PHYSICAL ASSESSMENT
PRESENTING PROBLEMS
Biological Age: ( ) This does not reflect how you look or the way you feel. It is an evaluation of the degree of effectiveness of your body/mind
Foundational Analysis: Lack of absorption, lack of processing, lack of elimination, lack of protection, toxicity, inflammation, degeneration, dysfunction form the core of our analysis and the optimal value is “0.” The degree to which each organ or nutrient contributes to this imbalance is measured on a scale of 0 to 10. We use 0 as a baseline because most frequently those levels express deficiencies. In some cases we may have an excess, in which case we add a (+) in front of the number.
Lack of Absorption
Nutrients: Min ( ) Vit ( ) EFA’s ( ) Carotenoids ( ) Bioflavanoids ( )
Amino Acids ( ) Others ( )
Digestive Fluids: Saliva ( ) HCL( ) Digestive Enzymes ( ) Bile ( )
Diet Balance: Water ( ) Protein ( ) Carbs ( ) Greens ( ) Fiber ( )
Oxygen ( )
Localized Deficiency: Cellular ( ) Brain ( ) Others ( )
Lack of Processing
Liver ( ) Pancreas ( ) Cells ( ) Stomach ( ) Small Intestine ( )
Large Intestine ( ) Endocrine ( ) Neurological ( ) Others ( )
Lack of Elimination
Liver ( ) LI ( ) KI ( ) Cells ( ) Lymphatic ( ) Others ( )
Lack of Protection
Fungus ( ) Fungoid ( ) Parasites ( ) Virus ( ) Viroid ( )
Stealth Virus ( ) Bacteria ( ) Mycoplasm ( ) Nano Bacterium ( ) Pleomorphic micro organisms ( ) Immune Modulation ( )
Membrane integrity ( ) Allergies ( ) Auto Immune ( ) Miasm ( )
Others ( )
GENERAL MANIFESTATION
General Toxicity ( )
Inflammation ( )
Degeneration ( )
Dysfunction ( )
Specific Functional Indicators
In this section we look at critical health indicators associated with specific systems: Endocrine, Immune, Neurological, Cardiovascular and Skeletal. Because these indicators are often deficient (hypo) or in excess (hyper) we use 10 as our ideal and values below indicate deficiencies and number above excess.
Endocrine
Pregnenolone ( ) Cortisol ( ) DHEA ( ) Estrogen ( ) Progesterone ( ) Testosterone ( ) DHT ( ) Insulin ( ) Glucagon ( ) TSH ( ) T4 ( )
T3 ( ) HGH ( )
Immune
Cell Mediated Th1 ( )
Humoral Th2 ( )
Regulatory Th3 ( )
Gene Expression (Cancer Risks)
Protective Gene Expression [ideal 10] ( )
Degenerative Gene Expression [ideal 0] ( )
Estrogen DNA Adducts [ideal 0] ( )
Neurological
Neurotransmitters [Ideal 10] Serotonin ( ) Dopamin ( ) GABA ( ) Acetylcholine ( ) Neuropeptides Function ( ) Brain circulation ( )
Brain Dysfunction [ideal 0] Neuro Inflammation ( ) Neuro Degeneration ( )
Cardiovascular
LDL ( ) HDL ( ) Triglycerides ( ) Blood Pressure ( ) Homocysteine ( ) CRPs ( ) Lipoprotein (a) ( ) Serum Fibrinogen ( ) Weight ( ) Blood Sugar ( )
Bone Health
Calcium ( ) Magnesium ( ) Phosphorus ( ) Boron ( ) Silica ( )
Strontium ( ) Vit D ( ) Vit K ( ) Estrogen ( ) Ipriflavone ( )
FOCAL ANALYSIS I
This section is designed for more in depth analysis of specific symptoms or concerns. Our scale is 0 to 10 , zero representing our optimal value.
Functional Analysis
Lack of Absorption ( ) Toxicity ( )
Lack of Processing ( ) Inflammation ( )
Lack of Elimination ( ) Degeneration ( )
Lack of Protection ( ) Dysfunction ( )
Negative impact of the physical on the psychological ( )
Specific findings and treatment suggestions:
PSYCHOLOGICAL ASSESSMENT
PRESENTING ISSUES
Psychological Foundation: Psychological disturbances exercise a powerful effect on the health of the body. The degree of satisfaction and contribution in our life is the foundation of our health and wellbeing.
Positive Negative
Receptivity ( ) Degree of reactivity ( )
Resourcefulness ( ) Dissatisfaction ( )
Staying present ( ) Self judgment ( )
Boundaries ( ) Resigned and/or cynical ( )
Living the life you love ( )
Negative impact of the psychological on the physical ( )
Legend
Optimal readings on negative psychological traits in the right column are 0.
Optimal readings on beneficial psychological traits in the left column are 10.
DESIRED OUTCOMES
Outcomes:
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