Magnesium Deficiency Questionnaire

MAGNESIUM DEFICIENCY QUESTIONNAIRE

Circle each yes answer which is given a numerical value.

When you finish, total your score.

QUESTIONS:

2 Under excessive emotional stress

3 Irritable, or easily provoked to anger

2 Restless, or hyperactive

4 Easily startled by sounds or lights

2 Difficulty sleeping

3 Chronic headaches or migraines

2 Convulsions

3 Fine tremor or shakiness in your hands

3 Fine, barely noticeable muscle twitching around your eyes, facial muscles, or

other muscles of your body

3 Muscle cramps

3 Muscle spasms in hands or feet

4 Gag or choke from spasms in your oesophagus

3 Have asthma or wheezing

2 Suffer from emphysema, chronic bronchitis, or shortness breath

5 Have osteoporosis

3 Have you ever had a kidney stone

2 Suffer from chronic kidney disease

4 Have diabetes

3 Have an overactive thyroid, or parathyroid gland

3 Have high blood pressure

4 Have mitral valve prolapse (“floppy heart valve”)

3 Have very fast heart beats, irregular heart beats, or arrhythmia

3 Take Digitalis (Digoxin)

5 Take any kind of diuretic

5 Recent radiation therapy or exposure

4 Have more than 7 alcohol drinks weekly

3 Have you ever had a drinking problem?

2 Have more than 3 servings of caffeine daily

2 Eat sugar containing food daily

2 Crave carbohydrates &/or chocolate

2 Crave salt

2 Eat a high processed food/ junk food diet

2 Eat a diet low in green, leafy vegetables, seeds, & fresh fruit

2 Eat a low protein diet

2 Pass undigested food or fat in your stools

3 Suffer from chronic intestinal disease, ulcerative colitis, Crohn’s, irritable bowel syndrome

3 Frequent diarrhea or constipation

3 Suffer from PMS or menstrual cramps

2 Pregnant or recently pregnant

4 In previous pregnancy had high blood pressure or pre-eclampsia

2 Chronic fatigue

2 Muscle weakness

2 Cold hands &/or feet

2 Numbness in face, hands, or feet

2 Persistent tingling in body

2 Chronic lack of interest, indifference, or apathy

2 Poor memory

2 Loss of concentration

3 Anxiety

2 Chronic depression for no apparent reason

2 Feelings of disorientation as to time or place

2 Feel your personality is stiff or mechanical

2 Hallucinations

2 Feel that people are trying to harm or persecute you

2 Face pale, puffy, or lacking in color

2 Loss of considerable sexual energy or vitality

2 Been told by your Dr. that your blood calcium is low

3 Been told by your Dr. that your blood potassium is low

2 Take Calcium supplements regularly without magnesium

2 Take iron or zinc supplements regularly without magnesium

2 Know chronic exposure to fluorides

3 Frequently use antibiotics, steroids or oral contraceptives

<— TOTAL …

–With 30-50, you likely have low magnesium.

–Over 50 & you most certainly have low magnesium.

Further Reading:

• Are You Magnesium Deficient?
• Your Guide to Magnesium – Free E-Book
• Not All Magnesium Supplements Are The Same
• Osteoporosis Risk Reduced by Magnesium Supplementation
• Magnesium Explained: Why You Need to Supplement Daily

Related Products

Magnesium Level Test

Bio-Practica Magnesium Diasporal

Medlab Mg Optima Relax

This is a Clinic Only Product.

This is a Clinic Only Product.

This is a Practitioner Only Product.

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