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Name *
Name
Type 1 - Low Serotonin
Choose a number from zero (no symptoms) to ten under each symptom you feel, with one being slightly felt or hardly ever felt and ten being strongly felt or felt all the time.
Substances used
Choose all substances that you used to reduce the symptoms experienced above.
List any substances used that were not listed listed above.
Type 2 - Low Catecholamines
Choose a number from zero (no symptoms) to ten under each symptom you feel, with one being slightly felt or hardly ever felt and ten being strongly felt or felt all the time.
Substances Used
Choose all substances that you used to reduce the symptoms experienced above.
List any substances used that were not listed listed above.
Type 3 - Low GABA
Choose a number from zero (no symptoms) to ten under each symptom you feel, with one being slightly felt or hardly ever felt and ten being strongly felt or felt all the time.
Substances used
Choose all substances that you used to reduce the symptoms experienced above.
List any substances used that were not listed listed above.
Type 4 - low endorphins
Choose a number from zero (no symptoms) to ten under each symptom you feel, with one being slightly felt or hardly ever felt and ten being strongly felt or felt all the time.
Substances used
Choose all substances that you used to reduce the symptoms experienced above.
List any substances used that were not listed listed above.
Type 5 - Low Blood Sugar
Choose a number from zero (no symptoms) to ten under each symptom you feel, with one being slightly felt or hardly ever felt and ten being strongly felt or felt all the time.
Substances used
Choose all substances that you used to reduce the symptoms experienced above.
List any substances used that were not listed listed above.

 

Neurotransmitters 

Serotonin promotes

Positive outlook, emotional flexibility, self-confidence, and sense of humor

Melatonin (made from Serotonin) promotes

8 hours of deep, restful sleep

Catecholamines promote

Alertness, energy, mental focus, drive, enthusiasm, concentration

GABA Promotes

Calmness, relaxation, stress tolerance

Endorphins promote

Psychological and physical pain relief, pleasure, reward, loving feelings