Toxicity Assessment | Happy & Healthy with Shelby

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Do you experience any of the following ear-related symptoms? *

Do you experience any of the following sinus or nasal symptoms? (Select all that apply) *

Do you experience any of the following eye-related symptoms? (Select all that apply) *

Do you experience any of the following ear-related symptoms? (Select all that apply) *

Do you experience any of the following teeth or gum-related symptoms? (Select all that apply) *

Tooth or gum pain

Bleeding gums

Silver (amalgam) fillings

None of the above

Do you experience any of the following mouth or lip symptoms? (Select all that apply) *

Do you experience any of the following tongue symptoms? (Select all that apply) *

Red spots or dots on the tongue

Scalloped edges (indentations on the sides of the tongue)

White, yellow, or brown coating on the tongue

Cracks or lines on the tongue

None of the above

Do you experience any of the following gland or swelling symptoms? (Select all that apply) *

Do you experience any of the following breathing or respiratory symptoms? (Select all that apply) *

Do you experience any of the following weight or metabolism-related symptoms? (Select all that apply) *

Do you experience any of the following joint or muscle symptoms? (Select all that apply) *

Do you experience any of the following sleep-related symptoms? (Select all that apply) *

Do you experience any of the following energy or mood-related symptoms? (Select all that apply) *

Feeling tired upon waking

Daytime or afternoon fatigue

Low overall energy

Apathy

Lack of ambition or motivation

Hyperactivity (difficulty sitting still)

Restlessness (feeling uncomfortable when still or quiet)

Tapping feet or shaking legs when seated

None of the above libido or sexual function

Do you experience any of the following focus or cognitive symptoms? (Select all that apply) *

Difficulty concentrating

Easily distracted or losing train of thought

Difficulty making decisions

Brain fog

Trouble forming sentences or finding the right words

Poor coordination or frequently dropping things

ADD/ADHD or learning difficulties

None of the above

Do you experience any of the following immune-related symptoms? (Select all that apply) *

Frequent colds or illnesses (more than 2–3 times per year)

Environmental allergies or non-severe food sensitivities

Pneumonia within the last 12 months

Diagnosed immune-related condition

Unexplained recurring illness

None of the above

First Name *

Email *

Toxicity Results

Toxicity Score

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