Phase five of eight 55% Medical Questionnaire 5 – Minerals Power Supply Are you a vegetarian? * Yes No Are you often working outdoors in the weather? * Yes No Do you drink a lot of soft drinks or carbonated and sugary drinks? * Yes No Loss of Minerals Do you regularly play sports or perform physical activity? * Yes No Do you go to the sauna? * Yes No Do you take a contraceptive, such as the pill? * Yes No Do you take antibiotics? * Yes No Do you take a laxative? * Yes No Do you take cortison/inflammation inhibitors (e.g. Diclofenac, Voltaren etc.)? * Yes No Do you take antacids? * Yes No Do you take medicine for rheumatism? * Yes No Do you take diuretic/dewatering tablets? * Yes No Diseases That Deplete Minerals In Our Body Do you suffer from lowered immunity? * Yes No Do you suffer from resistance bowel diseases? * Yes No Do you suffer from diabetes mellitus? * Yes No Do you suffer from diarrhea? * Yes No Do you suffer from liver disease? * Yes No Do you suffer from kidney disease? * Yes No Do you suffer from rheumatism? * Yes No Do you suffer from neuro dermis? * Yes No Risk Groups Are you pregnant? * Yes No Are you breast feeding? * Yes No Do you drink alcohol regularly? * Yes No Have you had surgery in the last twelve months? * Yes No Symptoms of Mineral Deficiency When you suffer a cut or wound, do they take longer than a week to heal? * Yes No Are you susceptible to infections? * Yes No Do you have and dermatological problems like psoriasis, acne or eczema? * Yes No Do you have thinning, fragile or brittle hair? * Yes No Do you occasionally suffer from inflamed, cracked mouth corners? * Yes No Do you have straight forward lines in your nails? * Yes No Do you suffer from impotence? * Yes No
