“Anabolic Activator Assessment” The contents of this assessment have been transcribed from: The “Flatten Your Your Abs Forever” Results Seminar, Paul Chek, 03/2003. ALSO, “How To Eat, Move & Be Healthy” by Paul Chek
YOU ARE WHAT YOU EAT
1. Do you shop shop less less frequ frequentl ently y than every every four four days? days? __ Yes Yes (1) __ No (0) 2. Do you eat eat more packaged packaged (frozen (frozen or canned) canned) fruits fruits and and vegetables vegetables than than fresh? fresh? __ Yes Yes (3) __ No (0) 3. Do you you eat more more cooked cooked vege vegetab tables les than than raw? raw? __ Yes Yes (3) __ No (0) 4. Do you eat vegetabl vegetables es with with less less than than two two meals meals daily? daily? __ Yes Yes (5) __ No (0) 5. Do you buy more more non-organ non-organic ic vegetables vegetables than organi organicc vegetables? vegetables? __ Yes Yes (5) __ No (0) 6. Do you you use use a micr microw owave ave oven? oven? Yes( check option below) __1-2 times per week (2) __3-4 times per week (5) __more than 4 times per week (10) 7. Do you eat eat quick cook cook grains grains such as Rice-aroni Rice-aroni,, Quaker Oats or or Minute Minute rice rice More often than slow cooked organic whole grains? __Yes __Yes (5) __No (0) 8. Do you eat white white bread bread more more often often than whole grain breads? breads? __Yes __Yes (5) __No (0) 9. Do you drink drink pasteuri pasteurized zed / homogenize homogenized d milk, or cheeses cheeses frequentl frequently? y? Yes (check option below) __No (0) __1-2 times per week (1) __3 times per week (3) __more than 3 times per week (5) 10. Do you eat non-organic yogurts from the stores that that are low fat, Presweetened or have fruit added? Yes (check option below) __No (0) __1-2 times per week (1) __3 times per week (3) __more than 3 times per week (5) 11. Do you eat typical store bought eggs from cage raised chickens ( as opposed to Free range, grain fed eggs)? __Yes __Yes (5) __No (0)
12. Do you eat red meat more than once every four days? __Yes(3) __No (0) 13. Do you commonly eat meats(beef, chicken, turkey) from sources other than a Free-range and hormone-free source? __ Yes (3) __ No (0) 14. Do you eat canned fish more frequently than fresh fish? __Yes (3) __No (0) 15. Do you use commercial salad dressings? __Yes (check option below) __No (0) __once a week (1) __twice per week (2) __more than 2 times per week (3) 16. Do you use Mayonnaise or products containing hydrogenated oils? Yes (check option below) __No (0) __once a week (1) __twice per week (2) __more than 2 times per week (5) 17. Do you eat nuts and / or seeds that are roasted and / or salted? __Yes (1) __No (0) 18. Do you use white table sugar as a sweetener? Yes (check option below) __No (0) __once a week (1) __2-3 times per week (3) __more than 3 times per week (5) 19. Do you use artificial sweeteners such as Sweet-n-Low, Equal or Nutrasweet? Yes ( check option below) __No (0) __once a week (1) __2-3 times per week (5) __more than 3 times per week (10) 20. Do you use standard white table salt? __Yes (5) __No (0) 21. Do you eat TV dinners or other highly processed foods more than three times a Week? __Yes (5) __No (0) 22. Do you eat from fast food restaurants like McDonalds, Arbey’s Wendy’s etc…
__Yes (check option below) __No(0) __1-2 times per week (2) __3 times per week (5) __more than 3 times per week (10)
23. Do you eat from vending machines? Yes (check option below) __No(0) __1-2 times per week (2) __3 times per week (5) __more than 3 times per week (10) 24. Do you drink tap water? __Yes (10)
__No(0)
25. Do you eat some form of store bought dessert, such as ice cream, cookies, Donuts, cakes or pies after dinner most nights? Yes (check option below) __No(0) __once a week (1) __2-3 times per week (3) __more than 3 times per week (5) TOTAL SCORE: _______
STRESS
