Do you have Adrenal Fatigue? (Questionnaire)

Adrenal Stress Indicator

Write the number “1” beside symptoms you have had in the past; “2” beside symptoms that occur occasionally; “3” beside symptoms that occur often; “4” beside symptoms that occur frequently.

 Add up the total score.

 ___ Blurred vision/spots in front of eyes

___ Hormonal imbalances (i.e. thyroid problems)

___ History of asthma/bronchitis

___ Prolonged exposure to stress (job, family, illness, care giving)

___ Environmental or chemical exposure or sensitivities

___ Hypoglycemia/blood sugar problems – Mood swings

___ Poor concentration/memory problems (Alzheimer’s disease)

___ Low energy, excessive fatigue

___ Easily overwhelmed, inability to handle stress

___ Post-exertion fatigue

___ Dizziness upon standing (or fainting)

___ Inflammatory conditions (Arthritis, bursitis)

___ Nervousness/anxiety, depression, irritability or anger

___ Shortness of breath/yawning (air hunger)

___ Cold hands or feet

___ Low back pain, knee problems, sore muscles

___ Insomnia/frequent waking

___ Excessive urination

___ Excessive perspiration or No perspiration

___ Heart palpitations

___ Edema of extremities or general edema

___ Eyes light-sensitive

___ Cravings: sugar, salt or coffee and other stimulants

___ Alcohol intolerance

___ Recurrent colds or infections

___ Digestive problems, Ulcers

___ Weight gain or Weight loss

___ High or low blood pressure

• Between 30 and 50, you’ve received an early-warning indicator that your adrenals are starting to weaken

• Between 50 and 80 – start with adrenal support such as AdrenaSense®

• Between 80 and 100 – your adrenal glands are taxed so you might want to take an adrenal glandular with your AdrenaSense®

• Over 100 – you are suffering from adrenal exhaustion and will require long-term adrenal support.