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METABOLIC ANALYSIS

PLEASE NOTE

You can only take the metabolic assessment one time.
Check the box next to everything you experience despite treatment… (Treatment = diet, meds, supplements, etc. Meaning if you stop treatment, you’ll get the symptoms back or you have symptoms even though you’re trying to avoid them)
Include all symptoms that developed later in life or that have gotten worse over time – Not things you were ‘born with’. For example, if you were born with allergies, exclude them. But if you could eat whatever you wanted as a kid, but now have allergies as an adult, include them.
Click ‘Next’ to start the Metabolic Analysis

HOW OLD ARE YOU?*

18 - 25

25 - 35

35 - 45

45 - 55

55+

HOW MUCH WEIGHT DO YOU WANT TO LOSE?*

less than 10 pounds

10-25 pounds

25-40 pounds

40-55 pounds

55+ pounds

HAIR, NAILS, & SKIN*

What do you experience regularly? (daily, weekly, monthly) Check all that apply

My hair is thinning (from head, body, lashes, and/or eyebrows)

I get pimples on my face/body only when I get my period or sweat (1 or more zit)

I have acne on my face/body (1 or more zits) all the time (even when I'm not getting my period)

Sometimes I get dandruff (small flakes)

I have dandruff often (tons of flakes + intense itching that's hard to treat)

My nails are thin and break easily

I have premature aging and dry skin (even though I drink water/moisturize/wear SPF)

I always have (a) white spot(s) somewhere on my nails

I have hyper-pigmentation (dark patches) on my skin (melasma, age spots, more moles, etc.)

My pores are changing/getting larger

I get rashes, hives, psoriasis and/or eczema

I never experience any of these symptoms

ENERGY & SLEEP*

What symptoms do you experience regularly? (daily, weekly, monthly) Check all that apply

I wake up feeling tired and stay tired - even if I sleep all night long and drink coffee

I don't get 7+ hours of undisturbed of sleep more than 5 days a week

I’m tired during the day but get a surge of energy in the afternoon/night

I have trouble falling asleep even though I'm tired

I feel tired but wired (on edge, hyper, jittery) especially if I have caffiene

I don’t feel energy without caffeine/stimulants (coffee, pre-workout, energy drinks, supplements, etc.)

I have trouble staying asleep - I wake up during the night & toss/turn

I have sleep apnea

I never experience any of these symptoms

DIGESTION & EXCRETORY*

What symptoms do you experience regularly? (daily, weekly, monthly) Check all that apply

My tongue has a white 'mossy' coating, cracks, and/or scalloped edges

I don’t poop 1 to 3 times every single day

If I didn't drink coffee (or use stimulants) I wouldn't poop

I'm bloated regularly (even when I’m not getting my period)

My poop is mushy, loose, or comes out in small pieces (it's not one solid piece)

It’s hard to poop... I have to push very harder to get it out

I get post nasal drip, a runny nose, and/or have to clear my throat after eating sometimes

I've been diagnosed with IBS, Chron's Disease, or SIBO

I have gas

I have heartburn

I never experience any of these symptoms

MOOD & MINDSET*

What symptoms do you experience regularly? (daily, weekly, monthly) Check all that apply

I experience mood swings (happy to sad, okay to angry) quickly, even when I'm not getting my period

I cry easily I get irritated/mad easily over little things that didn't use to bother me

I feel anxious, stressed, and overwhelmed often

I have ‘brain fog’ (difficulty concentrating/staying focused, remembering things, even when I try)

I get severe anxiety or have panic attacks (but never use to)

I use foods/drinks to cope with my feelings (example:: coffee when I feel tired, eat when I feel bored, alcohol when I feel stress, etc.)

I'm depressed and don't feel motivated to do things I used to enjoy

I feel burned out - I'm emotionally and mentally exhausted

I take medication to improve my mood

I never experience any of these symptoms

HUNGER & CRAVINGS*

What symptoms do you experience regularly? (daily, weekly, monthly) Check all that apply

I never/rarely feel hungry (and I'm not taking appetite suppressants or stimulants to prevent hunger)

I feel hungry within an hour or two after eating a meal

I'm always hungry (no matter what or how much I eat)

I feel out of control of my eating - I eat things I shouldn't/when I'm not hungry

I crave sugar & sweet things

I crave carbs (baked goods, potatoes, pasta, etc.)

I crave cheese & dairy products

I crave alcohol

I crave salt & salty foods

I crave specific foods (like chocolate, meat, or corn)

I never experience any of these symptoms

IMMUNITY & HEALTH*

What symptoms do you experience regularly? (daily, weekly, monthly) Check all that apply

I have sinus issues, post nasal drip, or congestion (not related to seasonal allergies)

I get yeast infections or bacterial vaginosis (more than 3 a year) whether I'm sexually active or not

I tend to get sick 2 or more times a year (regardless of my exposure to other sick people)

I have joint pain regardless of how much exercise I do

I have to go to the bathroom after I eat sometimes (extreme urgency need to go or you'll have an accident, not including food poisoning)

I feel hot and sweat more compared to others, regardless of the temperature

I have food sensitivities, intolerances, and/or allergies (you weren’t born with/developed later in life)

I heal slowly compared to how I used to when I was a kid

I am cold or heat intolerant

I never experience any of these issues

DIETARY HABITS*

Check everything that you do daily, weekly, or monthly

I eat the same foods over and over again and rarely try new things

I limit complete food/nutrient groups (ex: Keto, Adkin's, or Vegan diets)

I drink alcohol (more than 4 drinks a week)

I take specific supplements (ie. Vitamin D exclusively - not a multivitamin)

I eat processed foods daily (sodas, fast food, cereal, dairy, cookies, chips, etc)

I cut my caloric intake or skip meals

I eat (a meal or graze) more than 4 time a day

I eat 2 or less meals a day

None of the above apply to me

EXERCISE HABITS*

Check everything that applies

I never exercise

I do cardio 3-5 times a week (moderate intensity/get sweaty)

I weight train 3-5 times a week (moderate intensity/get sweaty)

I exercise with low intensity (don't sweat) (weights, cardio, or yoga)

I don't workout but I'm always moving and on my feet during the day

None of the above apply to me

HAVE YOU BEEN DIAGNOSED WITH ANY OF THE FOLLOWING?*

Check everything that a doctor's diagnosed that you were not born with

Diabetes (1 or 2)

High Triglycerides

High Cholesterol

Abnormal hormone levels (including thyroid, adrenals, cortisol, and sex hormones)

Hypothyroidism

Grave's disease

Fatty Liver Disease

Epstein Barr Virus (active or inactive)

Leaky Gut

Hashimoto's

Depression and/or anxiety

I take medication to treat something listed above

I have never been diagnosed with any of these things

WHERE SHOULD WE SEND YOUR RESULTS?

Where should we send a copy of your results? We do not save your assessment or results – and you can only take this once – so make sure you use your preferred email address.

First Name

Last Name

Email Address

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