• Magnesium Deficiency Questionnaire ~ quiz is to find correlation between health issues and/or symptoms related to deficiency ~ lack of bio magnesium.
  • Magnesium Deficiency Questionnaire ~ quiz is not a substitute for medical or psychological, diagnosis and treatment.
  • We make no claims to diagnose conditions, or to perform medical treatment, prescribe substances, or interfere with the treatment of a licensed medical professional.


  • Numerical values are assigned to Yes and No answers, once the form is submitted your score is tallied.
  • Return to the home page.

The Magnesium Deficiency Questionnaire can also be downloaded

(File Size: 18KB)



Under excessive emotional stress
N Irritable, or easily provoked to anger
N Restless, or hyperactive
N Easily startled by sounds or lights
N Difficulty sleeping
N Chronic headaches or migraines
N Convulsions
N Fine tremor or shakiness in your hands
N Fine, barely noticeable muscle twitching around your eyes, facial muscles, or other muscles of your body
N Muscle cramps
N Muscle spasms in hands or feet
N Gag or choke from spasms in your esophagus(food tube)
N Have asthma or wheezing
N Suffer from emphysema, chronic bronchitis, or shortness breath
N Have osteoporosis
N Have you ever had a kidney stone
N Suffer from chronic kidney disease
N Have diabetes
N Have an overactive thyroid, or parathyroid gland
N Have high blood pressure
N Have mitral valve prolapse (“floppy heart valve”)
N Have very fast heart beats, irregular heart beats, or arrhythmia
N Take Digitalis (Digoxin)
N Take any kind of diuretic
N Recent radiation therapy or exposure
N Have more than 7 alcohol drinks weekly
N Have you ever had a drinking problem?
N Have more than 3 servings of caffeine daily
N Eat sugar containing food daily
N Crave carbohydrates &/or chocolate
N Crave salt
N Eat a high processed food/ junk food diet
N Eat a diet low in green, leafy vegetables, seeds, & fresh fruit
N Eat a low protein diet
N Pass undigested food or fat in your stools
N Suffer from chronic intestinal disease, ulcerative colitis, Crohn’s, irritable bowel syndrome
N Frequent diarrhea or constipation
N Suffer from PMS or menstrual cramps
N Pregnant or recently pregnant
N In previous pregnancy had high blood pressure or pre-eclampsia
N Chronic fatigue
N Muscle weakness
N Cold hands &/or feet
N Numbness in face, hands, or feet
N Persistent tingling in body
N Chronic lack of interest, indifference, or apathy
N Poor memory
N Loss of concentration
N Anxiety
N Chronic depression for no apparent reason
N Feelings of disorientation as to time or place
N Feel your personality is stiff or mechanical
N Hallucinations
N Feel that people are trying to harm or persecute you
N Face pale, puffy, or lacking in color
N Loss of considerable sexual energy or vitality
N Been told by your Dr. that your blood calcium is low
N Been told by your Dr. that your blood potassium is low
N Take Calcium supplements regularly without magnesium
N Take iron or zinc supplements regularly without magnesium
N Know chronic exposure to fluorides
N Frequently use antibiotics, steroids, oral contraceptives,
Indomethacin, Cisplatin, Amphotericin B, Cholestyramine,
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