Do You Have A Leaky Gut?

1. I come down with colds or other illnesses

Never/almost never

Occasionally

Often

It feels like I am always fighting something

2. I take a probiotic

Yes - when I remember to

Yes - daily

No - what is a probiotic?

3. I exercise

1-3x per month

1-2 x per week

3-4x per week

5+ times per week

4. I am under stress

Never/almost never

Occasionally

Often

Daily

5. I drink alcoholic beverages

1-8 drinks per month on average

1-8 drinks per week on average

9+ drinks per week on average

I don't drink

6. I take antibiotics

I don't remember the last time I took antibiotics

Less than 1x per year

1-2x per year

3+ times per year

7. I take a non-steriodal anti-inflammatory (NSAID) like Motrin, Advil, or aspirin

Less than 1x per month on average

Less than 1x per week on average

1-4x per week on average

5+ times per week on average

8. I drink and of the following - soda, energy drinks, juice, sweetened teas or coffee

Never/almost never

Occasionally

Often

It is a daily occurrence

9. I rely on packaged/processed foods for meals and/or snacks

Never/almost never

Occasionally

Often

Almost always

10. I take a long time to get over illnesses and/or injuries

Yes

No

11. I have constipation and/or diarrhea

Never/Almost never

Occasionally

Often

Almost always

12. I suffer from depression and/or mood swings

Never/almost never

Occasionally

Often

Almost always

13. I experience poor memory, or can become confused

Never/almost never

Occasionally

Often

Almost always

14. I have food allergies or sensitivities

Yes

No

15. I am tired or fatigued

Never/almost never

Occasionally

Often

Almost always

16. I have asthma, hayfever, or airborn allergies

Yes

No

17. I get Eczema, skin rashes, hives

Never/almost never

Occasionally

Often

Almost always

18. I have sinus/nasal congestion

Never/almost never

Occasionally

Often

Almost always

19. My joints ache and/or swell

Never/almost never

Occasionally

Often

Almost always

20. I have abdominal pain and/or bloating

Never

Occasionally

Often

Almost always