Stress and Dehydration and The Effect on Health

Size: px
Start display at page:

Download "Stress and Dehydration and The Effect on Health"

Transcription

1 Stress and Dehydration and The Effect on Health Stress and adrenal fatigue affect the quality of life in the 21st Century - help your clients recover their energy, immune resistance and vitality.

2 The Adrenal Glands Small endocrine glands that sit on top of the kidneys Chiefly responsible for releasing hormones in conjunction with stress, including cortisol involved in sugar regulation and inflammation, and adrenaline which is involved in fight-or-flight. The adrenals also produce hormones such as testosterone and eostrogen (androgens) so are important, for instance, for menopausal women when the ovaries stop producing eostrogen. DHEA (dehydroepiandosterone) levels fall (this hormone is thought to affect metabolism, moods, heart function, skin tone and regulation of other androgens). DHEA is often used as a measure to indicate adrenal function.

3

4 Adrenal Fatigue

5 Where does Stress come from? Emotional relationships, trauma Physical poor diet, pain, dehydration, lack of exercise Spiritual is this all there is to life? Job or finance-related is redundancy round the corner, can I afford to retire?

6 Maladaptive Stress Syndrome

7 Stage One Alarm response Increased cortisol production. Nervous or agitated Tends to be situational once you can relax again, cortisol levels come back down Fatigue is usually mild and occurs on waking or in mid-afternoon.

8 Stage Two Resistance response Chronic or severe stress Fatigue is pronounced at the end of the day and harder to recover from Anxiety and insomnia are common PMS and symptoms suggestive of hypothryoidism (feeling cold, sluggish metabolism, weight gain) become prevalent

9 Stage Three Adrenal exhaustion Adrenals no longer able to keep up with everincreasing demand for cortisol production to overcome stress and they become exhausted Primary goal is to ensure survival, body starts to break down tissue to produce energy Chronic fatigue common, fibromyalgia, brain fog

10 Chronic Stress affects your Health Breaks down the body s defence mechanisms Leaves the body vulnerable to infections, allergies and more serious conditions such as cancer and diabetes Can increase blood pressure and risk of stroke or heart attack Can result in chronic fatigue, digestive problems such as Irritable Bowel Syndrome, headaches, back pain. Affects the endocrine system PMS, PCOS, fertility, menopause symptoms

11 How do you know if your adrenals are fatigued? Difficulty getting up in the morning Fatigue not relieved by sleep Craving for salt or salty foods Lethargy Decreased sex drive Decreased ability to handle stress Takes longer to recover from illness or injury Light-headed when standing up quickly Mild depression Less enjoyment or happiness with life Increased PMS Symptoms increase if meals are skipped or inadequate Thoughts less focused and memory less accurate

12 Dehydration and Stress Drinks with diuretic effects such as tea, coffee, fizzy drinks, alcohol Commuting, air travel Environmental computers, mobile phones, pollution, additives and chemicals in food, traffic fumes Medication and recreational drugs Digestive disorders, ie candidiasis

13 How to support the adrenals Eat little and often to balance blood sugar levels Combine fats, protein and carbs at very meal Consider digestive enzymes for low HCl Stay away from junk food Look at your lifestyle and relationships Meditation and deep breathing Regular exercise Drink plenty of good quality water and avoid caffeine and alcohol Consider food allergies and sensitivities Correct supplementation

14 How do colonics help? Rehydrates the bowel and improves transit time Removes pathogenic bacteria and waste products from the colon, giving the good bacteria a better environment in which to live. Lowers toxic burden on the liver Antidote to stress client focuses on their health

15 Case Study 37 year old women with constipation bowel movement every three or four days. Bloating and flatulence Fatigue Sugar cravings Skin problems Miscarriage two years ago and unable to get pregnant since Had three colonics, nutritional assessment, live blood analysis and twelve weeks later, energy returned, bowel movements daily, digestive issues resolve, and now pregnant.

16

HORMONE QUIZ Time to get clear about your symptoms

HORMONE QUIZ Time to get clear about your symptoms HORMONE QUIZ Time to get clear about your symptoms WHAT SYMPTOMS ARE YOU EXPERIENCING? Follow the instructions in each of the 4 categories, count your scores, discover how to interpret your symptoms and

More information

Stress: How It Affects You and What You Can Do About It. Andreas Schwerte, O.M.D., L.Ac

Stress: How It Affects You and What You Can Do About It. Andreas Schwerte, O.M.D., L.Ac Stress: How It Affects You and What You Can Do About It Andreas Schwerte, O.M.D., L.Ac Outline Pillars of Health What is Stress? Causes of Stress (Stressors) Effects of Sustained Stress What Can You Do?

More information

HORMONE QUIZ Time to get clear about your symptoms

HORMONE QUIZ Time to get clear about your symptoms HORMONE QUIZ Time to get clear about your symptoms WHAT SYMPTOMS ARE YOU EXPERIENCING? Follow the instructions in each of the 4 categories, count your scores, discover how to interpret your symptoms and

More information

Beat. Adrenal Fatigue Naturally!

