Absolute Health Science
Lifestyle and Nutritional Assessment FormDear Client: Please read the instructions of each form carefully and complete this questionnaire with care. Your answers will help me determine the most effective recommendations to make based on your main health concern(s) presented. This health history record is protected and kept strictly confidential. It will not be released without your consent.Name: _________________________________Date: __________________________________Telephone (Home): _______________________(Work): ________________________________(Cell): ___________________________Email: _________________________________Age: _______________Height: _________________Weight: _________________Sex: M FORMCHECKBOX F FORMCHECKBOX Appointment Reminders? No FORMCHECKBOX Email FORMCHECKBOX Phone FORMCHECKBOX AHS Quarterly Newsletters? Yes FORMCHECKBOX No FORMCHECKBOX Please answer each question carefully and LEAVE BLANK those that don’t apply to you.LIFESTYLE:What is your #1 goal you want to achieve during our time together_______________________________ _____________________________________________________________________________________What are your main health concerns? Please list concerns in priority and when they started:1. 4. 2. 5. 3. 6. Have you ever experienced any major trauma? _______________________________________________What level of stress do you currently experience? Please quantify on a scale of 1 (low) to 10 (high): ____What are the major causes of your stress? ___________________________________________________How does your stress manifest (show)? _____________________________________________________What coping mechanisms do you implement? _______________________________________________Do you vacation regularly? Yes FORMCHECKBOX No FORMCHECKBOX What was your last vacation? __________________________What is your current exercise routine? (Include type, frequency and duration) ___________________________________________________________________________________________________________Are you satisfied with your present weight? Yes FORMCHECKBOX No FORMCHECKBOX Do you wish to gain weight? FORMCHECKBOX lose weight? FORMCHECKBOX If so, how much? ______________________________How would you describe your energy levels on a scale of 1 (low) to 10 (high)? _____________________Do you experience any lulls or highs in energy levels throughout the day? Yes FORMCHECKBOX No FORMCHECKBOX If so, what time(s) of day? _______________________________________________________________How many hours on average do you sleep daily? ___________________________Do you: have difficulty falling asleep? FORMCHECKBOX Staying asleep? FORMCHECKBOX Awaken feeling unrested? FORMCHECKBOX Snore? FORMCHECKBOX What is your occupation? ________________________________________________________________What do you enjoy/not enjoy about work? _______________________________________________________________________________________________________________________________________How many hours each week do you work? ____________ Do you work shifts? FORMCHECKBOX Regular schedule? FORMCHECKBOX Do you smoke? Yes FORMCHECKBOX No FORMCHECKBOX If yes, how much and for how long? ______________________________Are you ever exposed to smoke at home or at work? Yes FORMCHECKBOX No FORMCHECKBOX Do you use recreational drugs? Yes FORMCHECKBOX No FORMCHECKBOX If yes, please describe: ____________________________Have you ever been treated for: drug dependency? FORMCHECKBOX Alcohol dependency? FORMCHECKBOX How many hours do you spend daily, on average: Driving? ________________Watching TV? ___________Reading? ________________On a computer? _________________Sitting at a desk? _____________What is your current morning/evening routine? ___________________________________________________________________________________________________________________________________What are your interests and hobbies? Please list: _____________________________________________How much free time do you feel you have in a day? ___________________________________________If need be, how would you make more time for yourself? ______________________________________Do you regularly check in with yourself (self-reflect)? Yes FORMCHECKBOX No FORMCHECKBOX Need reminders to do so FORMCHECKBOX Time permitting, what would you like to incorporate into your day? ___________________________________________________________________________________________________________________MEDICAL