1. Do you eat more or less when stressed than when not stressed? ___ Yes (10) ___ No (0) 2. Do you worry about job, income or money problems? ___ Yes (10) ___ No (0) 3. Are any of your relationships causing you stress? ___ Yes (10) ___ No (0) 4. Do you often feel anxious? ___ Yes (5)
___ No (0)
5. Do you often feel upset when things go wrong or feel that things go wrong often? ___ Yes (5) ___ No (0) 6. Do you lash out at others? ___ Yes (5)
___ No (0)
7. Do you feel your sex drive is lower than normal for you? ___ Yes (5) ___ No (0) 8. Do you feel stressed due to lack of intimacy in one or more relationships? ___ Yes (5) ___ No (0) 9. Have you had reduced contact from friends (feeling anti-social) or an increase in contact because you feel you need to vent your frustrations or stresses to others? ___ Yes (3) ___ No (0)
10. Do you feel isolated or suffer from loneliness? ___ Yes (3) ___ No (0) 11. Do you take any form of medication prescribed by a physicians directly or indirectly related to stress in your life or a psychological disorder? ___ Yes (15) ___ No (0) 12. Do you lose more than two days of work or school a year due to illness? ___ Yes (5) ___ No (0) TOTAL SCORE: _____
CIRCADIAN HEALTH
1. Do you live in the same time zone as you where born in? ___ Yes (0) ___ No (5) 2. Do you travel across time zones more than once a month? ___ Yes (10) ___ No (0) 3. Do you wake up un-rested and in need of more sleep? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times per week (5) ___ more than three times per week (10) 4. Do you commonly go to bed after 10:30 pm? ___ Yes (10) ___ No (0) 5. Are the times you have bowel movements consistent and predictable on a daily basis? ___ Yes (0) ___ No (5)
6. Do you suffer from reduced memory since moving to a new time zone or since traveling across time zones? ___ Yes (10)
___ No (0)
7. Has your sense of hunger changed from being hungry at breakfast (upon rising) , lunch (mid-day) and dinner times (sunset) since moving to a new time zone or traveling across time zones frequently? ___ Yes (10) ___ No (0) 8. Do you wake up at night between 1:00 am and 4:00 am and have a hard time falling back to sleep? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times per week (5) ___ more than three times per week (10) 9. Do you have a hard time staying awake in the afternoon after eating lunch? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times per week (5) ___ more than three times per week (10) 10. Do you do shift work that requires you to stay up late at night? ___ Yes (10) ___ No (0) TOTAL SCORE____
YOU ARE WHEN YOU EAT
1. Do you frequently skip meals? ___ Yes (3)
___ No (0)
2. Do you typically go more than four hours without eating? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times per week (5) ___ more than three times per week (10) 3. Do you sometimes skip breakfast? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times per week (5) ___ more than three times per week (10)
4. Do you avoid fats when eating? ___ Yes (5)
___ No (0)
5. Do you frequently eat carbohydrates ( i.e. breads, bagels, cookies, pasta, fruit, cereals, muffins, crackers, chocolate, or candy) by themselves? ___ Yes (5) ___ No (0) 6. Do you get hungry or crave sweets within two hours after eating a meal? ___ Yes (5) ___ No (0) 7. Do you use caffeine and / or sugar containing drinks (i.e. coffee, tea, sodas, fruit juices with sucrose, corn syrup or added sugar)? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times per week (3) ___ more than three times per week (5)
8. Have you used diets to lose weight? Yes (check option below) ___ No (0) ___ once (1) ___ twice (2) ___ three-five times (5) ___ more than five times (10) 9. Do you have difficulty burning fat around your belly, hips or thighs even with regular exercise? ___ Yes (3) ___ No (0) 10. Do you eat your largest meal at night? ___ Yes (1) ___ No (0) TOTAL SCORE____
DIGESTIVE SYSTEM HEALTH
1. Do you experience lower abdominal bloating? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than three times per week (10) 2. Do you frequently have loose stools or diarrhea?