Beat. Adrenal Fatigue Naturally! Beat Adrenal Fatigue Naturally! What is Adrenal Fatigue? Before we dive into adrenal fatigue, let s first start with the adrenal glands. The adrenal glands are glands that sit on top of the kidneys. They

More information

Hormone Evaluation Quiz

Hormone Evaluation Quiz Hormone Evaluation Quiz confusion & frustration understanding & empowerment Find Your FLO! Ø Follow the instructions in each of the 4 categories Ø Tally up your results Ø Discover how to interpret your

More information

What causes adrenal fatigue?

What causes adrenal fatigue? What is adrenal fatigue (also known as adrenal insufficiency, adrenal burn-out or hypoadrenia)? Adrenal fatigue occurs when the adrenal glands, situated above the kidneys, become overworked or damaged,

More information

INSOMNIA: WHERE DOES IT START?

INSOMNIA: WHERE DOES IT START? INSOMNIA: WHERE DOES IT START? One in three adults will experience insomnia at some point in their lives. We lie awake worrying over financial or relationship issues, studying the roof of our bedrooms,

More information

Symptoms of low blood sugar:

Symptoms of low blood sugar: One of the liver s functions is to be sure that your blood has enough sugar in it. Your brain requires an exact amount of sugar (known as glucose). If you have too much sugar in the blood, your pancreas

More information

Free Report: How Your Hormones Can Make You Overweight and Miserable

Free Report: How Your Hormones Can Make You Overweight and Miserable Free Report: How Your Hormones Can Make You Overweight and Miserable 39111 Six Mile Road Suite 160 Livonia, MI 48152 (734) 769-1650 HOW YOUR HORMONES CAN MAKE YOU OVERWEIGHT AND MISERABLE This report explains

More information

The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the bod

The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the bod The Players Part II The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the body Can affect all hormone systems

More information

Hormone. for Women. Dr. Melanie MacIver, ND

Hormone. for Women. Dr. Melanie MacIver, ND Hormone Balancing for Women Dr. Melanie MacIver, ND Topics About hormones Benefits of balanced hormones Causes of hormone imbalance Bio-identical hormones Lifestyle and nutrition tips for balance Hormone

More information

Living with Stress. Choices to help your Boarding School Life.

Living with Stress. Choices to help your Boarding School Life. Living with Stress Choices to help your Boarding School Life. STRESS: Stress is defined as an organism's total response to environmental demands or pressures. Can be a normal response, or more commonly

More information

Adrenal fatigue treatment: The Kalish Method in Australia

Adrenal fatigue treatment: The Kalish Method in Australia The Kalish Method in Australia Naturimedica.com Copy right Naturimedica Ever since completing my training with Dr Dan Kalish in 2011, I utilise his adrenal fatigue treatment method in my practice on a

More information

Metabolic Assessment Form

Metabolic Assessment Form Metabolic Assessment Form Approach Wellness and Aesthetics 200 Forsythe Street Fayetteville, NC 28303 Office: (910) 322-7368 Fax: (910) 483-5796 www.tawellness.net Name: Age: Sex: Date: Part 1: Please

More information

HORMONAL LEVELS SELF TEST. Date Full Name No.

HORMONAL LEVELS SELF TEST. Date Full Name No. HORMONAL LEVELS SELF TEST Date Full Name No. This self-test to help your doctor if your levels of hormones are below normal. Circle the score for each line then total the score at the bottom of each hormone.

More information

ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE AND FINANCIAL POLICY

ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE AND FINANCIAL POLICY Patient Information: Name: Date of Birth: Social Security #: Gender: Marital Status: Primary Address: City: State: Zip Code: Please put a check mark next to any phone number that we may leave a message

More information

Featured Topic: Adrenal Burnout (7 slides)

Featured Topic: Adrenal Burnout (7 slides) Featured Topic: Adrenal Burnout (7 slides) A Few Signs Your Adrenals Need Help Sleep: awake at midnight or after Crave salt or sugar Generally exhausted after exercising Intolerant of cold Low blood pressure

More information

Stress and Fatigue Management. Kalvin Smith

Stress and Fatigue Management. Kalvin Smith Stress and Fatigue Management Kalvin Smith 2015 - www.kalvinsmith.com BREATHE! Breathe Move Relax What is Stress? Stress is your body's way of responding to any kind of demand or threat. When threatened,

More information

Wellness on the Mountain ~UR Healing Connection Today's Date Name

Wellness on the Mountain ~UR Healing Connection Today's Date Name Wellness on the Mountain ~UR Healing Connection Today's Date Name Date of Birth Occupation Address Hours worked in week: Email Address Is this a good method of contact? Yes No Telephone May I add you to

More information

Accession #: Patient: Jane Doe Convert to pdf, Save or PRINT >> ADRENAL CHECK

Accession #: Patient: Jane Doe Convert to pdf, Save or PRINT >> ADRENAL CHECK Page 1 of 5 Patient: Jane Doe Tel: (123) 456-7890 Email: test@test.com Sex: Female Age: 36 yr Date of Birth: 1980-12-12 Height: 5 ft 0 in Weight: 135 lbs Waist size: 30 in 1st day of last menses: Day 07,

More information

Messer Chiropractic Amanda L. Messer, D.C E. Interstate Ave #21

Messer Chiropractic Amanda L. Messer, D.C E. Interstate Ave #21 Are Your Hormones Balanced? Would you believe any of the symptoms of estrogen dominance (yellow sheet) and any of the symptoms of chronic fatigue/adrenal fatigue/fibromyalgia (green sheet) and any the

More information

Stress is like an iceberg. We can see one-eighth of it above, but what about what s below?

