Parasite Infection

 PARASITES

In each box below enter the number that corresponds with your choice. (0 = Never, 1 = Occasionally, 2 = Often, 3 = Regularly)

NOTE: Some questions in this section may have different scoring, which will be written next to them in the following format: (0,2,4,6) (0,2,3,4) (0,1,2,4) (0,2,6,8) (0,1,2,6)

➢ Order: (Never, Occasionally, Frequently, Regularly)

Please note some questions in this section may have different scoring which will be written next to it in the following format (No=X, Yes=X).

Restless sleep (toss, turn, or wake often)

Skin issues, rashes, itches, hives, eczema, or acne

Frequent diarrhea or loose stools

Alternating constipation and diarrhea

SIBO (small intestinal bacterial overgrowth), feel bloated or gassy

Bowel urgency, occasional accidents

Abdominal pains, cramps, or burning

Rectal, anal itch (0,2,4,6)

Anal fissures (small, painful tears or cracks) (0,2,4,6)

Gut ulcers, sores, or lesions

Grinding of teeth when asleep (0,2,4,6)

Picking at nose, boring nose with finger (0,2,4,6)

Excess boogers in nose and scab-like boogers (0,2,4,6)

Fingernail Biting

Vertical wrinkles around mouth

Parallel lines (tracks) in soles of feet

Irritable (no apparent reason)

Mood disorder, depression, anxiety, or suicidal thoughts

Hyperactive tendency (nervous)

Dark circles under eyes (0,2,4,6)

Need for extra sleep, wake unrefreshed

Allergies and/or food sensitivities (0,2,3,4)

Fevers of unknown origin

Night sweats (not menopausal)

Kiss pets, allow pets to lick your face (0,1,2,4)

Increase of symptoms around a full moon (0,2,6,8)

Anemia (low iron/hemoglobin on blood test) (0,1,2,4)

Iron deficiency (0,2,4,6)

Vitamin B6 deficiency (0,2,4,6)

Zinc deficiency and/or white spots on nails (0,2,4,6)

Frequent colds, flu, sore throats

Go barefoot in garden or parks (0,1,2,4)

Travel in developing nations (0,2,4,6)

Eat pork products

Eat sushi, raw fish (0,2,4,6)

Sleep with pets on bed

Bed-wetting

Sexual dysfunction

Forgetfulness

Slow reflexes

Loss of appetite (0,1,2,6)

Hungry all the time, bottomless pit, hungry after meals (0,2,4,6)

Strong sugar and processed food cravings

Yellowish skin, face

Rapid heartbeat

Heart, chest pain

Breathing problems, asthma (0,2,4,6)

Pain in belly button area (umbilicus) (0,1,2,4)

Blurry, unclear vision

Eye floaters (0,2,4,6)

Back, thigh, or shoulder pain

Lethargy, apathy (disinterest)

Numbness, tingling in hands, feet

Menstrual problems

Dry lips

Drooling while asleep

Occult blood in stool (from lab test)

Swim in creeks, rivers, lakes (0,2,4,6)

History of Giardia, pin worms, worms, parasites? (N=0, Y=6)

Do you work in childcare? (N=0, Y=6)

History of or currently have cancer? (N=0, Y=20)

Parasite Infection Total_________

Risk for Parasite Infection:

Low = 0-46 , Medium = 47-96 , High = 97-264

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