Yes (check option below) ___ once a week (1) ___ 3 or more times per week (5)
___ No (0)
3. Do you experience constipation or stools that are compact / hard to pass? Yes (check option below) ___ No (0) ___ one to two times a week (3) ___ 3 or more times per week (5) 4. Do you find that you often burp or belch after meals? ___ Yes (3) ___ No (0) 5. Do you frequently have gas? ___ Yes (3)
___ No (0)
6. Do you crave certain foods, such as bread, chocolate, certain fruit, and red meat, if you have not eaten them in a day or two? ___ Yes (5) ___ No (0) 7. Do you have poor appetite and / or feel worse after eating? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than three times per week (10) 8. Do you have an excessive appetite and / or sweet craving? ___ Yes (5) ___ No (0)
9. Do you frequently ( more than twice per week) experience abdominal pain, cramps or general abdominal discomfort? ___ Yes (20) ___ No (0) 10. Do you have indigestion, heartburn, or upset stomach? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than three times per week (10) 11. Do you get a headache after eating? Yes (check option below) ___ No (0) ___ one to two times a week (3) ___ 3 or more times per week (5) TOTAL SCORE ____
FUNGUS AND PARASITES
1. Have you ever been given general anesthesia? ___ Yes (10) ___ No (0) 2. Have you ever taken prescription antibiotics? ___ Yes (10) ___ No (0) 3. Have you ever been or are you being treated for any condition requiring that you take medical drugs? ___ Yes (10) ___ No (0) 4. Would you consider you life to be: ___ Stress free (0) ___ Mildly stressful (5) ___ Very stressful (10) 5. In general, do your bowel movements: sink, are they loose, hard and sink, hard to pass or foul smelling? ___ Yes (10) ___ No (0) 6. Do you currently suffer from any digestive disorder such as irritable bowel syndrome, Crone’s, inflammatory bowel disease, or frequently have pain in the region above or below the naval? ___ Yes (10) ___ No (0)
7. Do you have mercury amalgam fillings in your mouth? ___ Yes (10) ___ No (0) 8. Do you have two different kinds of metal in your mouth, such as gold and silver or mercury amalgam and gold or silver? ___ Yes (10) ___ No (0) 9. Do you experience itching in the ears, nose or rectum area? ___ Yes (10) ___ No (0) 10. Do you have or have you had dandruff in the past year? ___ Yes (10) ___ No (0) 11. Do you regularly eat or drink products containing sugar, white flour, processed milk or dairy products? ___ Yes (5) ___ No (0) 12. Do you crave sugar, fruit or milk if you don’t have either of these items for more than three days?
___ Yes (10)
___ No (0)
13. Do you find that regardless of how much you eat, you get hungry very quickly? ___ Yes (5) ___ No (0) 14. In the past year, have you experienced athletes foot ( itching around the toes, soles or heel of the foot), jock itch, or have any fungal infection under a toenail (porus thickening of the toenail)? ___ Yes (20) ___ No (0) 15. Do you ever get a reddening around the mouth or nose area after eating or drinking one or more food items? ___ Yes (5) ___ No (0) 16. Do you experience muscle or joint aches on a regular basis? ___ Yes (5) ___ No (0)
17. Do you experience mood swings? ___ Yes (10)
___ No (0)
18. Do you snack on sweets or drink coffee, soda pop or sports drinks most days to keep your energy up? ___ Yes (10) ___ No (0) 19. Do you suffer from any type of skin condition? ___ Yes (10) ___ No (0)
20. Have you ever had sex or close physical contact with anyone who you know who had a fungal infection (including athletes foot, jock itch, dandruff) or parasite infection? ___ Yes (20) ___ No (0) TOTAL SCORE____
DETOXIFICATION SYSTEM HEALTH
1. Are your eyes sensitive to bright light? ___Yes (3) ___ No (0) 2. Do you suffer from irritability and have difficulty relaxing? ___Yes (10) ___ No (0)
3. Do you often fatigued or sluggish? ___Yes (10)
___ No (0)
4. Do you suffer from frequent headaches? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 or more times per week (5) 5. Do you have dark circles and or puffiness around your eyes? Yes (check option below) ___ No (0) ___ once a week (3) ___ 2-3 times per week (5) ___ more than three times per week (10) 6. Are you sensitive to paint fumes, perfume, traffic fumes, detergents or cigarette smoke? Yes (check option below) ___ No (0) ___ mildly (3) ___ moderately (5) ___ very (10) 7. Have you been unable to lose cellulite with diet and/ or exercise? ___Yes (10) ___ No (0) 8. Are you currently, or have you in the past, been frequently exposed to industrial or agricultural chemicals, such as solvents, cleaning fluids, paint fumes, plant sprays and fertilizers? Yes (check option below) ___ No (0) ___ brief exposure (3) ___ more than once a week (5) ___ daily (10)
