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TIB Survey

Take this FREE TIB questionnaire to better understand more about the toxic influences on your life.

During my clinics, I have been struck by how patients with hard-to-treat joint and muscle problems tend to have other (inflammatory) symptoms, which at first may not seem to be related to their joints – such as heartburn, constipation, gas/bloating, eczema, acne, recurrent thrush, athlete’s foot, high blood pressure, cholesterol, type 2 diabetes, kidney stones. It was when I started concentrating more on these ‘metabolic’ symptoms that I began to have a much higher success rate in treating my patients.

I have a blood test called The Toxins Test which can help me to see which toxins your body is most sensitive to and which Toxins become stuck to your DNA. I have also compiled this Toxic Inflammatory Burden (TIB) survey to help you better understand which toxins are influencing your health.

Do you work with or use the following items more than 3 times a week?

Inside pollutants	Yes	No	Sometimes
Industrial non-natural chemicals such as plastics, paints, cleaning materials
Chemical soaps/ conditioners/ shampoos/ deodorants ( non-natural ingredients)
Using hairsprays/room sprays/hand cleansers
Chemical cleaners for house
Living in a damp house or where there is mould in the rooms you spend majority of your time
Driving a new car (<3 years old)

Do you:

Do you use or consume the following items more than 3 times a week?

Kitchen utensils and foods	Yes	No	Sometimes
Stainless steel pans
Non-stick pans
Liquid oils - corn, rapeseed, olive oil in bottles and not cans
Margarine
Grains e.g. wheat, spelt, rice, oats, quinoa, millet, rye
Fish

Do you use or consume the following items every day?

Have you had any of the following:

Medical history	Yes	No
Sinus infections or blocked sinuses more than 1 per month
Urine/kidney/prostate symptoms - non cancer
Heart attack
High blood pressure
Brain condition e.g. parkinson, dementia, stroke
Cancer diagnosis
Skin condition e.g. eczema, psoriasis, itchy, dry, other
Hayfever
Asthma requiring medication or other lung condition
Irritable bowel, diarrhoea, constipation, bloating, gas
Acid indigestion
Autoimmune bowel disorder eg crohn's, colitis, caeliac, arthritis, lupus
Bowel operation
Chronic fatigue or infectious condition/EBV/Lyme
Unexplained ill health requiring time off work/school
Hormone imbalance e.g. hot flushes, testosterone deficiency/polycystic ovaries, erectile dysfunction, menstrual irregularities
Family history of kidney stones
Bone disorder e.g. osteoporosis, stress fracture, fracture, osteopenia
Joint pain one joint only
Joint pain more than one joint
Joint pain more than 3 joints - and not diagnosed with autoimmune disorder
Gall bladder disease more than once per year
Liver disease e.g. alcoholic or non-alcoholic
Family history of cancer

How many times a week do you do the following:

Weekly detox	Not at all	1	2	3	4
Saunas/steam for a minimum of 30 minutes
Meditation/breathing exercise/relaxation
One portion (small cup) seaweed consumption
Moderate exercise (out of breath but not exhausted)
Fermented foods such as sauerkraut, yoghurts, olives in brine, fermented vegetables

Answer the following questions about your dental fillings:

Oral health	Yes	No
Has your dentist said that you have dental cavitations
Currently do you have 3 or more metal fillings or have you had 3 or more metals fillings removed in the last 5 years

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Outside pollutants	Yes	No
Live near (within 400 m) fields that are sprayed with pesticides
Drink untested well water
Live near (1 km) from an industrial plant
Live near a busy road (> 10 cars per minute)

Daily habits	Yes	No	Sometimes
Coffee more than 2 cups per day
Fluoride toothpaste
Non-filtered, non-structured tap water

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TIB Survey

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