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Magnesium Status Questions
1 = Almost never ; 2 = sometimes ; 3 = Fairly often; 4 = Very often.
1. Drink alcohol every day or more than 7 alcoholic drinks per week.
1
2
3
4
2. Strenuous exercise or training more than 3 times per week (running, sports, gym, etc.)
1
2
3
4
3. More than 3 coffees per day
1
2
3
4
4. High sugar-containing foods daily
1
2
3
4
5.Eat processed food or junk food daily
1
2
3
4
6.Consume a diet high in fatty foods (fried foods, butter, hamburgers, bcon, ice-cream, cheese)
1
2
3
4
7.A diet low in green leafy vegetables, seeds and nut (less than one serve every day)
1
2
3
4
8. Consume soft drinks/fizzy drinks daily
1
2
3
4
9. Frequently have undigested food or fat in your stools (more than 3 times per week)
1
2
3
4
1). Chronic headaches or migraines
1
2
3
4
2). Asthma
1
2
3
4
3). Diabetes
1
2
3
4
4.) Gaucoma
1
2
3
4
5.) Osteoporosis
1
2
3
4
6.) Chronic kidney disease
1
2
3
4
7.) High blood pressure
1
2
3
4
8.) An overactive thyroid or underactive thyroid
1
2
3
4
9.) An endocrine condition such as hyperaldosteronism or Hyperpathyrodism
1
2
3
4
10.) Very fast heart beats, irregular heartbeats or arrhythmia (or have experienced these symptoms in the last 12 months)
1
2
3
4
11.) Chronic intestinal disease - Ulcerative colitis, Crohn's disease or irritable bowel syndrome
1
2
3
4
12.) Frequent diarrhoea or constipation
1
2
3
4
13.) PMS or menstrual cramps
1
2
3
4
14.) Frequent Lethargy or fatigue
1
2
3
4
15.) Known parasites
1
2
3
4
16.) Currently pregnant
1
2
3
4
17.) Recently pregnant (last 12 months)
1
2
3
4
18.) Breastfeeding or recently breastfed for longer than 12 months
1
2
3
4
19.) Have diagnosed Haemochromatosis (iron overload)
1
2
3
4
20.) In a previous pregnancy had high blood pressure or pre-eclampsia
1
2
3
4
21.) Recent traumatic stress, physical or emotional (in the last 12 months)
1
2
3
4
1.) Taking Digitalis (digoxin)
1
2
3
4
2.) Taking any kind f diuretic medication
1
2
3
4
3.) Known to have low blood potassium
1
2
3
4
4.) Known to have Vitamin D deficiency
1
2
3
4
5.) Taking Calcium supplements regularly without Magnesium
1
2
3
4
6.) Medically diagnosed malnutrition
1
2
3
4
7.) Taking Iron or Zinc suppements regularly withou Magnesium
1
2
3
4
8.) Told by your practitioner you have an acid/alkali imbalance
1
2
3
4
9.) Told or kow you have had exposure to heavy metals such as Mercury Cadmium or Aluminium or Lead
1
2
3
4
10.) Frequently use antibiotics (more than 3 courses in the last 6 months)
1
2
3
4
11.) Currently on steriod medication (e.g. Prednisolone, Symbacort, Cortisone)
1
2
3
4
12.) Taking Oral contraceptives
1
2
3
4
13.) Had recent radition therapy or exposure (in last 12 months)
1
2
3
4
1). Easily startled by sounds or people
1
2
3
4
2). Muscle spasms in hands or feet
1
2
3
4
3). Difficulty sleeping
1
2
3
4
4). Irritability, or being easily provoked
1
2
3
4
5). Feeling restless or agitated
1
2
3
4
6). Smal muscle twitching around your eyes, facial muscles
1
2
3
4
7). Convulsions
1
2
3
4
8). Experience long or intense periods of stress
1
2
3
4
9). Shakiness or tremor in your hands
1
2
3
4
10). Muscle cramps
1
2
3
4
11). Chronic lack of interest indifference or apathy
1
2
3
4
12). Poor memory
1
2
3
4
13). Experience physical or mental fatigue
1
2
3
4
14). Loss of concentration
1
2
3
4
15). Anxiety
1
2
3
4
16). Mood Swings
1
2
3
4
17). Depression for no apparent reason
1
2
3
4
18). Feelings of disorientation as to time or place
1
2
3
4
19). Experience emotional stress
1
2
3
4
20). Feelings that people are against you
1
2
3
4
21). Cold hands or feet
1
2
3
4
22). Numbness in face, hands, or feet
1
2
3
4
23). Experience tingling or pins and needles anywhere in your body
1
2
3
4
24). Loss of libido
1
2
3
4
SUBMIT