9. Do you experience mental sluggishness, poor memory or poor concentration? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than three times per week (10) 10. Do you suffer from skin reactions such as rashes, itching, burning, for which the cause is unknown? Yes (check option below) ___ No (0) ___ 1-2 times per month (3) ___ 3 times per month (5) ___ more than three times per month (10)
TOTAL SCORE:_____
IMMUNE HEALTH
1. Were your scores in the red zone on two or more of the other questionnaires in this trouble shooting section? Yes (check option below) ___ No (0) ___ 2 questionnaires (5) ___ 3 questionnaires (10) ___ more than three questionnaires (15) 2. Do you currently supplement your diet with a high quality, non-synthetic multivitamin? ___ Yes (0) ___ No (10) 3. Do you currently take one or more prescription medical drugs? ___ Yes (10) ___ No (0) 4. Have you been on antibiotics….and not been re-colonized, with friendly bacteria supplementation? ___ Yes (10) ___ No (0) 5. How many days of work have you miss due to illness or doctor visits? ___ 0-1 day (0) ___ 2-4 days (5) ___ 5-7 days (10) ___ more than 10 days per year (20) 6. Do you get fatigued within two hours after eating? Yes ___ No (0) ___ 1-2 times per week (5) ___ 3 or more times per week (10) 7. Do you drink or cook with water from the tap (city water containing chlorine)? ___ Yes (10) ___ No (0) 8. Do you work anywhere you can touch or smell industrial chemicals, cleaning agents, solvents or any known toxic materials, such as farming pesticides, janitorial supplies, engine cleaning solvents, paint thinners or paints, plastics manufacturing, or live within two miles of a commercial farm, commercial golf course, waste dump, industrial complex or have a neighbor that spays pesticide on their yard; or use bug sprays in your home or yard, including anti-insect insecticide? ___ Yes (10) ___ No (0)
9. Do you smoke cigarettes, drink more than one cup of coffee or artificially sweetened beverages daily, or drink alcoholic beverages more than once a week? ___ Yes (10) ___ No (0) 10. Do you use recreational drugs of any kind? ___ Yes (10) ___ No (0) 11. Do you work with children (in a day care center or school) or in a medical facility? ___ Yes (10) ___ No (0) 12. Do you work in a closed environment without fresh air? ___ Yes (10) ___ No (0) 13. Do you get less than an average of eight hours of sleep each night? ___ Yes (10) ___ No (0) 14. Are you emotionally challenged or stressed due to any of the following: a. Financial stress b. Stressful relationship with a family member or with co workers c. Religious belief system that may have been imposed upon you by parents, other family members or close friends d. A sexual relationship or lack there of e. Being underweight, overweight, or obese f. Feeling unfulfilled in your work life or daily life ___Yes to A (5) ___Yes to A – D (10) ___Yes to A - F (20)
___No to all (0)
15. Do you exercise at least three times a week for at least 20 minutes? ___Yes (0) ___No (10) 16. Do you use a tanning booth more than once a month? ___Yes (5) ___No (0) 17. Do you live within a ! mile of high power electrical lines? ___Yes (5) ___No (0)
18. Do you exercise more than three times a week and experience any of the following symptoms: Have a hard time warming up during your exercise sessions Nagging injury Get colds more than two times a year • • •
Problems with any form of infection, ear, eye, skin, or otherwise more than once a year Reduced motivation Low back pain ___Yes (10) ___No (0) •
• •
19. Do you use a microwave oven? Yes (check option below) ___once a week (5) ___up to 4 times per week (10) ___more than 4 times per week (20)
___No (0)
20. Do you sleep with an electric blanket or have electrical appliances within eight feet of your bed? ___Yes (10) ___No (0) 21. Are you a vegan? ___Yes (20)
___No (0)
22. Do you always try to maintain a low fat diet? ___Yes (10) ___No (0) 23. Do you have or have you had a yeast infection (Candida) in the past six months? ___Yes (20) ___No (0) 24. Did your mother breast-feed you as a baby? ___Yes (0) ___No (20) TOTAL SCORE: _______
THYROID FUNCTION
1. Do you have a tendency to feel cold, particularly in the hands or feet? ___Yes (5) ___No (0) 2. Do you have a tendency toward excessive weight gain or inability to lose weight? ___Yes (10) ___No (0) 3. Do you experience low energy, fatigue, lethargy, need lots of sleep (>8 hours) or have trouble getting going in the morning? ___Yes (10) ___No (0)
4. Do you tend to have a low body temperature (below 98.6°)? ___Yes (10) ___No (0)
5. Is your skin frequently dry? ___Yes (5)
