Do your lips get dry or chapped easily?
Yes+
Answer the following questions. When completed, press “Submit” to continue.
Do you get canker or cold sores?
Yes
No
Sometimes
Do you experience muscle spasms in your hands and/or feet?
Yes
No
Sometimes
Do you experience sensitive or burning sensations on your skin? (nerve irritation)
Yes
No
Sometimes
Do you experience a raspy or sore throat?
Yes
No
Sometimes
No
Sometimes
Do you experience stress?
Yes+
Answer the following questions. When completed, press “Submit” to continue.
Do you urinate within 10 to 15 minutes after drinking?
Yes
No
Sometimes
Do you feel lightheaded when bending over or standing up too fast?
Yes
No
Sometimes
Do your fingers prune easily in water?
Yes
No
Sometimes
Do you feel mentally confused or forgetful?
Yes
No
Sometimes
No
Sometimes
Can you sleep 10 hours or more and still feel the need to rest or lay down again?
Yes
No
Sometimes