HISTORY:Are you currently taking medication (including birth control)? Yes FORMCHECKBOX No FORMCHECKBOX Name of Prescription MedicationReason(s) for MedicationDuration of MedicationHave you taken antibiotics over the past 5 years? Yes FORMCHECKBOX No FORMCHECKBOX If yes, when were they last taken and the reason for taking it? ________________________________________________________________________________________________________________________Are you currently taking Natural Health Products (NHPs)? (Includes vitamins, minerals, herbs and homeopathic remedies) Yes FORMCHECKBOX No FORMCHECKBOX Name of NHPReason(s) for NHPDaily Amount/DoseDo you have any allergies or sensitivities (including to medication)? Yes FORMCHECKBOX No FORMCHECKBOX If so, please list: _______________________________________________________________________Are you anaphylactic (life-threatening allergy)? If so, to what: __________________________________Do you have any silver-mercury fillings? Yes FORMCHECKBOX No FORMCHECKBOX If so, how many and for how long? ________________________________________________________Do you have any root canals? Yes FORMCHECKBOX No FORMCHECKBOX If so, how many and for how long? ____________________Have you ever been a) Diagnosed with an illness? Yes FORMCHECKBOX No FORMCHECKBOX If so, please explain: ____________________________________________________________________________________________________b) Hospitalized? Yes FORMCHECKBOX No FORMCHECKBOX If so, for what reason: _________________________________________Have you had surgery to remove your gall bladder? FORMCHECKBOX Tonsils? FORMCHECKBOX Appendix? FORMCHECKBOX If so, explain: _________________________________________________________________________Have you experienced fungal infections (Ex. Jock itch, Athlete’s foot)? Yes FORMCHECKBOX No FORMCHECKBOX If so, please describe: ___________________________________________________________________Have you experienced a decline in sexual interest? Yes FORMCHECKBOX No FORMCHECKBOX Have you had kidney stones or gallstones? Yes FORMCHECKBOX No FORMCHECKBOX If yes, please describe: ___________________How often do you have a bowel movement daily? ____________________________________________Do you strain to have a bowel movement? Yes FORMCHECKBOX No FORMCHECKBOX Occasionally FORMCHECKBOX Related to particular food or circumstance? _________________________________________________Do you have loose bowel movements? Yes FORMCHECKBOX No FORMCHECKBOX Occasionally FORMCHECKBOX Related to particular food or circumstance? _________________________________________________Is there undigested food in your stools? Yes FORMCHECKBOX No FORMCHECKBOX Occasionally FORMCHECKBOX Other bowel-related concerns? (Colour, blood, oily, etc.) _______________________________________FAMILY HISTORY: Use “F” for father, “M” for mother, “S” for sibling, “G” for grandparent, “O” for other(s): FORMTEXT ?????Allergies FORMTEXT ?????Diabetes FORMTEXT ?????Intestinal Disease FORMTEXT ?????Alcoholism FORMTEXT ?????Drug Abuse FORMTEXT ?????Kidney Dysfunction FORMTEXT ?????Arthritis FORMTEXT ?????Gall Bladder Issues FORMTEXT ?????Mental Illness FORMTEXT ?????Asthma FORMTEXT ?????High Cholesterol FORMTEXT ?????Osteoporosis FORMTEXT ?????Autoimmune Disease FORMTEXT ?????Heart Disease FORMTEXT ?????Skin Conditions FORMTEXT ?????Cancer FORMTEXT ?????Hypertension FORMTEXT ?????UlcersType(s) of Cancer: FORMTEXT ?????Other condition(s): FORMTEXT ?????FEMALES:Are you pregnant? Yes FORMCHECKBOX No FORMCHECKBOX Are you currently breastfeeding? Yes FORMCHECKBOX No FORMCHECKBOX Have you noticed any changes in menses? (Ex. Frequency, duration, flow, clotting, etc.) Yes FORMCHECKBOX No FORMCHECKBOX If so, please specify: ____________________________________________________________________Do you suffer from PMS symptoms? Please specify: __________________________________________Are you pre-menopausal? Yes FORMCHECKBOX No FORMCHECKBOX Post-menopausal? Yes FORMCHECKBOX No FORMCHECKBOX Are you experiencing any menopausal symptoms? Yes FORMCHECKBOX No FORMCHECKBOX If yes, please specify: ___________________________________________________________________Have you had a bone density test? Yes FORMCHECKBOX No FORMCHECKBOX If yes, what was the result? ______________________MALES:Have you experienced any prostate problems? (Ex. frequent urination, discomfort during