Stress is like an iceberg. We can see one-eighth of it above, but what about what s below? Chapter 4: Managing Stress & Coping With Loss Stress is like an iceberg. We can see one-eighth of it above, but what about what s below? Something to consider... The Japanese eat very little fat &... The

More information

Tobacco Cessation Toolkit

Tobacco Cessation Toolkit You notice physical s, like moments of dizziness, sweating, hands trembling or a mild headache. When using tobacco, nicotine increases your heart rate (by about 10 20 beats per minute) and blood pressure.

More information

Notes: 43% of all adults suffer adverse health effects due to stress. 75%-90% of all medical visits are in some way related to stress.

Notes: 43% of all adults suffer adverse health effects due to stress. 75%-90% of all medical visits are in some way related to stress. Stress is an unavoidable part of our daily lives. A certain amount of stress is actually necessary for our survival; however, the amount of stress most people are under these days is causing more harm

More information

My energy is lower than I would like it to. I feel exhausted after exercising or physical activity.

My energy is lower than I would like it to. I feel exhausted after exercising or physical activity. SYMPTOMS Questionnaire Duplicate your answer across all of the 5 boxes that aren t blocked out. See example ENERGY My energy is lower than I would like it to be. I feel exhausted after exercising or physical

More information

FIBROMYALGIA. Raj Saini Greenbrook Pharmacy

FIBROMYALGIA. Raj Saini Greenbrook Pharmacy FIBROMYALGIA Raj Saini Greenbrook Pharmacy www.greenrx.ca 519-742-9955 OBJECTIVES Introduction Causes/Symptoms/Diagnosis Stress, Hormonal Balance & Fibromyalgia Treatment-Pharmaceutical Treatment-Natural

More information

You re NOT Losing Your Mind You ARE Losing Your Hormones!

You re NOT Losing Your Mind You ARE Losing Your Hormones! 3522 Kaliste Saloom, Lafayette, La. 70508 www.whatshealth.com (337)989-0572 You re NOT Losing Your Mind You ARE Losing Your Hormones! 80+ WARNING Signs Your Hormones are out of Balance By Marie Pace, DNM,

More information

Stress. Chapter Ten McGraw-Hill Higher Education. All rights reserved.

Stress. Chapter Ten McGraw-Hill Higher Education. All rights reserved. Stress Chapter Ten What Is Stress? } Stress is the collective physiological and emotional responses to any stimulus that disturbs an individual s homeostasis } A stressor is any physical or psychological

More information

METABOLIC ASSESSMENT FORM

METABOLIC ASSESSMENT FORM METABOLIC ASSESSMENT FORM Name: Age: Sex: Date: PART 1 Please list the 5 major health concerns in your order of importance: 1. 2. 3. 4. 5. PART 2 Please circle the appropriate number 0-3 on all questions

More information

GET YOUR GLOW CHALLENGE Hormone Balancing

GET YOUR GLOW CHALLENGE Hormone Balancing GET YOUR GLOW CHALLENGE Hormone Balancing HORMONE BALANCING - INTRODUCTION Hormones can be defined as chemical substances secreted by cells into the extracellular fluids and regulate the metabolic activity

More information

Here are some amazing exercise options to get you started...

Here are some amazing exercise options to get you started... Exercises Choose a vigorous exercise to do 3-4 times per week and more mild exercises 2-3 times per week. Make sure to get 1 day of TOTAL rest per week. I recommend you wake up and exercise before starting

More information

Natural and Integrative Care for PCOS

Natural and Integrative Care for PCOS Natural and Integrative Care for PCOS Maureen Kelly, M.D. Medical Director Society Hill Reproductive Medicine CoFounder The Wellnest 822 Pine Street, Suite 4B, Philadelphia, PA Natural and Integrative:

More information

Sleep, Stress, and Fatigue

Sleep, Stress, and Fatigue Sleep, Stress, and Fatigue Central Washington University E.A.S.E. Cancer Foundation Tim Burnham Ph.D. Interrelated Stress Sleep disturbance Fatigue Stress Stress is YOUR response to a situation Stressor:

More information

Benefits of Exercise. Cambridgeshire and Peterborough Falls Prevention Services

Benefits of Exercise. Cambridgeshire and Peterborough Falls Prevention Services Benefits of Exercise Cambridgeshire and Peterborough Falls Prevention Services CHANGE BEHAVIOUR THE MORE ONE SITS USE IT OR LOSE IT Problem I have or want to avoid No energy Short of breath High Blood,

