Autoimmune
Examples of autoimmune conditions include the following:
• Rheumatoid arthritis (RA) • Lupus (e.g., systemic lupus erythematosus [SLE])
• Type 1 diabetes • Inflammatory bowel disease (IBD)
• Crohn’s Disease • Ulcerative Colitis
• Hashimoto’s thyroiditis • Grave’s disease
• Neurological diseases • Myasthenia Gravis
• Multiple Sclerosis (MS) • Vitiligo
• Glomerulanephritis • Sjogren’s Syndrome
• Pernicious Anaemia • Addison’s Disease
• Goodpasture’s syndrome • Autoimmune Haemolytic Anaemia
• Scleroderma • Idiopathic Thrombocytopenic Purpura
• Raynaud’s Phenomenon
The term Autoimmune Diseases refers to a varied group of more than 80 distinct, chronic illnesses in which the underlying problem is similar — the body’s immune system is misdirected, attacking the body tissues it was designed to protect. Autoimmune disease can affect any system, organ, or tissue in the body, including the gastrointestinal (GI), nervous, and endocrine sysems as well as the eyes, blood, blood vessels, and skin and other connective tissues.
This subjective questionnaire will give your health care practitioner a quick summary of symptoms or signs that may be related to blood sugar and/or insulin function. It is not a substitute for professional medical advice from your health care provider.
Autoimmune Questionnaire :
Enter a number after the symptoms listed below ranging from 0 to 3. Then multiply your rating in each question by the number in the bracket ( indicates severity of the symptom) and place in the blank . Zero (0) represents symptom “not present”. Three indicates that the symptom is present in a severe form.
This partial check list touches upon some frequently noticed symptoms of some common autoimmune conditions.This list is not exhaustive, but can provide a helpful starting point.
Fever/Body Temperature
_____Recurrent fever,high body temperature (3)
_____Nightsweats (1)
Hair
_____Alopecia (loss of hair on the front and top of the head) (1)
_____Loss of hair in outer eyebrow (4)
Skin
_____Hyperpigmentation,or dark tanning in skin (3)
_____Skin thatbruises easily (1)
_____Acne (1)
_____Skin rashes of unknown cause (4)
_____Sun sensitivity (2)
_____Skin ulcers on the fingers and/or toes (2)
Eyes
_____Dryeyes (2)
_____Eye discomfort or pain (1)
Throat,Neck,Voice,and Mouth
_____Dry mouth (1)
_____Hoarseness,husky,or gravelly voice (1)
_____Difficulty swallowing (1)
_____Mouth and nose sores (1)
Fatigue and Sleep
_____Lack of energy (1)
_____Exhausted after minimal effortor exercise (1)
Muscles,Joints,and Tendons
_____Pain and tenderness throughoutthe body (3)
_____Loss of muscle control (4)
_____Muscle weakness (1)
_____Jointstiffness (1)
_____Bone,joint,and muscle aches,inflammation,and pain (4)
_____Backaches,unexplained rib and spinal column fractures (1)
_____Carpal tunnel syndrome/tendonitis (1)
Hands and Feet
_____Raynaud’s phenomenon (extreme sensitivity to cold in the hands and feet) (4)
_____Swelling in hands and Feet(1)
Digestion/Gastrointestinal
_____Recurring abdominal bloating and pain (1)
_____Pale,foul-smelling stool (1)
_____Constipation (1)
Mood and Thinking
_____Irritability,anxiety,and depression (1)
_____“Brain Fog,”difficulty concentrating, forgetfulness (1)
Balance, Coordination,and NeurologicalSymptoms
_____Dizziness (1)
_____Vertigo (the room spins) (2)
_____Loss of balance (4)
Blood Changes
_____Unexplained anemia (low countof red blood cells) (3)
_____High cholesterol levels (1)
Total Score______
If your score is more than 10 you may have an autoimmune condition.
It is recommended to consult with your health care professional team.