urination) Yes FORMCHECKBOX No FORMCHECKBOX If yes, please describe: ______________________________________________________NUTRITIONAL AND DIETARY HABITS:How many times a day do you eat, on average? Main meals: ______________ Times of day: ________________________________________________Snacks: __________________ Times of day: ________________________________________________Provide examples of your typical meals and snacks:Breakfast: ____________________________________________________________________________Lunch: ______________________________________________________________________________Dinner: ______________________________________________________________________________Snacks: ______________________________________________________________________________Do you eat: With family? FORMCHECKBOX Home alone? FORMCHECKBOX On the run? FORMCHECKBOX Restaurant? FORMCHECKBOX Fast food? FORMCHECKBOX Where do you commonly grocery shop? ____________________________________________________What percentage of meals/snacks consumed are homemade? ____________________________________In terms of preparing your own meals, what is your skill level in the kitchen? Please quantify on a scaleof 1 (low) to 10 (high): __________How many servings of each food type do you typically consume in a day?________ FruitFresh FORMCHECKBOX Frozen FORMCHECKBOX Canned FORMCHECKBOX Dried FORMCHECKBOX ________VegetablesCooked FORMCHECKBOX Raw FORMCHECKBOX Frozen FORMCHECKBOX Canned FORMCHECKBOX ________Whole GrainsType: _____________________________________________________________ProteinType: _____________________________________________________________DairyType: ____________________________________________________________________FatsType: ____________________________________________________________________OtherType(s): __________________________________________________________Do you eat or use (indicate “1” for “rarely”, “2” for “regularly”, “3” for “often”):______Aluminum pans______Artificial Sweeteners______Candy______Cigarettes______Refined Foods (pastries, white pasta, etc.)______Fried Foods______Luncheon Meats______Margarine______Microwave______Fast FoodsPlease indicate how many cups of the following you drink per day: ______Tap water______Coffee______Tea______Soft drinks (diet)______Soft drinks (regular)______Fresh fruit juices______Fruit juices (prepared)______Milk______Prepared vegetable juices______Fresh vegetable juices______Red wine______White wine______Beer______Other alcoholic beverages______Bottled or spring water______Herbal tea______Other: ___________________________Do you currently follow a special diet? Yes FORMCHECKBOX No FORMCHECKBOX If yes, please explain: ____________________________________________________________________________________________________________Do you avoid certain foods? Yes FORMCHECKBOX No FORMCHECKBOX If yes, list food(s) and reason why: __________________________________________________________________________________________________________How often do you eat meat? Daily FORMCHECKBOX 3-5/week FORMCHECKBOX Once/week or less FORMCHECKBOX How often do you consume dairy? Daily FORMCHECKBOX 3-5/week FORMCHECKBOX Once/week or less FORMCHECKBOX What’s your favourite food(s) and how often do you eat them? _______________________________________________________________________________________________________________________Which food(s) do you crave, and how often do you eat them? ________________________________________________________________________________________________________________________Do you experience any symptoms of meals are missed? Yes FORMCHECKBOX No FORMCHECKBOX Please explain: ________________________________________________________________________Do you experience any symptoms after meals? Yes FORMCHECKBOX No FORMCHECKBOX Please explain: ________________________________________________________________________COMMENTS: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Nutri-System Profile (NSP) Assessment FormPlease indicate if you’re experiencing any of the symptoms or activities below by indicating: 1 for mild or rarely occurring, 2 for moderate or regularly occurring, 3 for severe or often occurring or LEAVE BLANK if the symptom/statement does not apply.General fatigue or weaknessVaricose veinsDifficulty losing weightFeeling out of controlFrequent illness/infectionsFood/chemical sensitivitiesHigh stress lifestyleFrequent