___No (0)
6. Do you have little red bumps on the back of your arms (from below your shoulders)? ___Yes (10) ___No (0) 7. Is your hair dry, course, split, or falling out more than normal? ___Yes (5) ___No (0) 8. Is your sex drive reduced? ___Yes (5)
___No (0)
9. Is your concentration and memory reduced? ___Yes (5) ___No (0) 10. Do you experience swollen eyelids, puffiness in face and under eyes or general water retention more than once a week? ___Yes (10) ___No (0) TOTAL SCORE: _______
HORMONES AND FAT BURNING
1. Do you feel that you do not tolerate exercise well or feel worse after exercise? ___ Yes (10) ___ No (0) 2. Do you experience depression or rapid mood swings for no apparent reason? Yes (check option below) ___ No (0) ___ 1-2 times per month (3) ___ once a week (5) ___ more than once a week (10) 3. Do you get dizzy or lightheaded when you stand up quickly? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 2 times per week (5) 4. Do you have trouble falling asleep or staying asleep? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ more than 2 times per week (5)
5. Upon waking in the morning, do you feel rested? ___ Yes(0) No (check option below) _ ___ 1-2 times per week (3) ___ more than 2 times per week (5) 6. Is your sex drive decreased? Yes (check option below) ___ mildly (1) ___ moderately (3) ___ significantly (5)
___ No (0)
7. Are you lacking mental alertness or having difficulty concentrating? ___ Yes (5) ___ No (0) 8. In General do you feel that you have low energy, feel tired or fatigued during the day? ___ Yes (5) ___ No (0) 9. Do you have the feeling of being mentally and emotionally over stressed? ___ Yes (10) ___ No (0) 10. Do you need caffeine ( coffee, tea or other stimulating drinks ) to get you going in the morning? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than 3 times per week (10) TOTAL SCORE_____
WOMANS HEALTH
1. Do you experience symptoms of PMS? ___ Yes (10) ___ No (0)
1. 2. 3. 4. 5. 6.
If you have PMS, it is likely that you will experience five or more of the following symptoms while premenstrual, but not at other times during your cycle. Depression, feelings of hopelessness or self-depreciating thoughts. Marked anxiety, tension, feelings of being “ keyed up” or “on edge” Feeling suddenly sad or tearful, increased sensitivity to rejection Persistent and marked anger, irritability or increased interpersonal conflicts Decreased interest in usual activities (i.e. work, school, friends, hobbies) Difficulty concentrating
7. Tire quickly or marked lack of energy 8. Marked change in appetite, overeating or specific food cravings 9. Sleep more or less than usual 10. A sense of being overwhelmed or out of control 11. Physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, weight gain 2. Have you experienced a change in the average length of your menstrual cycle in the past year? ___ Yes (5) ___ No (0) 3. Have you noticed a change in symptoms experienced with your periods in the last year? Yes (check option below) ___ No (0) ___ becoming worse (1) ___ mildly worse (3) ___ moderate (5) ___ severe (10) 4. Do you experience migraine type headaches? Yes (check option below) ___ No (0) ___ 2 per year (1) ___ 4 per year (3) ___ 5 per year (5) ___ more than 6 per year (10) 5. Have you experienced a change in your normal sleep patterns in the past year ( or at any time if the pattern still persists and is less favorable than previously)? ___Yes (3) ___ No (0) 6. Do you experience unexpected weight gain or fluid retention? ___Yes (3) ___ No (0) 7. Is your sex drive diminished? Yes (check option below) ___ slightly (3) ___ moderately (5) ___ significantly (10)
___ No (0)
8. Are you emotionally fragile or easily upset? Yes (check option below) ___ No (0) ___ slightly (3) ___ moderately (5) ___ significantly (10) 9. Do you feel depressed for no apparent reason? Yes (check option below) ___ No (0)
___ once a month (1) ___ once a week (5) ___ daily (10) 10. Do you experience lower abdominal bloating? Yes (check option below) ___ No (0) ___ once a week (1) ___ 3 times a week (2) ___ 3 times a week (3) 11. Have you been unable to flatten your abdominal wall through diet and/or exercise since having one or more children? ___ Yes (5) ___ No (0) 12. Do you need to urinate more frequently than other females? ___ Yes (1) ___ No (0) 13. Do you have any incontinence (trouble controlling urine, particularly during physical activities such as running, lifting heavy objects or during an exercise class or activity such as tennis)? ___ Yes (10) ___ No (0) 14. Do you suffer from bed wetting? ___ Yes (5) ___ No (0) 15. Do you have a harder time controlling urination after intercourse? ___ Yes (5) ___ No (0) 16. Do you have a hard time passing urine? ___ Yes (5) ___ No (0) 17. Do you currently, or in the past three months< have pain or a burning sensation when urinating? ___ Yes (10) ___ No (0) 18. Do you experience lower abdominal bloating? Yes (check option below) ___ No (0) ___ 1-2 times a week (3) ___ 3 times per week (5) ___ more than 3 times per week (10) 19. Are you constipated or do you have a hard time passing a bowel movement? Yes (check option below) ___ No (0) ___ 1-2 times a week (3) ___ more than 3 times per week (5)
Note: If you don’t pass 12 inches of bowel movement, have a bowel movement after each meal, or if you feel like you are not fully eliminating your bowel each time, you are most likely constipated. 