More information

during the cleanse BAD FATS... margarine, vegetable oil, partially hydrogenated oil, shortening, cooking spray, corn oil, canola oil, peanut oil

during the cleanse BAD FATS... margarine, vegetable oil, partially hydrogenated oil, shortening, cooking spray, corn oil, canola oil, peanut oil WITHDRAWAL GUIDE It s time to break up with the emotional crutches and artificial energy. Tap into your true energy! Foods and drinks with additives, stimulants and refined ingredients will drag your body

More information

Dr Cara Flamer GSH Medical 801 Eglinton Ave West, Suite 100 Toronto, ON

Dr Cara Flamer GSH Medical 801 Eglinton Ave West, Suite 100 Toronto, ON Dr Cara Flamer GSH Medical 801 Eglinton Ave West, Suite 100 Toronto, ON 416-789-2449 Date: Please fill out the following information for your chart profile, and bring it to your first visit (please remember

More information

Extreme Deficiency. Never. 1. I look older than I am I have trouble falling asleep at night

Extreme Deficiency. Never. 1. I look older than I am I have trouble falling asleep at night Test yourself for Melatonin Deficiency Melatonin Deficiency 1. I look older than I am 2. I have trouble falling asleep at night 3. I wake up during the night 4. and I can't get back to sleep 5. My mind

More information

Contents. Page. Can t sleep 3. Insomnia 4. Sleep 5. How long should we sleep? 8. Sleep problems 9. Getting a better night s sleep 11

Contents. Page. Can t sleep 3. Insomnia 4. Sleep 5. How long should we sleep? 8. Sleep problems 9. Getting a better night s sleep 11 I Cannot Sleep Contents Page Can t sleep 3 Insomnia 4 Sleep 5 How long should we sleep? 8 Sleep problems 9 Getting a better night s sleep 11 Treatment for insomnia 15 For more information 19 2 Can t sleep

More information

STRESS AND YOUR ADRENAL HEALTH

STRESS AND YOUR ADRENAL HEALTH STRESS AND YOUR ADRENAL HEALTH by Karen Jensen, (Retired ND) Scientists know that stress is a serious problem. Research conducted by the Center for Disease Control and Prevention indicates that up to 90%

More information

Rhythm Plus- Comprehensive Female Hormone Profile

Rhythm Plus- Comprehensive Female Hormone Profile Rhythm Plus- Comprehensive Female Hormone Profile Patient: SAMPLE REPORT DOB: Sex: F Order Number: K00000 Completed: Received: Collected: SAMPLE REPORT Sample # Progesterone (pg/ml) Hormone Results Oestradiol

More information

12 Signs of Adrenal Fatigue

12 Signs of Adrenal Fatigue 12 Signs of Adrenal Fatigue More or less every negative thing that happens to you contributes to adrenal fatigue. It could be a death, loss of a job, or some other major happening. The main issue, however,

More information

Stress 101. The Living Proof Institute

Stress 101. The Living Proof Institute Stress 101 The Living Proof Institute Add More Live To Your Life 9277 Centre Pointe Drive Suite 350 West Chester Ohio 45069 O: 513 785 0686 F: 877 426 0285 C: 513 728 0416 drpatel@thelivingproofinstitute.com

More information

STRESS AND THE HEALTH OF THE BODY

STRESS AND THE HEALTH OF THE BODY Slide 1 STRESS AND THE HEALTH OF THE BODY Slide 2 What is Stress It is a physical response that occurs in our body when we are stressed Physiologically, it is a series of actions in the body that are regulated

More information

Abdul R. Khan, MD LABORATORY DIRECTOR S. Pioneer Blvd Artesia, CA Tel: Fax: LABORATORY REPORT

Abdul R. Khan, MD LABORATORY DIRECTOR S. Pioneer Blvd Artesia, CA Tel: Fax: LABORATORY REPORT Patient Info: Name: DOB: Gender: Phone No: Collection Date: Received Date: Report Date: Age: Abdul R. Khan, MD LABORATORY DIRECTOR 18173 S. Pioneer Blvd Artesia, CA 90701 Tel: 562 924 2299 Fax: 562 924

More information

Last Name: First Name: Address: Apt/Unit #: City: State: Zip: Best Contact Phone Number: Date of Birth: Age: Profession:

Last Name: First Name: Address: Apt/Unit #: City: State: Zip: Best Contact Phone Number:   Date of Birth: Age: Profession: Health Profile Our 30/10 program is intended to help participants with their personal weight loss efforts. We are not a medical facility, and our staff cannot give you medical or psychological advice.

