Fibromyalgia Book Quizzes            
 
Name:   Date:   
Email:  
Directions:   
Type in the number related to the frequency of your symptoms  
1 - Less than once per month  
2 - Weekly or more than 4 times per month  
3 - Daily or more than 3 times per week  
Focus on the areas with the highest scores.  
 
Stress and Adrenal Fatigue Quiz  
Panic attacks  
Feel tired and wired  
Get fatigued easily  
Reoccurring  headaches  
Crave sweets  
Crave salt  
Get dizzy when rising  
Tired even after sleeping well  
Have trouble falling asleep or staying asleep all night  
Cannot concentrate  
TOTAL  
 
Oxidative Stress  
Exposed to environmental chemicals at home or at work  
Sensitive to smells like fragrances, smoke, and chemicals  
Have colds or sinus infections  
Eat more than two servings of processed (boxed, microwave) meals
Eat sugary treats or white flour products   
Eat less than 5 servings of fruit and vegetables  
Exercise less than 30 minutes 3 times per week  
Drink more than 3 alcoholic drinks per week  
Smoke cigarettes or are exposed to cigarette smoke  
TOTAL  
 
Energy Metabolism Quiz  
Too tired to do what I want to do  
Wake up unrefreshed  
Have chronic muscle aches or weakness  
Have chronic infections  
Feel irritable and moody  
Tired after exercise  
Trouble falling asleep or staying asleep  
Feel depressed often  
Poor memory and concentration  
Commonly exposed to pesticides or other household chemicals  
TOTAL  
 
Toxic Quiz  
Less than 1 bowel movement per day  
Drink tap water or soft drinks instead of filtered water  
Sensitive to caffeine (stays in system a long time)  
Sensitive to perfumes and other smells  
React to MSG and other preservatives  
Treat my home for insects more than once per year  
Have more than 2 mercury fillings in my mouth  
Sweat less than 3 times per week  
Have headaches often  
Exposed to chemicals at work or home daily  
TOTAL  
 
Digestion Quiz  
Have heartburn or take anti-acids daily  
Have fullness or bloating often after eating  
Tired after eating  
Less than one bowel movement per day  
Have food reactions  
Crave sweets and bread  
Have undigested food in my stool  
Have reoccurring yeast infections  
Stools have a strong odor  
TOTAL  
 
Thyroid Quiz  
Have cold hands or feet often  
Have thin hair or lose many hairs daily  
Frequently constipated  
Weak outside edge eyebrows  
Have dry skin  
Weak sex drive  
Weak memory and concentration  
Swollen hands or feet  
Tend to be depressed  
TOTAL  
 
Essential Fatty Acids Quiz  
Joints are achy or stiff  
Skin is dry or flaking  
Nails are soft or brittle  
Thirsty often  
High blood pressure  
High cholesterol  
TOTAL