focus?	5	3	8
2.Feeling Blocked?	5	3	8
3.Night Sweats?	5	3	8
4.Feeling Depressed?	5	3	8
5.Bouts of Feeling Unwell?	5	3	8
6.Lazy Bowel?	5	3	8
7.Diarrhea Alternating With Constipation?	5	3	8
8.Thinning or Loss of Hair?	5	3	8
9.Food Sensitivities	5	3	8
10.Body Aches and Pain?	5	3	8
11.Suffer With Allergies	5	3	8
12.Diarrhea?	5	3	8
13.Bad Breath?	5	3	8
14.Overall Body Odor?	5	3	8
15.Excessive Smelly Fatulence	5	3	8
16.Abdominal Bloating//Tenderness?	5	3	8
17.Skin Problems Dry/Acne?	5	3	8
18.Foggy Brain?	5	3	8
19.Fluctuations in Weight ?	5	3	8
20.Problems Sleeping?	5	3	8
21.Stomach Feels Bloated?	5	3	8
22.Yeast/Fungus Infections	5	3	8
23.Passing Smelly Poo?	5	3	8
24.Abdominal Pain?	5	3	8
25.Low Energy/Fatigued	5	3	8
26.Feeling Sluggish?	5	3	8
27.Unexplained Headaches	5	3	8
28.Low Blood Pressure?	5	3	8
29.Painful Spasms and Stomach Cramping?	5	3	8
30.Low Energy?	5	3	8