Adrenal Assessment Welcome to the Adrenal Assessment! Please check off each statement that applies to you. Each is worth 1 point. Name Email Markedly reduced ability to handle stress or pressure. yes noDecreased cognitive ability. I don't think as clearly as I used to. yes noTend to avoid emotional situations. yes noOften shake or feel nervous when under pressure. yes noNervous stomach or indigestion when tense. yes noUnexplained fears/anxieties. yes noSex drive noticeably reduced. yes noGet lightheaded or dizzy when rising rapidly from a sitting or lying position yes noChronic fatigue not usually relieved by sleep. yes noFeel unwell much of the time. yes noSwollen ankles—worse in the evening. yes noNew or increasingly severe allergic reactions. yes noFeel weak all over. yes noDecreased cold tolerance. yes noLow blood pressure (under 105/65) yes noOften hungry, confused, shaky, or somewhat paralyzed under stress. yes noLost weight without reason while feeling very tired and listless. yes noPeople irritate me more. yes noLymph nodes in my neck frequently swollen. yes noExtended, severe, or recurring respiratory infections. yes noFrequently overwhelmed by normal life events. yes noWorse if I skip a meal or go too long without eating yes noCry Easily yes noPrescribed antidepressants/antianxiety drugs, but you know that is not the problem yes noTanned appearance (or brown spots) without being in the sun yes noExhausted but jittery, jump at loud noises yes noWide range of symptoms that mimic other illnesses or are unexplained by doctor yes noI frequently get rashes, dermatitis, or other skin conditions yes noI have allergies to several things in the environment. yes noI have multiple chemical sensitivities. yes noI have chronic fatigue syndrome. yes noI have insomnia or difficulty sleeping. yes noI have fibromyalgia. yes noI suffer from nervous breakdowns. yes noMy allergies are becoming worse (more severe, frequent, or more diverse). yes noMy eyes are puffy underneath upon rising, but it goes away after I’ve been up a couple hours. yes no(Women Only) I have increasing symptoms of premenstrual syndrome (PMS) such as cramps, bloating, moodiness, irritability, emotional instability, headaches, tiredness, and/or intolerance before my period (only some of these need be present). yes no(Women Only) My periods are generally heavy but they often stop, or almost stop, on the fourth day, only to start up profusely on the 5th or 6th day. yes noTime is Up!