Could Lyme Disease or Tick-Borne Illness be the Root of Your Health Concerns?

Quiz Questions

• 1.
  Unexplained fevers, sweats, chills, or flushing

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 2.
  Unexplained weight change; loss or gain

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 3.
  Fatigue, tiredness

  • A.
    None
  • B.
    Mild
  • C.
    Moderate 
  • D.
    Severe
• 4.
  Unexplained hair loss

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 5.
  Swollen glands

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 6.
  Sore throat

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 7.
  Testicular or pelvic pain

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 8.
  Unexplained menstrual irregularity

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 9.
  Unexplained breast milk production; breast pain

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 10.
  Irritable bladder or bladder dysfunction

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 11.
  Sexual dysfunction or loss of libido

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 12.
  Upset Stomach

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 13.
  Change in bowel function (constipation or diarrhea)

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 14.
  Chest pain or rib soreness

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 15.
  Shortness of breath or cough

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 16.
  Heart palpitations, pulse skips, heart block

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 17.
  History of a heart murmur or valve prolapse

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 18.
  Joint pain or swelling

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 19.
  Stiffness of the neck or back

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 20.
  Muscle pain or cramps

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 21.
  Twitching of the face or other muscles

  • A.
    None
  • B.
    Mild
  • C.
    Moderate 
  • D.
    Severe
• 22.
  Headaches

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 23.
  Neck cracks or neck stiffness

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 24.
  Tingling, numbness, burning, or stabbing sensations

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 25.
  Facial paralysis (Bell’s palsy)

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 26.
  Eyes/vision: double, blurry

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 27.
  Ears/hearing: buzzing, ringing, ear pain

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 28.
  Increased motion sickness, vertigo

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 29.
  Light-headedness, poor balance, difficulty walking

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 30.
  Tremors

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 31.
  Confusion, difficulty thinking

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 32.
  Forgetfulness, poor short-term memory

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 33.
  Disorientation: getting lost; going to wrong places

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 34.
  Difficulty with speech or writing

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 35.
  Mood swings, irritability, depression

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 36.
  Disturbed sleep: too much, too little, early awakening

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 37.
  Exaggerated symptoms or worse hangover from alcohol

  • A.
    None
  • B.
    Mild
  • C.
    Moderate
  • D.
    Severe
• 38.
  You have had a tick bite with no rash or flulike symptoms

  • A.
    Yes
  • B.
    No
• 39.
  You have had a tick bite, an erythema migrans, or an undefined rash, followed by flulike symptoms.

  • A.
    Yes
  • B.
    No
• 40.
  You live in what is considered a Lyme-endemic area.

  • A.
    Yes
  • B.
    No
• 41.
  You have a family member who has been diagnosed with Lyme and/or other tick-borne infections.

  • A.
    Yes
  • B.
    No
• 42.
  You experience migratory muscle pain.

  • A.
    Yes
  • B.
    No
• 43.
  You experience migratory joint pain.

  • A.
    Yes
  • B.
    No
• 44.
  You experience tingling/burning/numbness that migrates and/or comes and goes.

  • A.
    Yes
  • B.
    No
• 45.
  You have received a prior diagnosis of chronic fatigue syndrome or fibromyalgia.

  • A.
    Yes
  • B.
    No
• 46.
  You have received a prior diagnosis of a specific autoimmune disorder (lupus, MS, or rheumatoid arthritis), or of a nonspecific autoimmune disorder.

  • A.
    Yes
  • B.
    No
• 47.
  You have had a positive Lyme test (IFA, ELISA, Western blot, PCR, and/or borrelia culture).

  • A.
    Yes
  • B.
    No
• 48.
  Thinking about your overall physical health, for how many of the past thirty days was your physical health not good?________ days

  • A.
    0-5 days
  • B.
    6-12 days
  • C.
    13-20 days
  • D.
    21-30 days
• 49.
  Thinking about your overall mental health, for how many days during the past thirty days was your mental health not good?________ days

  • A.
    0-5 days
  • B.
    6-12 days
  • C.
    13-20 days
  • D.
    21-30 days

Quiz Outcomes

• 1.
  You are not likely to have a tick-borne disorder!

  Image Source

  The Horowitz Lyme-MSIDS Questionnaire is a validated tool designed to assist practitioners with diagnosing patients with tick-borne illness. According to your results, your symptoms do not correlate with what is typically seen in people affected by tick-borne disease. To identify what other sources may be contributing to your symptoms, partner with a Functional Medicine expert so you can find the state of optimal health we all deserve! Contact GrassRoots Functional Medicine at 888-644-7668 to learn how to set up an appointment.
• 2.
  Possible Tick-Borne Disorder!

  Image Source

  The Horowitz Lyme-MSIDS Questionnaire is a validated tool designed to assist practitioners with diagnosing patients with tick-borne illnesses. According to your results, you possibly have a tick-borne disorder and should partner with a Lyme literate Functional Medicine expert for further evaluation. Contact GrassRoots Functional Medicine at 888-644-7668 to learn how to set up an appointment.
• 3.
  High Probability of Tick-Borne Disorder!

  Image Source

  The Horowitz Lyme-MSIDS Questionnaire is a validated tool designed to assist practitioners with diagnosing patients with tick-borne illnesses. According to your results, you have a high probability of a tick-borne disorder. You should partner with a Lyme literate Functional Medicine expert for further evaluation. Even if tick-borne illness is not the source of your dysfunction, your symptoms are significant enough to warrant a comprehensive Functional Medicine workup. Life is too short to feel this poorly, get to the root of what is going on! Contact GrassRoots Functional Medicine and set up an appointment if you are ready to regain your health!