yeast/fungus problemsSmokingBones break easily, osteoporosisDrink more than 2 cups of coffee/dayToo little exerciseBad breathe and/or body odourExcessive mucousConstipationShortness of breath climbing stairsBags under eyesTingling in lips, fingers, arms, legsCraves sugar, bread, alcoholChest painsDifficulty digesting certain foodsVery rapid or slow heart beatRecent antibiotic usePainful, hard or thin bowel movementsAllergiesAlternating constipation/diarrhea Poor concentration or memoryRecurrent bladder infectionsBelching or burping after mealsFemale: Menopause, hot flashesSkin/complexion problemsFemale: PMSFrequent consumption of red meatDifficult urinationRegular use of dairy productsSwollen glands, puffy throatHeavy alcohol consumptionLower abdominal painExposure to toxins/chemicalsFrequent need to urinateFrequent mood swingsJoint painDepressed and/or irritableSinus inflammation/dischargeBrittle fingernailsArthritisDry, brittle hair, split endsSudden weight gain/lossHigh fat/high cholesterol dietHeadache/MigrainesNervousness/anxiety/tension/worryFemale: Taking birth control pillsInsomnia, restless sleepLower back painsLow fiber dietDry, flaky skinMuscle crampsDrink less than 6 glasses of fluid/daySleepy when sitting upWater retentionFemale: menstrual crampsLow sex driveBronchitis/asthma//pneumonia/emphysemaFeeling heavy/bloated after mealsCelluliteChronic coughCold hands and feetCOMMENTS: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PLEASE COMPLETE THE FOLLOWING SUB-QUESTIONNAIRES USING THE SAME RATING SYSTEM: 1 for mild or rarely occurring, 2 for moderate or regularly occurring, 3 for severe or often occurring or LEAVE BLANK if the symptom/statement does not apply.THE DIGESTIVE SYSTEMExcessive gas, belching or burping after mealsFull feeling after heavy meat mealStomach bloated after eatingHeavy, tired feeling after eatingSleepy after eatingNausea after taking supplementsLongitudinal striations on fingernailsAcneEat when rushed/in a hurryUndigested food in the stoolBad breatheStomach pain 1 hour after eating or at nightSensation of acidity in abdominal areaBurning sensation in stomachHeartburn, indigestionPain aggravated by worry/tensionBlood in stoolHiatal herniaLower back painGastritis, gastric ulcerLong term aspirin useNausea, vomitingYellow or pale fingernailsFood allergiesSkin oily on nose and foreheadIrritable, easily angeredFats/greasy foods cause nausea, headachesWeight gain around the abdomenVertical white streaks on fingernailsYellow palmsOnions, cabbage, radishes, cucumbers cause bloating/gasJaundiceBad breathe; bad taste in mouthPoor concentrationExcess body odourDifficulty losing weightHigh cholesterol/high cholesterol dietAcne, boils, rashes, psoriasis or eczemaMigraine headachesConstipationDiscomfort underneath right ribcageGall stones; history of gallstonesHigh cholesterol diet; high blood cholesterol levelsStool appears clay-coloured, foul odouredSevere pain in right upper abdomenConstipationSevere abdominal painFeverNausea and vomitingAlcohol addictionSlow digestion; feel full for hours after eatingJaundiceHungry up to 3 hours after eatingFamily history of diabetesStrong cravings for sweets, starches, coffee or alcoholFatigueNervous/anxious feelings relieved by eatingFrequent headachesIrritable if late for or skip a mealFainting spellsOverweightDepressionAddicted to pop and/or coffee with sugar Lose temper easilyFrequent “midnight snacks”PLEASE COMPLETE THE FOLLOWING SUB-QUESTIONNAIRES USING THE SAME RATING SYSTEM: 1 for mild or rarely occurring, 2 for moderate or regularly occurring, 3 for severe or often occurring or LEAVE BLANK if the symptom/statement does not apply.THE INTESTINAL SYSTEMExtreme fatigueRectal itchingRecurrent vaginal infectionsAbnormal muscle aches from exerciseFrequent use of antibioticsExcessive wax in earsWhite coated tongue, oral thrushUnexpected/unexplained weight gainCraves sugars, bread, alcoholImpotenceHeadachesCanker soresTonsillitis, recurrent strep throatAthlete’s foot, finger/toenail fungus, ringwormItchy, watery or dry eyesJock itchSkin flushes“Brain fog”Chronic indigestion, frequently use antacidsIrritabilityAlways cold, especially in extremitiesMemory lossFemale: PMSMental confusionPain in pelvic areaDepression or anger for no reasonAbdominal gas and bloatingAnxiety/panic attacksLoss of sex driveInability to concentrateCystitis, repeated bladder infectionPhobic/compulsive Increasing food and