PMDD Mini-NAQ Instrument

What needs to happen

This is the instrument as I think it should sit. Anything marked * needs Jes.

90scored questions 19gates 13sections 8client-facing bars

Four things, in order:

Three sections do not exist yet and have to be written. Menstrual cycle, histamine, and thyroid. Menstrual cycle is the serious one: there is not a single cycle question in any source document, yet this is a PMDD assessment. It should be the deepest section here, not the missing one.
Three of the eight bars have no scoring behind them. Thyroid, Immune and Inflammation, and Sex Hormones are blank in every column of the source sheet. Those columns are marked * on every row below. Until they are filled, three of the eight bars would plot as zero.
The weights shown are my first pass, carried across from the merged sheet. They are a starting point to correct, not a proposal to approve. Diet, Hydration, Digestion, Blood Sugar and Nervous System have real numbers behind them. Everything else is open.
Then I build it. The scoring engine, the conditional flow, the graph and the reports are mine and take days, not weeks. The clinical content is the long pole.

Pick any section from the left. Gate questions are shaded with an olive edge: answering no to a gate hides everything under it, which is how a 90-question instrument stays short for most women.

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Diet

No gate. Everyone answers these.

Practitioner call *

Reverse-scored: a higher score means LESS of the food. Confirm this reads correctly to a client answering quickly.

Question	Scale	Diet	Digestion	Blood Sugar	Thyroid	Immune	Sex Horm
How often do you eat less than one serving of animal based proteins (meat, eggs, dairy) per day?	`0-3`	3		3	*	*	*
How often do you eat less than one serving of vegetables per day?	`0-3`	3	3		*	*	*
How often do you eat less than one serving of fruit per day?	`0-3`	3			*	*	*
How often do you eat less than one serving of whole grains or legumes per day?	`0-3`	3	3	3	*	*	*
How often do you eat less than 3 meals per day?	`0-3`	3		3	*	*	*
How often have you dieted for weight control?	`0-3`	3		3	*	*	*
How often have you followed a low-fat or reduced-fat diet?	`0-3`	3	3	3	*	*	*

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Hydration

No gate.

Question	Scale	Diet	Hydration	Digestion	Blood Sugar	Thyroid	Immune	Sex Horm
How often do you drink less than 40 ounces of pure water per day?	`0-3`		3	3		*	*	*
How often do you drink more than 100 ounces of water per day?	`0-3`	3	3			*	*	*
How often do you experience frequent or excessive thirst?	`0-3`		3		3	*	*	*

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Digestion

Five gated blocks. A woman with no digestive symptoms answers five yes/no questions instead of twenty-six.

Question	Scale	Diet	Hydration	Digestion	Thyroid	Immune	Sex Horm
Do you experience indigestion? (bloating, acid reflux, gas)	`yes/no, unscored`				*	*	*
Heartburn or acid reflux	`0-3`	3	3	3	*	*	*
Belching after eating	`0-3`			3	*	*	*
Bloating	`0-3`			3	*	*	*
Gas or flatulence	`0-3`			3	*	*	*
Do you experience nausea?	`yes/no, unscored`				*	*	*
Stomach upset by taking vitamins	`0-3`			3	*	*	*
Stomach upset by greasy food	`0-3`			3	*	*	*
Motion sickness (sea, car, airplane)	`0-3`			3	*	*	*
Do you experience abdominal pain or cramping?	`yes/no, unscored`				*	*	*
Upper abdominal stomach pain or cramping	`0-3`			3	*	*	*
Pain under the right side of the rib cage	`0-3`			3	*	*	*
Cramping in the lower abdominal region	`0-3`			3	*	*	*
Do you have a history of gallbladder issues?	`yes/no, unscored`				*	*	*
Do you experience gallbladder attacks?	`0-3`	3		3	*	*	*
Have you had your gallbladder removed?	`0-1`	1		1	*	*	*
Do you experience diarrhea or unformed stools?	`yes/no, unscored`				*	*	*
Chronic diarrhea (3 or more loose stools in 24 hours, for 4 weeks or more)	`0-3`		3	3	*	*	*
Diarrhea shortly after meals	`0-3`			3	*	*	*
Do you experience constipation or difficult to pass stools?	`yes/no, unscored`				*	*	*
Fewer than one bowel movement per day	`0-3`			3	*	*	*
Feelings of incomplete evacuation	`0-3`			3	*	*	*
Do you pay attention to the appearance of your bowel movements?	`yes/no, unscored`				*	*	*
Black or tarry stools	`0-3`			3	*	*	*
Undigested food in stools	`0-3`			3	*	*	*
Greasy or shiny stools	`0-3`			3	*	*	*
Light or clay coloured stools	`0-3`			3	*	*	*
Blood in stool Safety: any yes here should prompt 'please tell your doctor', regardless of score.	`0-3`			3	*	*	*
Mucus in stool	`0-3`			3	*	*	*

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Alcohol

Gated.