More information

Health & Nutrition to Boost your working life Becca Millar BSc BANT CNHC

Health & Nutrition to Boost your working life Becca Millar BSc BANT CNHC Health & Nutrition to Boost your working life Becca Millar BSc BANT CNHC Life is a journey - We are living in a time with greater longevity but more chronic disease Humans are not computers! We are not

More information

Medications/Supplements/Vitamins/Herbs currently taking regularly

Medications/Supplements/Vitamins/Herbs currently taking regularly Consultation Evaluation Name Date of birth E-mail address Phone # What is the main issue that brought you here? Primary Physician Health Insurance HMO?PPO? Last Paps Last Blood Tests Last Mammogram Social

More information

Addiction Food Revolution

Addiction Food Revolution Addiction Food Revolution Food for Recovery & A Happy Vibrant Life How to Implement a Pro-Recovery Diet Full Recovery Needs all 3 Legs The Missing Link The Body...The Bio-chemistry Bio-chemical Factors

More information

Reboot Your Energy. Presented by Jo Lichten, Ph.D., RDN CM12 5/23/ :00 AM - 12:30 PM

Reboot Your Energy. Presented by Jo Lichten, Ph.D., RDN CM12 5/23/ :00 AM - 12:30 PM May 22-25, 2016 Los Angeles Convention Center Los Angeles, California Reboot Your Energy Presented by Jo Lichten, Ph.D., RDN CM12 5/23/2016 11:00 AM - 12:30 PM The handouts and presentations attached are

More information

FACTSHEET F18 COPING WITH TIREDNESS

FACTSHEET F18 COPING WITH TIREDNESS COPING WITH TIREDNESS Many people with chest, heart and stroke conditions experience tiredness or fatigue. This factsheet explains some of the reasons why you might feel so tired. It also offers advice

More information

UNDERSTANDING PMS AND DIY ACTIVITIES FOR ITS MANAGEMENT

UNDERSTANDING PMS AND DIY ACTIVITIES FOR ITS MANAGEMENT UNDERSTANDING PMS AND DIY ACTIVITIES FOR ITS MANAGEMENT Premenstrual syndrome (PMS) is a condition that affects a woman s emotions, physical health, and behavior during certain days of the menstrual cycle,

More information

Therapeutic Cohort Results

Therapeutic Cohort Results Patient: JANE DOE DOB: December 31, 1968 Sex: F MRN: Order Number: Completed: February 26, 2016 Received: February 26, 2016 Collected: February 26, 2016 One Day Hormone Check - Salivary Profile Therapeutic

More information

Stress Transforming Tools that Recharge Your Energy and Accelerate Healing

Stress Transforming Tools that Recharge Your Energy and Accelerate Healing Stress ing Tools that Recharge Your Energy and Accelerate with Dr. Ritamarie Loscalzo Three 10 year studies concluded that emotional stress was more predictive of death from cancer and cardiovascular disease

More information

Metabolic Mastery Method

Metabolic Mastery Method Metabolic Mastery Method The Ayurvedic Approach To Burning Fat For Health And Energy Jacob Griscom Version 1.0 Why Practice the Metabolic Mastery Method? If you'd like to restore your body's ability to

More information

The Stress Response & The Relaxation Response. Living (Well!) with Gastroparesis Program Class 4

The Stress Response & The Relaxation Response. Living (Well!) with Gastroparesis Program Class 4 The Stress Response & The Relaxation Response Living (Well!) with Gastroparesis Program Class 4 Why is stress so important? How we think about, react to, and handle stress effects: digestive symptoms/gastroparesis

More information

Sleep History Questionnaire

Sleep History Questionnaire Sleep History Questionnaire Name: DOB: Phone: Date of Consultation: Consultation is requested by: Primary care provider: _ Preferred pharmacy: Chief complaint: Please tell us why you are here: How long

More information

Welcome! The Glandular System. Rachel Rauch. How the adrenal glands affect the thyroid, pancreas, pituitary, hypothalamus and sex hormones.

Welcome! The Glandular System. Rachel Rauch. How the adrenal glands affect the thyroid, pancreas, pituitary, hypothalamus and sex hormones. Welcome! The Glandular System How the adrenal glands affect the thyroid, pancreas, pituitary, hypothalamus and sex hormones. Rachel Rauch July 9 th, 2013 This NSPWebinar will begin at 11:00 am MDT A recording

More information

Welcome! Type in Your Questions! 7/9/2013. A recording of this webinar will be available at

Welcome! Type in Your Questions! 7/9/2013. A recording of this webinar will be available at Welcome! The Glandular System How the adrenal glands affect the thyroid, pancreas, pituitary, hypothalamus and sex hormones. Rachel Rauch July 9 th, 2013 This NSPWebinar will begin at 11:00 am MDT A recording

More information

One Day Hormone Check

One Day Hormone Check One Day Hormone Check Patient: EMILY TEST DOB: January 18, 1948 Sex: F MRN: 0000000004 Order Number: J5070009 Completed: March 07, 2014 Received: March 07, 2014 Collected: March 07, 2014 Alec Smart, ND

More information

HE 250 PERSONAL HEALTH. Stress

HE 250 PERSONAL HEALTH. Stress HE 250 PERSONAL HEALTH Stress Stress Stress General state of the body, mind, and emotions when an environmental stressor has triggered the stress response Stressor Events or agents in the environment that

More information

Sleep History Questionnaire. Sleep Disorders Center Duke University Medical Center. General Information. Age: Sex: F M (select one)

Sleep History Questionnaire. Sleep Disorders Center Duke University Medical Center. General Information. Age: Sex: F M (select one) Sleep History Questionnaire Sleep Disorders Center Duke University Medical Center Part I: General Information Name: Address: Date: Phone: Age: Sex: F M (select one) Education (years of school): Occupation:

More information

Exhausted No More! Carol Ebert Exhausted No More! Waking Up to New Science on Why You Can't Sleep and What You Can Do About It.