chemical sensitivitiesLethargyFemale: Endometriosis/ ovary problemsMood swingsChronic diarrhea Itchy ears, nose, anusHives, psoriasis, acne, skin rashesForgetfulnessPain in the back, thighs, shouldersSlow reflexesNumb handsGas and bloatingDrooling while sleepingUnclear thinkingDamp lips at nightLoss of appetiteDry lips during the dayYellowish or pale faceGrind teeth while asleepFast heartbeatBedwettingHeart pinLethargy; chronic fatiguePain in navelDark circles under eyesEating more than normal but still feeling hungryCancerBlurry or unclear visionRectal itchingTHE LYMPHATIC SYSTEMExcessive sleepSoreness on both sides of neck at shoulderVery susceptible to infectionsFeel puffiness in throatSwollen glands: tonsils, throat, armpitsLook older than chronological ageHistory of cancer, MS, Parkinson’s, arthritisFlu-like symptoms often occurLoss of appetite LupusHeadachesPLEASE COMPLETE THE FOLLOWING SUB-QUESTIONNAIRES USING THE SAME RATING SYSTEM: 1 for mild or rarely occurring, 2 for moderate or regularly occurring, 3 for severe or often occurring or LEAVE BLANK if the symptom/statement does not apply.Acne, psoriasis, dermatitis, eczemaExcessive sweating, night sweatsRapid pulse, heart irregularitiesBowel disease: IBS, IBD, Crohn’s, etc.Frequent headachesJoint pains or stiffnessHay feverFrequent night urinationFrequent cravings for certain foodsWheezingPeriods of blurred visionPale faceRepeated ear troubleHivesHyperactivityNose runs constantly Dizzy spellsNoticeable changes in writing throughout dayPeriods of confusionNosebleedsPoor concentrationBloating or gas after eating certain foodsEpilepsyCanker soresMuscle cramps or spasmsDark circles under eyesAbnormal body odourStuffy noseTHE ENDOCRINE SYSTEMDistinct, lethargic tiredness or sluggishnessHair dry, brittle, dull, lifelessCold hands or feetFlaky, dry rough skinMercury amalgams (fillings)Feel stiff after sitting still for some timeGain weight easily, fail to lose on dietsMood swingsConstipation, less than one bowel movement a dayUsually square and wide fingernailsLow energy in the morningHigh cholesterolLow pulse rateLow sex driveLow body temperature, especially bed restLosing weight without tryingInsomniaHeart races while at restIncreased appetiteFeel warm/flushed at room temperatureFrequent bowel movements, diarrheaHands shake or trembleExcessive sweating without exercisingProtruding tongueNervous behavior, hyperactivityHeart palpitationsHeadaches affecting one side of headExcessive urinationFemale: Loss of menstrual functionPain in little finger of left handMoodySwelling in ankles, fingers and/or feetOverweight from waist upCold hands or feetOverweight from waist downPain in left side of upper neckStress or emotional upset cause exhaustionOccasional cold sweatsDizzy/light-headed upon standing quickly from a lying or crouched positionTightness or lump in throat, especially when emotionally disturbedSweat excessivelyHigh or low blood pressureNeck and/or shoulder tension/painRapid pulseFrequent headachesShort temperBow lines (depressed furrows) on fingernailsPuffy facePLEASE COMPLETE THE FOLLOWING SUB-QUESTIONNAIRES USING THE SAME RATING SYSTEM: 1 for mild or rarely occurring, 2 for moderate or regularly occurring, 3 for severe or often occurring or LEAVE BLANK if the symptom/statement does not apply.Forgetfulness, “brain fog”Low resistance to infections, catch cold/flu easilyEnergy crash mid-afternoon (around 2-5pm)Difficulty falling or staying asleepNeed to snack to help energy levels and cravingsIncreased muscle soreness with similar physical activity levelAbdominal weight gainFemale: Worsened PMS symptoms during menstrual cycleLow sex drive or lack of interestFrequently wake up around 2-4pm, can’t fall back asleepAnxiety, irritability, depression (mood swings)Low stamina, energy and difficulty maintaining muscle massDecreased ability to deal with stress and deadlinesLow tolerance towards alcohol or caffeineStrong carbohydrate or salt cravingsCold hands or feet/other extremitiesHair loss Dry skinSignificant improvements in stress levels during vacation or time away from work?THE STRUCTURAL-MUSCULAR/SKELETAL SYSTEMPain, swelling, stiffness in jointsRounding of shoulders, stoopingJoint inflammation (rheumatoid arthritis)Female: MenopausePain, stiffness, inflammation of spinePain in forearm or bicepsFacial painCramps in calf muscle during sleep or exerciseJoints making popping soundsPainful cramping in feet or