Chemical Hypersensitivity
Answer the questions below, using the symptom scale:0=Never 1=Seldom 2=Occasionally 3=Frequently 4=Infrequently with severe symptoms 5=Almost always
4=Infrequently with severe symptoms 5=Almost always
Fatigue, lethargy, exhaustion
Overeating/ undereating
Numbness
Nausea
Blurred or dimmed vision
Impaired memory and thinking
Unwarranted depression
Arthritis
Weight loss
Eye irritation
Sore or irritated throat
Wheezing
Painful or irregular menstrual periods
Thyroid disease
Multiple sclerosis
Headaches
Dizziness
Birth defects in offspring
Persistent cough
General feeling of ill health
Emotional instability
Weakness
Muscle aches and pains
Burning sensations in mouth, throat, lungs
Menstrual abnormalities
Anaemia
Suspected dental toxicity
Insomnia
Uncoordination
Chest pains
Constipation
Loss of sense of smell
Flushing
History of miscarraige
Parkinson's disease
Flu-like symptoms that are not the flu
Behavioural or personality change
Hoarseness
Hives, rashes, acne
Infertility
Discomfort after fasting, or exertion
Tremors or seizures
Abdominal pain or cramps
Ulcerations in mouth
Low body temperature
Increased susceptibility to chronic fatigue syndrome, yeast overgrowth, food and inhalant allergies, autoimmune diseases
Unexplained lymph swelling
Amyotrophic lateral sclerosis
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