Optimum Nutrition Questionnaire Page 2
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5YOUR SCORE
Bleeding or tender gums
Acne
VITAMIN B1
YOUR SCORE
Tender muscles
Eye pains
VITAMIN B5
Irritability
Muscle tremors, cramps, or spasms
Poor concentration
Apathy
"Prickly" legs
Poor concentration
Poor memory
Burning feet or tender heels
Stomach pains
Nausea or vomiting
Constipation
Lack of energy
Tingling hands
Exhaustion after light exercise
Rapid heartbeat
Anxiety or tension
YOUR SCORE
Teeth grinding
YOUR SCORE
MAGNESIUM
Muscle cramps, tremors, or
MANGANESE
spasms
Muscle twitches
Muscle weakness
Childhood "growing pains"
Insomnia, nervousness, or
Dizziness or poor sense of
hyperactivity
balance
High blood pressure
Fits or convulsions
Irregular or rapid heartbeat
Sore knees
Constipation
YOUR SCORE
Fits or convulsions
Breast tenderness or water
SELENIUM
retention
Family history of cancer
Depression or confusion
Signs of premature aging
YOUR SCORE
Cataracts
High blood pressure
ZINC
YOUR SCORE
Decline in sense of taste or
smell
CHROMIUM
White marks on more than two
Excessive or cold sweats
finger nails
Dizziness or irritability after six
Frequent infections
hours without food
Stretch marks
Need for frequent meals
Acne or greasy skin
Cold hands
YOUR SCORE
Need for excessive sleep or
drowsiness during the day
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Parent category: Life