toesGoutTeeth prone to decay; frequent toothachesAnkylosing spondylitisMalformation of bonesBones fracture easilyInsomniaGradual loss of heightMuscles weak, weak grip, light objects feel heavyTooth loss; teeth “falling out”Heart palpitationsLack of exerciseDiet high in animal foods (meat, dairy, eggs)Muscle painSprains; muscle strainsMuscle weaknessMuscle(s) spasmMuscle wasting in some part of the bodyTremorsNumbness or loss of sensationLoss of peripheral visionMood swings and/or depressionSlurred speechBlurred or double visionObjects fall from hand, reach in wrong placeTingling and/or numbness, especially in extremitiesHands trembleMuscular stiffnessImpaired speechMale: ImpotenceDifficulty breathingCOMMENTS: _______________________________________________________________________Nutrient Deficiency TestPLEASE COMPLETE THE FOLLOWING TEST USING THE SAME RATING SYSTEM: 1 for mild or rarely occurring, 2 for moderate or regularly occurring, 3 for severe or often occurring or LEAVE BLANK if the symptom/statement does not apply.Excess fluid retention (edema)Nausea or dizzinessPoor coordinationGeneral, overall weaknessAnemiaCataractsCatch colds, flu, infections easilyCuticles tear easilyHair dull, dry, sparse, loose and fallingRough, dry or scaly skinDry, brittle hairEczemaPsoriasisPoor memoryIrregular menstrual periodsOsteoporosisBones break easilyIrregular heart beatBrittle nailsMuscle crampsCrowded teethInsomniaHigh blood cholesterolIntolerance to alcoholDiabetic or hypoglycemiaOverweightSugar cravingsChronic dieterKidney diseaseFatigue, extreme lack of energyDry hairThyroid problems; goiterOverweightConstipationCold hands or feetBrittle nailsLack of energy or strengthDizzinessCravings for icePale lower eyelidTachycardiaSpoon shaped nailsMuscle spasms or tremorsGall stonesCravings for chocolateIrregular heartbeatExcessive body odourJoint painsBursitis, tendonitisProne to injuriesWeak kneesCreaking or clicking of jointsWeak musclesHigh blood pressureSwelling of anklesAlways thirstyIrregular heartbeatMuscular weakness and fatigueDry hairThin hairWeak immunity; frequent infectionDandruffCataractsWhite spots on fingernailsAcneMale: Poor sperm productionFrequent infectionPoor dream recallCuts/wounds heal slowlyLoss of sense of smell or tasteThinning hairRed stretch marksHard little bumps around elbows Dry or rough skinDry hair, acnePoor night vision; night blindnessSusceptibility to respiratory infectionsSlow light to dark adaptationEyes unable to produce tearsWeak tooth enamelDandruffFatigueApathy, depressionLoss of knee jerk responseIrregular heartbeatGI disordersDry skin around nose and lipsCracks/sores in corner of mouthBloodshot or itchy eyesCataractsEyes sensitive to lightAbnormal hair lossTrembling painful and purplish-red tongueSore tongueFatigueLoss of appetiteSkin disordersSwelling of mouthSmooth tongueMental confusionLoss of sense of humourCanker sores in mouthAnemiaIrritability or nervousnessInsomnia, poor dream recallSore thumbs, kidney stonesFemale: acne worse during menstruationFemale: morning sickness during pregnancyFatigue and weaknessLightheadedness or dizzinessHeart palpitationsShortness of breath; chest painSore, red, glazed-looking tongueIrritability; inability to concentrateRinging in ears (tinnitus)Nausea and diarrheaMemory loss, forgetfulnessPoor coordinationSkin disordersSmooth and pale tongueLoss of appetitePale fingernailsIrregular heartbeatSevere depressionMild anemiaHair lossHigh blood pressureHigh blood cholesterolOverweightEczemaBleeding ulcerDisoriented, memory lossDifficulty losing weightPalenessSore red tongueBleeding gumsDiarrheaInsomniaIrritabilityFatigueConstipationGeneral gastrointestinal disordersPremature greyingDepression and irritabilityFatigueHeadacheAbdominal painAnorexiaNauseaBurning feetDepression and irritabilityHeadacheNervousnessPurplish red tongueBleeding gumsUrinary tract infectionsAbnormal nose bleedsSlow healing of woundsGeneral weaknessShortness of breathSkin bruises easilyRuptured blood vessels in eyesExcessive hair lossAching bones and jointsMuscle weaknessPain in ribs, spine, legsMalformation of bonesOsteomalaciaOsteoporosisMuscle crampsRickets, insomniaNearsightedness (myopia)Heart diseasePremature agingWeaknessIrritabilityDiarrheaPoor skin conditionBrittle hairMuscle wastingCOMMENTS: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ................
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