20. Do you ever have kidney pain (pain in region between your bottom rib and belt line)? Yes (check option below) ___ No (0) ___ 1-2 times a month (3) ___ once a week (5) ___ more than once a week (10) 21. Do you currently, or in the last three months, have painful menstruation? ___ Yes (10) ___ No (0) TOTAL SCORE:_____ MEN’S HEALTH
1. Are you easily fatigued? Yes (check option below) ___ No (0) ___ 1-3 days per week ___ more than 3 days per week (10) 2. Do you feel depressed or have a negative mood? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than 3 times per week (10) 3. Are you irritable, angry, or generally bad tempered? Yes (check option below) ___ No (0) ___ 1-2 times per week (3) ___ 3 times per week (5) ___ more than 3 times per week (10) 4. Do you suffer from backache, joint pains or stiffness of the body in general? Yes (check option below) ___ No (0) ___ once a month (1) ___ twice a month (3) ___ weekly (5) 5. Do you feel older biologically than your actual age? Yes (check option below) ___ No (0) ___ 5 years (3) ___ 6-10 years (5) ___ more than 10 years (10)
6. Do you feel flushing or sweating in concert with for or more of the other symptoms on this questionnaire ? ___ Yes (10) ___ No (0) 7. Have you had a vasectomy? ___ Yes (5) ___ No (0) 8. Do you experience erection or impotence problems? ___ Yes (10) ___ No (0) *Note: If you are not waking up with an erection and sexual urge, this is an indicator of stress in the male. It is also an indicator of circadian stress; please be sure to complete the circadian health questionnaire. 9. Have you had testicular trauma in your life, such as a blow to the testicles in a sporting event? ___ Yes (5) ___ No (0)
10. Do you notice a decrease in your sex drive? ___ Yes (10) ___ No (0) 11. Have you noticed an increase in fat around the belly button region in concert with four or more symptoms on this questionnaire or since turning 35? Yes (check option below) ___ No (0) ___ 1inch more (3) ___ 2 inches more (5) ___ more than 2 inches (10) 12. Do you have problems with your prostate? If you experience any two of the following answer “Yes” to this question. • Difficulty starting your urine stream • Decrease strength and force of your urine stream • Urinating more frequently than normal for you • Feeling as if your bladder isn’t empty, even after you just finished urinating • Dribbling after you have just finished urinating • Frequently have an urge or need to urinate • Blood in your urine ( make sure that you have not eaten beets in the past 72 hours before mistaking it for blood) • Painful ejaculation • Pain or burning sensation while urinating • Tenderness or pain in the pelvis region, particularly when associated with hip or low back pain • Pain or swelling in testicles ___ Yes (10) ___ No (0) 13. Have you noticed a reduction in strength in concert with four or more symptoms in this questionnaire or since turning 35?
___ Yes (5)
___ No (0)
14. Have you experienced a reduction in muscle mass in concert with four or more other symptoms in this questionnaire or since turning 35? Yes (check option below) ___ No (0) ___ Butt only (3) ___ abdominals and butt (5) ___ abdominals, butt, and shoulders (10) 15. Do you suffer from loss of memory or poor concentration? ___ Yes (10) ___ No (0) TOTAL SCORE____
STEP #1 - Please Record Your Answers Here: 1.
You Are What You Eat ____________
2.
Stress _____________
3.
Digestive Health _____________
4.
Fungus / Parasites ____________
5.
Detoxification ____________
6.
Immune Health __________
7.
Thyroid Function ___________
8.
Hormones and Fat Burning _________
9.
Woman s Health __________ !
10. Men s !
Health___________
Total Anabolic Assessment Score ____________
STEP #2 - If you want to know what the heck these scores mean... make sure you are on the Lean Hybrid Muscle e mail list and keep an look out for an e mail titled “Anabolic Assessment Review” ...that is coming in a few weeks.
http://www.leanhybridmuscle.com/muscleshifting.htm <- this
Thanks, Elliott Hulse :)
