ADRENAL FATIGUE QUICK CHECK (SOME OF THE FOLLOWING LIST IS FROM THE BOOK ADRENAL FATIQUE BY JAMES WILSON) Rate the following from 0-5, with 0 being no problem & 5 being a severe problem. Name *FirstLastGender *GenderMaleFemaleAge *Phone *Email *1-Difficulty getting up in the morning1-Difficulty getting up in the morning123452-Continuing fatigue, not relieved by sleep & rest2-Continuing fatiquw, not relieved by sleep & rest123453-Lethargy, lack of energy to do normal daily activities3-Lethargy, lack of energy to do normal daily activities123454-Sugar Craving4-Sugar Craving123455-Salt Cravings5-Salt Cravings123456-Allergies6-Allergies123457-Digestion Problems7-Digestion Problems123458-Increeased effort needed for everyday tasks8-Increeased effort needed for everyday tasks123459-Decreased interest in sex9-Decreased interest in sex1234510-Decreased ability to handle stress10-Decreased ability to handle stress1234511-Increased time needed to recover from illness, injury or traumas11-Increased time needed to recover from illness, injury or traumas1234512-Light-headed or dizzy when standing up quickly12-Light-headed or dizzy when standing up quickly1234513-Low mood13-Low mood1234514-Less enjoyment or happiness with life14-Less enjoyment or happiness with life1234515-Increased PMS15-Increased PMS1234516-Symptons worsen if meals are skipped or inadequate16-Symptons worsen if meals are skipped or inadequate1234517-Thoughts are less focused, brain fog17-Thoughts are less focused, brain fog1234518-Memory is poorer18-Memory is poorer1234519-Decreased tolerance for stress, noise, disorder19-Decreased tolerance for stress, noise, disorder1234520-Don't really wake up until after 10:00A.M.20-Don't really wake up until after 10:00A.M.1234521-Feel better after supper21-Feel better after supper1234522-Feel better after supper22-Feel better after supper1234523-Get a "second wind" in the evening, and stay up late23-Get a "second wind" in the evening, and stay up late1234524-Decreased ability to get things done - less productive24-Decreased ability to get things done - less productive1234525-Have to keep moving - if I stop, I get tired25-Have to keep moving - if I stop, I get tired1234526-Feeling overwhelmed by all that needs to be done26-Feeling overwhelmed by all that needs to be done1234527-It takes all my energy to do what I have to. There's none left over for anything or anyone else27-It takes all my energy to do what I have to. There's none left over for anything or anyone else12345EmailSubmit
