LSMDLeland Stillman, MD

Heavy Metals Burden Questionnaire

Answer 10 quick yes/no questions to estimate how much hidden heavy metal burden may be driving your fatigue, brain fog, and inflammation.

Takes about 60 seconds.

1. Have you ever regularly (monthly or more often) eaten high-mercury fish like tuna, mahi-mahi, grouper, or swordfish for months or years at a time?

Yes

2. Do you have, or have you ever had, mercury ("silver") amalgam dental fillings?

Yes

3. Have you ever regularly consumed aluminum-canned beverages or used aluminum-based deodorant, sunscreen, or other personal care products for months or years?

Yes

4. Have you received vaccines as a child or as an adult?

Yes

5. Have you ever lived or worked in or near a major city with a population of more than one million people?

Yes

6. Have you ever worked in heavy industry, construction, metal-working, machining, aviation, or as a mechanic?

Yes

7. Do you currently struggle with any of the following? Fatigue or low energy; brain fog or memory issues; anxiety, depression, or mood swings; gut issues (bloating, IBS, reflux); skin issues (rashes, eczema, psoriasis); sleep problems.

Yes

8. Have you ever been told "everything looks fine" by a doctor even though you still feel tired, foggy, or inflamed?

Yes

9. Do your current symptoms regularly limit your ability to fully show up for your family, work, or calling?

Yes

10. On most days, do you feel worse than you believe someone your age should feel?

Yes

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