Exhausted No More! Carol Ebert Exhausted No More! Waking Up to New Science on Why You Can't Sleep and What You Can Do About It. Exhausted No More! Waking up to new science on why you can t sleep and what you can do about it Presented by Carol Ebert RN, BSN, MA, CHES, CWP Certified Wellness Practitioner Certified Wellness Coach

More information

CHEK NUTRITION AND LIFESTYLE QUESTIONNAIRES FOR HLC 1

CHEK NUTRITION AND LIFESTYLE QUESTIONNAIRES FOR HLC 1 Corrective Holistic Exercise Kinesiology CHEK Holistic Lifestyle Coach Level 1 CHEK NUTRITION AND LIFESTYLE QUESTIONNAIRES FOR HLC 1 You Are What You Eat 1. Do you shop less frequently than every four

More information

Physiotherapy Assessment (Condition > 4 weeks)

Physiotherapy Assessment (Condition > 4 weeks) Greg de Jong: Physiotherapist & Nutritionist 35 Beach Street Merimbula NSW 2548 Ph: 02 64951097 Fax: 02 64951397 Physiotherapy Assessment (Condition > 4 weeks) By accurately and in detail completing this

More information

Peak Performance through 4 elements of Wellbeing. Presented By: Athletic Mentors

Peak Performance through 4 elements of Wellbeing. Presented By: Athletic Mentors Peak Performance through 4 elements of Wellbeing Presented By: Athletic Mentors Corporate Wellness The Coached Gym Athletic Performance Functional Fitness Athletic Mentors Components of Good Physical Health

More information

Evolve180 / Ideal Northwest Health Profile

Evolve180 / Ideal Northwest Health Profile Evolve180 / Ideal Northwest Health Profile ABOUT YOU First Name: Last Name: Address: City: State: Zip: Phone: Email: Date of Birth: Age: Height: Occupation: How did you find out about our program? Marital

More information

Name: Date of birth: Address: City: State: Zip: Phone: (day) (evening): (cell): address: Occupation: Who referred you/how did you hear about us?

Name: Date of birth: Address: City: State: Zip: Phone: (day) (evening): (cell):  address: Occupation: Who referred you/how did you hear about us? Name: Date of birth: Address: City: State: Zip: Phone: (day) (evening): (cell): Email address: Occupation: Who referred you/how did you hear about us? Your primary health care provider: Phone: Emergency

More information

All nutrition appointments NOT given 24 hours notice of cancellation will incur a $50 charge.

All nutrition appointments NOT given 24 hours notice of cancellation will incur a $50 charge. Nutritional Counseling Food Sensitivity Testing Neurotransmitter Testing Hormone Testing Wellness & Prevention 111 O Fallon Commons Drive O Fallon, MO 63368 Phone: 636-978-0970 Fax: 636-978-7570 Dr. Olivia

More information

Therapeutic Cohort Results

Therapeutic Cohort Results Patient: SAMPLE PATIENT DOB: Sex: MRN: Menopause Plus - Salivary Profile Therapeutic Cohort Results Hormone Average Result QUINTILE DISTRIBUTION 1st 2nd 3rd 4th 5th Therapeutic Range* Estradiol (E2) 8.7

More information

Practitioner Mentorship

Practitioner Mentorship Practitioner Mentorship Module 7.2 Adrenal Gland Dysfunction & Lyme With Hillary Thing, MS, LAc., Cert. Herbalist 7.2: Adrenal Gland Dysfunction & Lyme Learning Objectives: Understand role of the adrenal

More information

PRNRX COMPOUNDING PHARMACY

PRNRX COMPOUNDING PHARMACY Female Patient Health History Form Complete the following form and mail to: PRNRx LLC, 17755 W. Liberty Lane, New Berlin, WI 53146 Or fax to: 1-855-957-7679 or email to: MichelleK@prnrx.com To provide

More information

Atrial Fibrillation. Lesser-known triggers. Lauren Martin MPH, BSN, RN Centra Stroobants Cardiology

Atrial Fibrillation. Lesser-known triggers. Lauren Martin MPH, BSN, RN Centra Stroobants Cardiology Atrial Lesser-known triggers Lauren Martin MPH, BSN, RN Centra Stroobants Cardiology Atrial An irregular, often rapid heart rate that commonly causes poor blood flow. Can increase the risk of stroke and

