Make a Copy of MC Scorecard.xlsx

	A	B	C	D	E	F	G	H	I	K
1	Metabolic Chaos® Scorecard
2		1st Test Date			Name		Sex
3		2nd Test Date
4		3rd Test Date
5		4th Test Date
6	List your top five health complaints in the left column. Then, each time you fill out this self-screen, rate the intensity of your symptoms on a scale of 0 - 5 below.
7	0 = Not Present 1 = Weak 2 = Mild 3 = Moderate 4 = Strong 5 = Severe
8	Complaints					1st Test - Symptom Scores	2nd Test		3rd Test	4th Test
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14	4th Test	3rd Test	2nd Test	1st Test	Past	Overall Totals
15	0	0	0	0	0	Overall Totals
16	0	0	0	0	0	Hormone Subtotal
17	0	0	0	0	0	Immune Subtotal
18	0	0	0	0	0	Digestion Subtotal	Copyright © 2008-2022
19	0	0	0	0	0	Detoxification Subtotal		Functional Diagnostic Nutrition® (FDN)
20	0	0	0	0	0	Energy Production Subtotal
21	0	0	0	0	0	Nervous System Subtotal
22	0	0	0	0	0	Oxidative Stress Subtotal
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24	Rate any condition that applies to you NOW (1st Test) and in the PAST using the following scale:
25	0 = Not Present 1 = Weak 2 = Mild 3 = Moderate 4 = Strong 5 = Severe Using the scale above, go through the "Now" column first, marking only the symptoms that apply to you currently. Then complete the "Past" column, grading any symptoms you experienced when they were at their worst.
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28			KEY: Red numbers indicate worsening since last test. Green numbers indicate improvement.
29	4th Test	3rd Test	2nd Test	Now	Past	Hormone	Notes and Comments
30						best sleep between 7-9 am
31						constipation
32						crave salt
33						crepey skin at neck and/or eyelids
34						delicate joints or cartilage
35						difficulty concentrating/ learning new things
36						diminished sex drive, low libido
37						do not wake feeling refreshed
38						drowsy during the day
39						energy dips in the afternoon
40						exercise exhausts, makes me feel worse
41						fatigue not relieved by sleep
42						female fertility issues
43						gets tearful easily
44						hair loss/ thinning hair
45						hard to calm down
46						headaches
47						heavy menstrual bleeding
48						impotence
49						incontinence
50						increased effort to perform daily tasks
51						increased or excessive facial or body hair
52						irritable/ short-tempered
53						lack of motivation
54						loss of bone density
55						loss of muscle mass/ inability to keep muscle
56						male fertility issues
57						menstrual irregularities
58						nails brittle, break easily
59						night sweats
60						obessive/ circular thinking
61						often awake between 2-3 a.m. (not because I’m hungry)
62						oily skin
63						overweight
64						seasonal depression (during darker, colder months)
65						sensitivity to light
66						slow to get going in a.m. and/or like to sleep late
67						tender breasts - women
68						tender or enlarged breat tissue - men
69						tooth fractures
70						type "A" personality
71						vaginal dryness
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73	0	0	0	0	0	Hormone Subtotal
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75	4th Test	3rd Test	2nd Test	Now	Past	Immune	Notes and Comments
76						aversion to particular foods
77						coughs or colds usually last for weeks
78						digestive issues
79						dry skin
80						environmentally sensitive, reactive
81						fatigue
82						feeling of grit or dirt in the eye
83						frequent ear infections
84						frequent sore throats
85						frequent upset stomach
86						frequent urinary tract infections
87						frequently swollen glands
88						gets coughs or cold easily
89						gum inflammation/ bleeding
90						hay fever - seasonal allergies
91						headaches/ migraines
92						issues with blood clotting
93						joint pain
94						joint stiffness
95						joint swelling
96						joints are easily injured
97						losing strands or clumps of scalp hair
98						noise sensitivity
99						patchy hair loss on scalp, face, or arms
100						poor circulation