Question	Scale	Digestion	Thyroid	Immune	Sex Horm
Do you drink alcohol, currently or in the past?	`yes/no, unscored`		*	*	*
How many alcoholic drinks do you have per week? Bands: 0 = 0-1/day, 1 = 2-3/day, 2 = 3-5/day, 3 = 6+/day. These bands are per DAY on a question asking per WEEK.	`banded 0-3`	3	*	*	*
Would you easily become sick, intoxicated or hungover from any amount of wine?	`0-3`	3	*	*	*

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Cravings and appetite

Checklist, no gate. Appetite block is gated.

Question	Scale	Diet	Digestion	Blood Sugar	Nerv/Adrenals	Thyroid	Immune	Sex Horm
Cravings: bread or noodles	`0-3`		3			*	*	*
Cravings: sweets	`0-3`		3	3		*	*	*
Cravings: salty foods	`0-3`				3	*	*	*
Cravings: coffee or sugar, specifically in the afternoon	`0-3`			3		*	*	*
Do cravings make it very difficult to give up dairy or grains?	`0-3`		3			*	*	*
Do you experience binging or uncontrolled eating?	`0-3`			3		*	*	*
Do you experience changes in appetite or food aversions?	`yes/no, unscored`					*	*	*
Generally feel better if you don't eat	`0-3`		3			*	*	*
Loss of taste for, or aversion to, meat	`0-3`		3			*	*	*
Reduced appetite	`0-3`	3	3	3		*	*	*
Excessive appetite	`0-3`			3		*	*	*

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Energy, blood sugar and head

Three gated blocks. Note these gates are themselves scored 1-3, unlike the digestive gates.

Question	Scale	Diet	Hydration	Digestion	Blood Sugar	Nerv/Adrenals	Thyroid	Immune	Sex Horm
Do you experience headaches?	`1-3, scored`	3	3				*	*	*
Headaches if meals are skipped or delayed	`0-3`				3		*	*	*
Headache after exercising	`0-3`				3	3	*	*	*
Afternoon headaches	`0-3`				3	3	*	*	*
Do you feel dizzy, shaky or jittery?	`1-3, scored`				3	3	*	*	*
Become dizzy when standing up quickly	`0-3`				3	3	*	*	*
Shaky if meals are delayed	`0-3`				3		*	*	*
Feel wired or jittery after coffee or caffeine	`0-3`				3	3	*	*	*
Do you experience fatigue or energy fluctuations?	`1-3, scored`		3		3	3	*	*	*
Slow starter in the morning	`0-3`				3	3	*	*	*
Fatigue that is relieved by eating	`0-3`				3		*	*	*
Sleepy after meals	`0-3`			3			*	*	*
Afternoon yawning or sleepiness	`0-3`				3	3	*	*	*

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Mood, clarity and sleep

Two gated blocks.

Practitioner call *

These currently all score into Adrenals. If Nervous System is to be its own bar rather than a rename of Adrenals, this section needs its own weights.

Question	Scale	Hydration	Digestion	Blood Sugar	Nerv/Adrenals	Thyroid	Immune	Sex Horm
Do you experience issues with mood or mental clarity?	`yes/no, unscored`					*	*	*
Brain fog, or feeling spacey or unreal	`0-3`		1			*	*	*
Irritable before meals	`0-3`			3		*	*	*
Tend to be keyed up, trouble calming down	`0-3`			3	3	*	*	*
Calm on the outside, troubled on the inside	`0-3`			3	3	*	*	*
Nervous, anxious or frequently agitated	`0-3`	3		3	3	*	*	*
Do you have difficulty falling or staying asleep?	`yes/no, unscored`					*	*	*
Difficulty falling asleep	`0-3`			1	1	*	*	*
Waking a few hours in and struggling to get back to sleep	`0-3`			3		*	*	*

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Skin, mouth and urinary

Three gated blocks.

Question	Scale	Diet	Hydration	Digestion	Blood Sugar	Nerv/Adrenals	Thyroid	Immune	Sex Horm
Do you experience skin symptoms? (appearance, texture, colour, itching)	`yes/no, unscored`						*	*	*
Dry, flaky skin	`0-3`	1		1			*	*	*
Hives, or lip, eye or facial swelling	`0-3`	3		3			*	*	*
Puffy or dark circles under the eyes that don't improve with sleep	`0-3`			3			*	*	*
Do you experience frequent urination?	`0-3, scored`	3			3		*	*	*
Do you wake at night to urinate?	`0-3`		3		3		*	*	*
Do you experience mouth symptoms? (odour, taste, coating, grinding)	`yes/no, unscored`						*	*	*
Bad breath	`0-3`			1			*	*	*
Coated tongue	`0-3`			3			*	*	*
Bitter taste in the mouth, especially after meals	`0-3`			3			*	*	*
Clench or grind teeth	`0-3`				3	3	*	*	*

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Allergies, sensitivities and immune

Gated.

