Toxiflammation Assessment

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Name(Required)

Domain 1: Gut & Microbiome

The primary portal for both toxic entry and inflammatory signaling
Constipation(Required)
Bloating, gas, or abdominal distension(Required)
Diarrhea(Required)
Nausea or vomiting(Required)
History of antibiotic use or acid blockers(Required)
Undigested food in stool(Required)
Heartburn or reflux(Required)
Food sensitivities(Required)
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Domain 2: Environmental Exposures

Assessing daily toxic load and chemical vulnerabilities
Known exposure to mold or damp buildings(Required)
Frequent use of conventional cleaning products or pesticides(Required)
Regular consumption of non-organic foods (pesticide risk)(Required)
Use of unfiltered tap water for drinking or bathing(Required)
Living near heavy traffic, industrial areas, or agricultural fields(Required)
Frequent use of scented products, candles, or synthetic perfumes(Required)
History of high alcohol consumption or heavy prescription/OTC drug use(Required)
Amalgam (silver) dental fillings or known heavy metal exposure(Required)
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Domain 3: Immune & Inflammatory Reactivity

Evaluating systemic immune activation and chronic inflammatory triggers
Frequent infections (colds, sinus infections, or urinary tract infections)(Required)
Allergies, hay fever, or seasonal asthma(Required)
Skin rashes, eczema, hives, or unexplained itching(Required)
Joint pain, muscle aches, or stiffness without injury(Required)
Swollen lymph nodes or tender glands(Required)
Slow healing from cuts, wounds, or physical exertion(Required)
History of confirmed or suspected autoimmune conditions(Required)
Sensitivities to fabrics, jewelry, or topical products(Required)
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Domain 4: Endocrine & Energy Production

Assessing hormonal balance, thyroid function, and cellular energy output
Fatigue or low energy that doesn't improve with rest(Required)
Unexplained weight gain or difficulty losing weight(Required)
Cold hands and feet, or intolerance to cold temperatures(Required)
Brain fog, poor concentration, or memory lapses(Required)
Sleep disturbances, insomnia, or waking up tired(Required)
Hair loss, thinning hair, or brittle nails(Required)
Irregular menstrual cycles, severe PMS, or menopausal symptoms(Required)
Low libido, mood swings, or high susceptibility to stress(Required)
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Domain 5: Neurological & Cognitive Function

Evaluating neurotransmitter balance, cognitive reserve, and sleep quality
Anxiety, irritability, or panic attacks(Required)
Depression, flat mood, or loss of interest in activities(Required)
Difficulty falling asleep or staying asleep(Required)
Frequent headaches or migraines(Required)
Dizziness, lightheadedness, or balance issues(Required)
Tinnitus (ringing in the ears) or sensitivity to loud noises(Required)
Muscle tremors, twitches, or restless legs(Required)
Poor stress tolerance or feeling easily overwhelmed(Required)
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Domain 6: Cardiorespiratory & Metabolic Health

Assessing cardiovascular function, oxygenation, and metabolic efficiency
Heart palpitations, racing heart, or skipped beats(Required)
Shortness of breath with minimal exertion(Required)
Cold extremities or poor circulation (numbness/tingling)(Required)
Chest tightness or pressure without diagnosed cardiac issues(Required)
Frequent cravings for sweets, carbohydrates, or salty foods(Required)
Energy crashes or irritability if meals are delayed (hangry)(Required)
Excessive thirst or frequent urination(Required)
Difficulty waking up without caffeine or stimulants(Required)
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Domain 7: Musculoskeletal & Structural Integrity

Evaluating bone density, joint stability, muscle mass, and structural alignment
Chronic lower back pain, stiffness, or sciatica(Required)
Neck pain, shoulder tension, or frequent muscle knots(Required)
Clicking, popping, or painful joints (knees, hips, wrists)(Required)
Muscle weakness, loss of muscle tone, or rapid fatigue during exercise(Required)
Frequent muscle cramps, spasms, or charley horses(Required)
History of bone fractures, osteopenia, or osteoporosis(Required)
Poor posture, rounded shoulders, or forward head carriage(Required)
Slow recovery or prolonged soreness after physical activity(Required)
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