More information

New Client Health & Wellness Paper Work

New Client Health & Wellness Paper Work Nutritionally Yours Health Solutions 604 Macy Drive, Roswell GA 30076 678-372-2913 / alanepnd@gmail.com New Client Health & Wellness Paper Work Today's Date Patient Name: _ Parents Name (if patient is

More information

THE STRESS DETOX : TAKE BACK CONTROL OF YOUR LIFE

THE STRESS DETOX : TAKE BACK CONTROL OF YOUR LIFE THE STRESS DETOX : TAKE BACK CONTROL OF YOUR LIFE GET TO KNOW YOUR STRESS ON ONE SIDE OF YOUR NOTECARD 1. RATE YOUR STRESS: 1-10 (1 =HIGH, 10 =LOW) 3. RATE YOUR HANDLE ON STRESS: 1-10 (1 =HIGH, 10 =LOW)

More information

Neuroendocrine Evaluation

Neuroendocrine Evaluation Elizabeth Lee Vliet, M.D. Medical Director Neuroendocrine Evaluation When women have health concerns they usually prefer to discuss them with another woman. Dr. Vliet is a national expert on hormone-related

More information

One Day Hormone Check

One Day Hormone Check One Day Hormone Check DOB: Sex: F MRN: Order Number: Completed: Received: Collected: Salivary Hormone Results Estradiol pmol/l >3330.0 Testosterone pmol/l

More information

STRESS MANAGEMENT 101

STRESS MANAGEMENT 101 STRESS MANAGEMENT 101 Lois Coleman, MS, CHES July 15, 2013 at 3:30 PM PRESENTATION OUTLINE What is stress? What is a stressor? How does the body respond to stress? What can I do to manage stress? DID YOU

More information

Metabolic Hormones Assessment

Metabolic Hormones Assessment Metabolic Hormones Assessment (Insulin, Cortisol, Digestion, Adrenals, Thyroxin, Fatty Liver, Melatonin, & Leptin) Identify the metabolic hormones or conditions that contributes to your sluggish metabolism.

More information

Health History Questionnaire. Age Date of Birth Gender. Married Single Separated Divorced Widowed Partnership

Health History Questionnaire. Age Date of Birth Gender. Married Single Separated Divorced Widowed Partnership Health History Questionnaire Name Date Age Date of Birth Gender Married Single Separated Divorced Widowed Partnership Live with: Spouse Partner Parents Children Friends Alone Please complete these next

More information

What is Estrogen Dominance? What Causes Estrogen Dominance?

What is Estrogen Dominance? What Causes Estrogen Dominance? Hormonal imbalances can trigger monthly pain and bloating, impede our sleep and wreck havoc on our energy, moods and fertility. When looking to balance our hormones, the key players are Estrogen and Progesterone.

More information

Cortisol has a bad reputation.

Cortisol has a bad reputation. This stress hormone is essential for energy and health, but when it s out of balance, you are, too. Learn how to manage to keep inflammation, cravings, and belly fat at bay. By Elizabeth Millard Cortisol

More information

Guide to CBD and Essential Oils for Stress Relief, Energy and Vitality

Guide to CBD and Essential Oils for Stress Relief, Energy and Vitality Guide to CBD and Essential Oils for Stress Relief, Energy and Vitality http://www.mindfulmomentum.org Hi, I m! I work with who are tired of hi, Hi, I m Christina. For years I was caught up in a busy cycle

More information

TEST REPORT # SB. Patient Name: Comprehensive Male Profile I Patient Phone Number: TEST NAME RESULTS 08/12/18 RANGE

TEST REPORT # SB. Patient Name: Comprehensive Male Profile I Patient Phone Number: TEST NAME RESULTS 08/12/18 RANGE TEST REPORT Ordering Provider: David Getuwell, MD 8605 SW Creekside Place Beaverton, OR 97008 Phone: 503-466-2445 Fax: 503-466-1636 Samples Received 08/15/2018 Report Date 08/20/2018 Samples Collected

More information

DO YOU HAVE ADRENAL FATIGUE?

DO YOU HAVE ADRENAL FATIGUE? John B. DeCosmo, DO, PA 4800 4 th Street North, Saint Petersburg, Florida 33703 (727) 498-6488, Fax: (727) 362-6772 drdecosmo@gmail.com DO YOU HAVE ADRENAL FATIGUE? A complete list of your current symptoms

More information

Adrenal Fatigue Questionnaire Dr. James L. Wilson*

Adrenal Fatigue Questionnaire Dr. James L. Wilson* This questionnaire was originally created and used by Dr. James L. Wilson in his practice and later published on page 61 in his book, Adrenal Fatigue: The 21 st Century Stress Syndrome. The author s permission

More information

What does stress do to the body?

