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Asthma and related allergic disorders (hay fever, eczema, angioedema,hives)
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1) Do you take any of these medications regularly for your asthma?
*
Short acting (rescue) beta agonist inhalers such as albuterol
Long acting inhalers such as Serevent and Foradil
Anticholinergic inhalers such as Atrovent
Steroid inhalers such as Flovent and Pulmicort
Oral steroids such as Prednisone or Prednisolone
Leukotriene modifiers such as Singulair, Accolate, or Zyflo
Xolair (only by injection)
No, I don't take any of these medications
Combination inhalers such as Symbicort and Advair
2) Do you take medications that can worsen asthma?
*
Yes
No
I don't know
3) Do you filter the air in your bedroom?
*
Yes
No
4) Do pets sleep in your bedroom?
*
Yes
No
5) Have you had skin tests to determine what you're allergic to?
*
Yes
No
6) Have you had tests for delayed hypersensitivity?
*
Yes
No
7) Have you been tested for leaky gut syndrome?
*
Yes
No
8) Do you take probiotics?
*
Yes
No
9) Do you have other allergies such as hay fever, eczema, angioedema, or hives?
*
Yes
No
10) Are you stressed out or depressed?
*
Yes
No
11) Do you eat healthy food?
*
Yes
No
12) Do you take supplements for asthma?
*
Yes
No
13) Are you interested in lifestyle, dietary, and supplement recommendations to help your symptoms?
*
Yes
No
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