Do you suffer with chronic illness and malaise? Are you unsure what the cause of your symptoms is? Are you desperate to get your health back on track? Complete our Lyme disease questionnaire and find out today if it's this bacterial infection causing/contributing to your symptoms.
What Is Lyme Disease?
Lyme disease is an infection caused by the bacterium Borrelia Burgdorferi. Borrelia is most frequently transferred by a tick bite, however, may be transferred through mosquito bites, blood transfusions, pregnancy etc. Ticks and mosquitos typically get the bacterium by biting infected animals such as deer and mice. The chance of contracting Lyme disease increases the longer a tick is attached to the body, however, not all ticks are infected. It is common for someone to contract both Borrelia and co-infections such as Bartonella and Babesia from the same source, thus, symptoms will be increased.
How Does This Questionnaire Work?
In each category, mark 1 point for each symptom present. At the end of each category you will add the marks and either land in band 0, 1, 2 or 3. Do this for each category until you add up your band points at the end of the questionnaire.
Category A
Unexplained fevers, chills sweats or flushing
Unexplained weight gain or loss
Chronic fatigue
Swollen glands
Sore throat
Testicular or pelvic pain
Unexplained menstrual irregularity
Unexplained breast milk production
Breast pain
Irritable bladder/ bladder dysfunction
Loss of libido
Stomach upset
Diarrhoea/constipation or fluctuations between the 2
Chest pain or rib soreness
Shortness of breath
Cough
Heart palpitations
Heart arrhythmia (pulse skips)
History of a heart murmur or valve prolapse
Joint pain or swelling
Carditis
Back or neck stiffness
Muscle cramps or pain
TOTAL CATEGORY A BOXES MARKED:
0-2 boxes marked = Score 0
3-5 boxes marked = Score 1
6-9 boxes marked = Score 2
10+ boxes marked = Score 3
Category A total score: ..........
Category B
Twitching of the face or other muscles
Headaches
Neck cracks or stiffness
Tingling, numbness, burning or stabbing sensations
Facial paralysis
Double vision
Blurry vision
Eye floaters
Tinnitus
Increased motion sickness/ vertigo
Light-headed feeling
Poor balance
Difficulty walking
Heart attack
Dementia
Schizophrenia
Tremors
Confusion/ difficulty thinking
Difficulty with concentration or reading
Forgetfulness/ poor short-term memory
Disorientation: getting lost, going to the wrong places etc
Speech or writing difficulty
Mood swings
Irritability
Depression
Insomnia/ sleep disturbances
Exaggerated symptoms or worse hangover from alcohol
TOTAL CATEGORY B BOXES MARKED:
0-2 boxes marked = Score 0
3-5 boxes marked = Score 1
6-9 boxes marked = Score 2
10+ boxes marked = Score 3
Category B total score: ..........
Category C
Had a tick bite with no rash or flu like symptoms
Had a tick bite, an erythema migrans or undefined rash, followed by flu-like symptoms
You live in what is considered a Lyme endemic area
You have a family member who has been diagnosed with Lyme disease or co-infections
Migratory muscle pain
Migratory joint pain
Tingling/ burning/ numbness that migrates and/or comes and goes
Fibromyalgia diagnosis
Motion sickness
Chronic conjunctivitis
Chronic fatigue syndrome diagnosis
Autoimmune diagnosis
Positive Lyme disease or co-infection test
Shin splints
Tender soles of the feet
Light sensitivity
Sound sensitivity
Seizures
Low blood pressure
Difficulty swallowing
Decreased sight and/or hearing
OCD
Paranoia
Anxiety and/ or panic attacks
Violent outbursts
Hallucinations
Nausea and/ or vomiting
TOTAL CATEGORY C BOXES MARKED:
0-2 boxes marked = Score 0
3-5 boxes marked = Score 1
6-9 boxes marked = Score 2
10+ boxes marked = Score 3
Category C total score: ..........
Total Lyme Disease Risk Results
CATEGORY A SCORE: +
CATEGORY B SCORE: +
CATEGORY C SCORE: =
TOTAL:
0-4 = Not Likely Lyme Disease Sickness
5-9 = Possible Lyme Disease Sickness
10+ = Probable Lyme Disease or Co-infection Sickness
OTHER THINGS TO CONSIDER: MOULD TOXICITY, MSIDS, LYME DISEASE CO-INFECTIONS, OTHER ENVIRONMENTAL TOXINS (MERCURY, LEAD, PM2.5, GLYPHOSATE, PESTICIDES, VOCs etc), INTESTINAL PARASITES, CHRONIC VIRAL SYNDROMES, INFECTIONS, FOOD SENSITIVITIES, CVIDS OR IMMUNODEFICIENCY SYNDROMES.
This tool is intended as a clinical information aid, and is not intended to diagnose or treat disease. Symptoms listed have been reported in mould illness patients, however, not all symptoms have been proven in scientific studies.
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