Zinc/Copper Imbalance Questionnaire

 Symptoms and Signs of zinc/copper imbalance              Yes No

Mood

Agitation/hyperactivity

Apathy/lethargy

Irritability

Nervousness

Nose

Difficulty smelling

Neuromuscular

Fatigue/tiredness

Eyes

Poor night vision

Ears

Difficulty hearing

Central nervous system

Poor concentration

Poor memory

Difficulty learning

Cloud in the head

Insomnia