Toxicity Self-Assessment Test

Rate each of the following symptoms based upon your health profile for the
past 30 days.
This questionnaire is a general indicator of toxicity based on symptoms.
Point Scale:
0 = Never or Almost never have the symptom
1 = Occasionally have the symptom, effect is not severe
2 = Occasionally have the symptom, effect is severe
3 = Frequently have the symptom, effect is not severe
4 = Frequently have the symptom, effect is severe
  • 01234
    Nausea or vomiting
    Bloated feeling
    Belching or passing gas
  • 01234
    Itchy ears
    Earaches, ear infections
    Drainage from ear
    Ringing in ears
    Hearing loss
  • 01234
    Mood swings
    Anxiety, fear, or nervousness
    Anger, irritability
  • 01234
    Fatigue, sluggishness
    Apathy, lethargy
  • 01234
    Watery or itchy eyes
    Swollen, reddened, or sticky eyes
    Dark circles under eyes
    Blurred or tunnel vision
  • 01234
  • 01234
    Irregular or skipped heartbeat
    Rapid heartbeat
    Chest pain
  • 01234
    Pain or aches in joints
    Stiffness or limited movement
    Pain or aches in muscles
    Feeling of weakness or tiredness in joints
  • 01234
    Chest congestion
    Asthma, bronchitis
    Shortness of breath
    Difficulty breathing
  • 01234
    Poor memory
    Poor concentration
    Poor coordination
    Difficulty making decisions
    Stuttering or stammering
    Slurred speech
    Learning disabilities
  • 01234
    Stuffy nose
    Sinus problems
    Hay fever
    Sneezing attacks
    Excessive mucus formation
  • 01234
    Chronic coughing
    Gagging, frequent need to clear throat
    Sore throat, hoarseness
    Swollen or discolored tongue, gums, or lips
    Canker sores
  • 01234
    Hives, rashes, or dry skin
    Hair loss
    Flushing or hot flashes
    Excessive sweating
  • 01234
    Binge eating/drinking
    Craving certain foods
    Excessive weight
    Compulsive eating
    Water retention
  • 01234
    Frequent illness
    Frequent or urgent need to urinate
    Genital itch or discharge
  • This field is for validation purposes and should be left unchanged.
If your score is: More than 50 points total OR 10 or more points in any one section, a Detoxification Program would definitely be a good idea for you. Most of us could benefit from a Detoxification Program about twice a year.

Don’t rush; be a beginner; weave pearls in your hair; grow potatoes; light the candles; keep the fire; dare to love someone; tell yourself the truth; stay inside the rapture.”
~ Marlena de Blasi, from the book
“A Thousand Days in Venice”


One of the most calming and powerful actions you can do to intervene in a stormy world is to stand up and show your soul. Struggling souls catch light from other souls who are fully lit and willing to show it.”
~ Clarissa Pinkola Estes


Mindfulness must be engaged. Once there is seeing, there must be acting. Otherwise, what is the use of seeing?”
~ Thich Nhat Hanh


The important thing is this:
To be able at any moment to sacrifice what we are for what we could become.”
~ Charles Dubois