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Pyroluria Questionaire
   Check if anwser is YES
__ 1. When you were young, did you sunburn easily? Do you have fair or pale skin?
__ 2. Do you have a reduced amount of head hair, eyebrows, or eyelashes, or do youhave prematurely gray hair?
__ 3. Do you have poor dream recall or nightmares?
__ 4. Are you becoming more of a loner as you age? Do you avoid outside stressbecause it upsets your emotional balance?
__ 5. Have you been anxious, fearful, or felt a lot of inner tension since childhood but mostly hide these inner feelings from
   others?
__ 6. Is it hard to clearly recall past events and people in your life?
__ 7. Do you have bouts of depression and/or nervous exhaustion?
__ 8. Do you have cluster headaches?
__ 9. Are your eyes sensitive to sunlight?
__ 10, Do you belong to an all-girl family, or have look-alike sisters?
__ 11. Do you get frequent colds or infections, or unexplained chills or fevers?
__ 12. Do you dislike eating protein? Have you ever been a vegetarian?
__ 13. Did you reach puberty later than normal?
__ 14. Are there white spots/flecks on your fingernails, or do you have opaquely or paper-thin nails?
__ 15. Are you prone to acne, eczema, or psoriasis?
__ 16. Do you prefer the company of one or two close friends rather than a gathering of friends?
__ 17. Do you have stretch marks on your skin?
__ 18. Have you noticed a sweet smell (fruity odor) to your breath or sweat when ill or stressed?
__ 19. Do you have or did you have, before braces crowded upper front teeth?
__ 20. Do you prefer not to eat breakfast, or even experience light nausea in themorning?
__ 21. Does your face sometimes look swollen while under a lot of stress?
__ 22. Do you have a poor appetite, or a poor sense of smell or taste?
__ 23. Do you have any upper abdominal, splenic pain? As a child, did you get a "twitch" in your side when you ran?
__ 24. Do you tend to focus internally (on yourself) rather than on the external world?
__ 25. Do you frequently experience fatigue?
__ 26. Do you feel uncomfortable with strangers?
__ 27. Do your knees crack or ache?
__ 28. Do you overreact to tranquilizers, barbiturates, alcohol, or other drugs? does a little produce a powerful response?
__ 29. Does it bother you to be seated in a restaurant in the middle of the room?
__ 30. Are you anemic?
__ 31. Do you have cold hands and/or feet?
__ 32. Are you easily upset (internally) by criticism?
__ 33. Do you have a tendency toward morning constipation?
__ 34. Do you have tingling sensations or muscle spasms in your legs or arms?
__ 35. Do changes in your routine (traveling, new situations) provoke stress?
__ 36. Do you tend to become dependent on one person whom you build your life around?
   Yes Score____
   If you scored 15 or more, it would be worth your while to be tested for pyroluria

   Contact Information
   Direct Healthcare Access II Inc.
   sommerfed@aol.com
   350 W Kensington Road Suite 107 Mount Prospect IL. 60056
   Phone 847-222-9546
   Fax 847-222-9547

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Kryptopyrrole Health Questionaire to define Nutritional Needs

  • 1. Pyroluria Questionaire Check if anwser is YES __ 1. When you were young, did you sunburn easily? Do you have fair or pale skin? __ 2. Do you have a reduced amount of head hair, eyebrows, or eyelashes, or do youhave prematurely gray hair? __ 3. Do you have poor dream recall or nightmares? __ 4. Are you becoming more of a loner as you age? Do you avoid outside stressbecause it upsets your emotional balance? __ 5. Have you been anxious, fearful, or felt a lot of inner tension since childhood but mostly hide these inner feelings from others? __ 6. Is it hard to clearly recall past events and people in your life? __ 7. Do you have bouts of depression and/or nervous exhaustion? __ 8. Do you have cluster headaches? __ 9. Are your eyes sensitive to sunlight? __ 10, Do you belong to an all-girl family, or have look-alike sisters? __ 11. Do you get frequent colds or infections, or unexplained chills or fevers? __ 12. Do you dislike eating protein? Have you ever been a vegetarian? __ 13. Did you reach puberty later than normal? __ 14. Are there white spots/flecks on your fingernails, or do you have opaquely or paper-thin nails? __ 15. Are you prone to acne, eczema, or psoriasis? __ 16. Do you prefer the company of one or two close friends rather than a gathering of friends? __ 17. Do you have stretch marks on your skin? __ 18. Have you noticed a sweet smell (fruity odor) to your breath or sweat when ill or stressed? __ 19. Do you have or did you have, before braces crowded upper front teeth? __ 20. Do you prefer not to eat breakfast, or even experience light nausea in themorning? __ 21. Does your face sometimes look swollen while under a lot of stress? __ 22. Do you have a poor appetite, or a poor sense of smell or taste? __ 23. Do you have any upper abdominal, splenic pain? As a child, did you get a "twitch" in your side when you ran? __ 24. Do you tend to focus internally (on yourself) rather than on the external world? __ 25. Do you frequently experience fatigue? __ 26. Do you feel uncomfortable with strangers? __ 27. Do your knees crack or ache? __ 28. Do you overreact to tranquilizers, barbiturates, alcohol, or other drugs? does a little produce a powerful response? __ 29. Does it bother you to be seated in a restaurant in the middle of the room? __ 30. Are you anemic? __ 31. Do you have cold hands and/or feet? __ 32. Are you easily upset (internally) by criticism? __ 33. Do you have a tendency toward morning constipation? __ 34. Do you have tingling sensations or muscle spasms in your legs or arms? __ 35. Do changes in your routine (traveling, new situations) provoke stress? __ 36. Do you tend to become dependent on one person whom you build your life around? Yes Score____ If you scored 15 or more, it would be worth your while to be tested for pyroluria Contact Information Direct Healthcare Access II Inc. sommerfed@aol.com 350 W Kensington Road Suite 107 Mount Prospect IL. 60056 Phone 847-222-9546 Fax 847-222-9547