Articles
Health Questionnaire
Since 2002 Clinical Nutritionist Blake Graham, B.Sc (Honours) has years designed and refined a very detailed 17 page questionnaire to help assess the large array of potential factors which may be contributing to a person symptoms. All illness is multi-factorial, and it is very logical to at least consider all of these variables when assessing a patient. You can see a copy of this regularly updated questionnaire HERE (pdf file). Print it off , carefully fill it in, and see what turns up.
Factors assessed via this questionnaire.
- 1. Illness triggers or precipitating factors.
- 2. Family history / genetic predisposition.
- 3. Sleep.
- Lack of adequate sleep.
- Sleep apnea.
- Sleep disruption.
- Restless leg syndrome.
- Circadian rhythm imbalance.
- 4. Dietary inadequacies and excesses.
- 5. Post infectious state/chronic infection.
- 6. Blood sugar imbalances.
- Diabetes mellitus.
- Hypoglycemia.
- 7. Nutrient imbalances.
- Essential fatty acid deficiencies.
- Copper excess.
- Magnesium deficiency.
- Iron deficiency.
- Vitamin D deficiency.
- Zinc deficiency.
- 8. Pyroluria.
- 9. Impaired liver detoxification.
- 10. Gastrointestinal - intolerances/allergies/maladigestion.
- Celiac disease/gluten intolerance.
- Fat malabsorption.
- Stomach acid deficiency (hypochlorhydria).
- Food allergies/intolerances - general.
- Fructose malabsorption.
- Lactose intolerance.
- 11. Gastrointestinal - microbiology.
- Intestinal bacterial imbalance (dysbiosis).
- Intestinal yeast overgrowth.
- Intestinal parasites.
- 12. Environmental exposures.
- Electromagnetic radiation exposure.
- Environmental mold.
- Environmental chemicals.
- Heavy metals.
- 13. Neurotransmitter imbalances.
- Serotonin deficiency.
- Dopamine/noradrenaline deficiency and excess.
- Acetylcholine deficiency.
- Endorphin deficiency.
- GABA deficiency.
- 14. Psycho-social stress/emotional issues.
- 15. Hormone imbalances.
- Hypo-adrenal.
- Hypo-thyroid.
- Sex hormone imbalances.
- Women: Progesterone deficiency, estrogen excess, estrogen deficiency and androgen dominance.
- Men: Testosterone deficiency and estrogen excess.
Blake Graham, BSc (Honours), AACNEM
Clinical Nutritionist
Perth, Western Australia
Phone/Email: See Contact page
*Non-Perth residents may enquire about phone consultations.