What does stress do to the body? Stress is any reaction to a physical, emotional, psychological or environmental stimulus that triggers the release of adrenal hormones. Since our bodies prioritize a stress response over all other bodily

More information

First Name. Profession. Weight lbs. Weight 1 year ago lbs. Min. Adult Weight lbs. at age Maximum Weight lbs. at age

First Name. Profession. Weight lbs. Weight 1 year ago lbs. Min. Adult Weight lbs. at age Maximum Weight lbs. at age Date Time Dietary consultation involves a health profile whose purpose is not to establish a diagnosis, but rather to determine a client's health status in order to guide his or her weight loss plan. A

More information

Waccamaw Chiropractic & Wellness Center

Waccamaw Chiropractic & Wellness Center Waccamaw Chiropractic & Wellness Center Dr. John Evans Dr. Jeff Evans 658 Wachesaw Rd. Murrells Inlet, SC 29576 www. waccamawchiropractic.com (843)357-9617 Fax (843)357-9639 DO YOU HAVE ADRENAL FATIGUE?

More information

Male New Patient Questionnaire

Male New Patient Questionnaire Patient Demographics First Name: Middle: Last Name: Home Phone: Cell Phone: Email: Address: SSN: City: State: Zip: Age: Date of Birth: Referred by: Occupation: Primary Care Physician: Employer: Emergency

More information

Resources: 5/26/

Resources: 5/26/ Karen Kan, MD Holistic Physician & Acupuncturist #1 Amazon Bestseller Featured on PBS TV Featured on Biography TV Certified Emotion Code Practitioner *Body Code Practitioner (see brochure) Resources: Copy

More information

City: State: Zip: Age: Height: Current weight: Weight 6 months ago: Employer: Work #: Ext:

City: State: Zip: Age: Height: Current weight: Weight 6 months ago: Employer: Work #: Ext: 1 Last Name: First Name: Middle Initial: Address: Apartment #: City: State: Zip: Home #: Cell #: Email: How did you find us? Patient (who) : Doctor (who) : Staff (who) : Date of Birth: / / Gender (circle

More information

SLEEP DISORDERS CENTER QUESTIONNAIRE

SLEEP DISORDERS CENTER QUESTIONNAIRE Carteret Health Care Patient's name DOB Gender: M F Date of Visit _ Referring physicians: Primary care providers: Please complete the following questionnaire by filling in the blanks and placing a check

More information

Name: Date of Birth: Age: Address: City State Zip

Name: Date of Birth: Age: Address: City State Zip Today s Date: Client History Name: Date of Birth: Age: Address: City State Zip Cell Phone: Home Phone: Work Phone: Email Address: Female Male Emergency Contact: Phone Number: How did you hear about us?

More information

Consultation Intake Form. Name: Age: Sex: M F T Address: Phone: (day) (evening) Birth date: Present physical complaints:

Consultation Intake Form. Name: Age: Sex: M F T Address: Phone: (day) (evening)   Birth date: Present physical complaints: Consultation Intake Form Date: Name: Age: Sex: M F T Address: Phone: (day) (evening) e-mail: Birth date: What would you like help with at this time? Present physical complaints: Onset and length of symptoms:

More information

New Patient Medical History Intake Form

New Patient Medical History Intake Form New Patient Medical History Intake Form Name: Todays Date: / / Date of Birth: / / Age: Gender: M / F Marital Status: S M D W Address: City: State: Zip Code Primary Ph.# (cell, hm, wk) Email Address 2nd

More information

STEPS to better gut health

STEPS to better gut health 5 STEPS to better gut health More than 2000 years ago, the renowned Greek Physician Hippocrates and Father of Medicine said... Let Food be Your Medicine & Medicine be Your Food. His words of wisdom are

More information

Symptom Review (page 1) Name Date

Symptom Review (page 1) Name Date v2.4, 2/13 JonathanTreasure.com Botanical Medicine & Cancer Herb Drug Interactions Herbalism 3.0 Symptom Review (page 1) Name Date INSTRUCTIONS Please read each section below carefully and, after each

More information

SURVIVING TO THRIVING. Using Your Personal Stress Toolbox to Manage Your Physical and Emotional Health

SURVIVING TO THRIVING. Using Your Personal Stress Toolbox to Manage Your Physical and Emotional Health SURVIVING TO THRIVING Using Your Personal Stress Toolbox to Manage Your Physical and Emotional Health The Manifestation of Stress Blood pressure rises Breathing becomes more rapid Digestive system slows

More information

3. Male? 4. Hydrocortisone (or derivates)? 5. Other? Vitamins/minerals/trace elements: How are you doing? very well well average not well very bad

3. Male? 4. Hydrocortisone (or derivates)? 5. Other? Vitamins/minerals/trace elements: How are you doing? very well well average not well very bad LAUREN CIEL SWERDLOFF MD INCORPORATED 1821 WILSHIRE BLVD. SUITE # 220 SANTA MONICA, CA 90403 (310) 829-5189 FAX: (310) 829-5942 Could you please fill in this questionnaire and bring it at the next appointment?

More information

12 hours. Your body has eliminates all excess carbon monoxide and your blood oxygen levels become normal.

12 hours. Your body has eliminates all excess carbon monoxide and your blood oxygen levels become normal. Balance March 2018 What happens after the last cigarette? You know that smoking is one of the leading causes of preventable deaths but the process of quitting seems too daunting. After all, you ve tried

More information