Practitioner call *

Every question here should almost certainly also feed the Immune and Inflammation bar. The source sheet has that column blank throughout, so all Immune weights below are unset.

Question	Scale	Diet	Hydration	Digestion	Thyroid	Immune	Sex Horm
Do you experience allergies or sensitivities? (food, chemical, environmental)	`yes/no, unscored`				*	*	*
Reactions or symptoms triggered by specific foods	`0-3`			1	*	*	*
Airborne or environmental allergies	`0-3`			3	*	*	*
Feel worse in mouldy or musty places	`0-3`			3	*	*	*
Sensitive to chemicals or smells (perfume, cleaning agents, tobacco)	`0-3`			3	*	*	*
Asthma, wheezing or difficulty breathing	`0-3`	3	3	3	*	*	*
Sinus congestion, stuffy head or sinus infections	`0-3`			3	*	*	*
Cough at night	`0-3`			3	*	*	*
Frequent throat clearing or post nasal drip	`0-3`			3	*	*	*
Do you have a history of fungal or yeast infections?	`1-3, scored`			3	*	*	*
Do yeast symptoms increase with sugar, starch or alcohol?	`0-3`	3		3	*	*	*

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History and exposures

No gate. Short answers.

Question	Scale	Diet	Digestion	Blood Sugar	Nerv/Adrenals	Thyroid	Immune	Sex Horm
In the past 2 years, have you taken antibiotics for over 4 weeks? (90 days on reassessment)	`0-1`		3			*	*	*
In the past 2 years, diagnosed with or exposed to parasites? (90 days on reassessment)	`0-1`		1			*	*	*
In the past 90 days, have you experienced anemia? (30 days on reassessment)	`0-1`	1	1			*	*	*
Do you use over-the-counter pain medications?	`0-3`		1			*	*	*
Are you exposed to diesel fumes?	`0-3`		3			*	*	*
Have you noticed a strong body odour?	`0-3`		3			*	*	*
Does your pulse speed up after eating?	`0-3`		3			*	*	*
Are your eyes sensitive to light?	`0-3`	3		3	3	*	*	*
Itchy or peeling feet	`0-3`		3			*	*	*
Itchy anus	`0-3`		3			*	*	*
Haemorrhoids or varicose veins	`0-3`		3			*	*	*
Fingernails chip, peel or break easily	`0-3`	3	3			*	*	*

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Menstrual cycle *

TO BE AUTHORED *

Nothing exists for this in any source. The pattern list already contains Menstrual Irregularities, Female Hormone Imbalance and Hormone Detoxification Dysfunction with nothing feeding them. For a PMDD assessment this should be the deepest section in the instrument, not the thinnest.

Jes writes this *

Suggested coverage below. This is a starting list to react to, not a proposal. Every line needs her wording, her scale, and her weights.

Are you currently cycling? (gate: pregnant, postpartum, on continuous contraception, perimenopausal, post-menopausal) *
Typical cycle length, and how much it varies *
Bleed length, flow, clotting, pain *
How many days per cycle are affected by mood symptoms *
When symptoms begin relative to the bleed, and whether they clear once it starts *
Symptom-free window: is there one, and how long *
Current and past hormonal contraception, and what changed on starting or stopping *
Pregnancies, births, terminations, losses, and any postpartum mood history *
Formal PMDD or PMS diagnosis, by whom *
Whether symptoms have ever been severe enough to affect safety *

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Histamine *

TO BE AUTHORED *

Requested in the outline, no source list exists. Partly overlaps the allergy block above, so the first decision is whether this is its own gated section or folded into Immune and Inflammation.

Jes writes this *

Suggested coverage below. This is a starting list to react to, not a proposal. Every line needs her wording, her scale, and her weights.

Reactions to aged, fermented or leftover foods *
Flushing, itching or hives after eating or drinking *
Reaction to red wine specifically *
Symptoms that worsen at particular points in the cycle *
Nasal congestion or headache after eating *
Whether antihistamines reliably help *

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Thyroid *

TO BE AUTHORED *

Thyroid is one of the eight client-facing bars, but the source sheet has the THYROID column almost entirely blank and the question list has no thyroid section. There is currently nothing to plot on that bar.

Jes writes this *

Suggested coverage below. This is a starting list to react to, not a proposal. Every line needs her wording, her scale, and her weights.

Cold intolerance, cold hands and feet *
Weight that will not shift despite effort *
Hair thinning, shedding or coarsening *
Mentally sluggish, reduced initiative *
Constipation as a persistent pattern *
Outer eyebrow thinning *
Known thyroid diagnosis, medication, or family history *