Stress & Adrenal Quiz Section 2

Stress & Adrenals Quiz Section 2

Hidden
Name
First Last
Hidden
Email
Hidden
At which Revitalize Health location are you a patient?
- Sugar Land
- The Woodlands
I experience long periods of stress that affect my well-being*
Never Occasionally Often Always
I experience severely stressful events that affect my well-being*
Never Occasionally Often Always
I drive myself to physical or mental exhaustion*
Never Occasionally Often Always
My ability to handle stress or pressure is decreased*
Never Occasionally Often Always
I am less productive at work*
Never Occasionally Often Always
I have decreased cognitive ability; I don't think as clearly as I used to.*
Never Occasionally Often Always
I have to force myself to accomplish tasks; everything seems like a chore.*
Never Occasionally Often Always
I tire easily*
Never Occasionally Often Always
I feel fatigued rather than energetic*
Never Occasionally Often Always
I feel like I am working harder and harder but accomplishing less*
Never Occasionally Often Always
I forget appointments, deadlines, or personal possessions*
Never Occasionally Often Always
I don't have an appetite in the morning*
Never Occasionally Often Always
I need coffee or some other stimulant to get going in the morning*
Never Occasionally Often Always
I often crave salt and/or foods high in salt; I like salty foods*
Never Occasionally Often Always
My energy and motivation are low during the first hour after waking*
Never Occasionally Often Always
I feel worse if I eat high potassium foods (like bananas, figs, and raw potatoes), especially if I eat them in the morning*
Never Occasionally Often Always
I crave high protein foods, like meats and cheeses*
Never Occasionally Often Always
I crave sweet foods, like pies, cakes, pastries, donuts, candies, and desserts*
Never Occasionally Often Always
I am more irritable*
Never Occasionally Often Always
I experience increased complaints, such as aches, pains, headaches, or lingering colds*
Never Occasionally Often Always
I have difficulty getting up in the morning; I really don't wake up until about 10:00 AM*
Never Occasionally Often Always
I have an energy crash 1-3 hours after eating carbohydrates*
Never Occasionally Often Always
I often have an afternoon low between 3:00-5:00 PM*
Never Occasionally Often Always
I suddenly run out of energy*
Never Occasionally Often Always
I experience fatigue easily*
Never Occasionally Often Always
I feel weak all over*
Never Occasionally Often Always
I get light-headed or dizzy when rising rapidly from a sitting or lying position*
Never Occasionally Often Always
I am chronically fatigued--a tiredness that is not usually relieved by sleep*
Never Occasionally Often Always
I notice that my ankles are swollen and the swelling is worse in the evening*
Never Occasionally Often Always
I feel like sex is more trouble than it's worth*
Never Occasionally Often Always
I feel like my sex drive is noticeably less than it used to be*
Never Occasionally Often Always
I have insomnia or difficulty sleeping and/or insomnia*
Never Occasionally Often Always
I get coughs/colds that stay around for several weeks*
Never Occasionally Often Always
I have frequent, recurring bronchitis or pneumonia*
Never Occasionally Often Always
I have extended, severe, or recurring respiratory infections*
Never Occasionally Often Always
I have taken long-term or intense steroid therapy (corticosteroids)*
Never Occasionally Often Always