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Medical Symptom/Toxicity Questionnaire (MSQ)

The MSQ assesses degree of symptomology associated with potential body toxicity burden.

Jennifer Glen, Tim Michalski

Provided by EVAL Foundation
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Instructions

 

There are 14 sections with a list of symptoms (71 total) representing various body domains (head, heart, energy level, ears, lungs, eyes, skin, other, nose, joints / muscles, GI / DIG, mouth / throat, mind / emotions, weight). 

 

  • First time, rate each of the following symptoms based upon your health profile for the past 30 days. 
  • Follow-up, rate your symptoms for the last 48 hours ONLY. 
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Usage

The Toxicity and Symptom Screening Questionnaire (MSQ) identifies symptoms that help to identify the underlying causes of illness, and help to track a patient's progress over time. Practitioners often use this assessment to evaluate the impact of environmental toxicants and cumulative toxic body burden in the context of chronic disease. Examples of exposures to toxicants include heavy metals, mold, pesticides and other endocrine-disrupting chemicals (EDCs). Many toxicants have been associated with immune system dysfunction and linked to cancer, poor mental health and autoimmune conditions (Ratnaseelan, 2018; Doi, 2011; Bansal, 2018; Gangemi, 2016; Joo, 2019). The accumulation of toxicants from our modern world may lead to an overloaded detoxification pathway, increased systemic inflammation, and clinical patterns such as immune dysfunction or endocrine disruption (Pizzorno, Patrick & Marchese, 2020). For more on the topic refer to The Institute for Functional Medicine.

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Summary

The Medical Symptom/Toxicity Questionnaire (MSQ) is one of many versions of detoxification questionnaires available. The MSQ consists of 14 body domains (head, heart, energy level, ears, lungs, eyes, skin, other, nose, joints / muscles, GI / DIG, mouth / throat, mental / emotional and weight) and comprises a total of 71 questions (symptoms) that are rated as follows:

 

     0 = Never or almost never have the symptom

     1 = Occasionally have it, effect is not severe

     2 = Occasionally have it, effect is severe

     3 = Frequently have it, effect is not severe

     4 = Frequently have it, effect is severe

 

The points are added and resulted as follows

 

     < 10       = Optimal

     10-49    = Mild Toxicity

     50-100  = Moderate Toxicity

     > 100    = Severe Toxicity

 

There are a plethora of toxicity and symptom screening questionnaires that can be found online implementing differing cutoffs and custom symptomology lists. The Institute of Functional Medicine references a Detoxification Questionnaire that varies from the MSQ with much lower cutoffs (Very Poor > 50, Marginal 31-40, Good 16-30 & Excellent ≤ 15). Other practices expand the assessment to include a xenobiotic tolerability test and an alkalizing assessment, and rate symptoms at lower cutoffs (high > 50, moderate 15-49 & low < 14).

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All questions & possible results

HeadTitle not visible
Headaches

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Dizziness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Insomnia

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Faintness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Heart
Chest Pain

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Irregular or skipped heartbeat

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Rapid or pounding heartbeat

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Energy Level
Fatigue / sluggishness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Restlessness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Hyperactivity

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Apathy / lethargy

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Ears
Itchy Ears

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Ringing in ears or loss of hearing

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Earaches / infections

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Drainage from ear

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Lungs
Asthma, bronchitis

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Chest congestion

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Shortness of breath

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Difficulty breathing

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Eyes
Bags or dark circles under eyes

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Watery or itchy eyes

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Swollen / red / sticky eyelids

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Blurred or tunnel vision (excluding near/far sight)

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Skin
Acne or brown age or brown "liver" spots

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Hives, rashes, cysts or boils

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Hair loss, thinning

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Flushing or hot flushes

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Excessive sweating

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Other
Genital itch or discharge

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Frequent colds, flu or illness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Frequent or urgent urination

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Nose
Stuffy nose

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Sinus congestion / infection

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Hay fever / allergies

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Excess mucus formation

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Sneezing attacks

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Joints / Muscles
Pain or aches in joints or lower back

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Stiffness or limitation of movement

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Feeling of weakness or tiredness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Pain or aches in muscles

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Arthritis

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
GI / DIG
N / V

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Diarrhea

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Constipation

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Bloating

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Belching / Gas

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Heartburn

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Intestinal / Stomach Discomfort

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Mouth / Throat
Chronic coughing

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Sore throat / hoarseness, loss of voice

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Gagging, frequent need to clear throat

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Swollen / discolored tongue, gums, lips

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Canker sores, mouth ulcers

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Mind / Emotions
Poor memory

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Confusion / poor comprehension

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Difficulty concentrating

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Poor physical coordination

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Difficulty in making decisions

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Stuttering or stammering

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Slurred speech

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Learning Disabilities

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Mood swings

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Depression

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Anxiety, fear, or nervousness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Anger, irritability or aggressiveness

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Weight
Binge eating / drinking

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Craving certain foods

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Excessive weight

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Compulsive eating

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Water retention

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Underweight

Select one option:

  • Never or almost never have the symptom
  • Occasionally have it, effect is not severe
  • Occasionally have it, effect is severe
  • Frequently have it, effect is not severe
  • Frequently have it, effect is severe
Possible results
Severe Toxicity Score (>100 points)
Optimal Toxicity Score (<10 points)
Mild Toxicity Score (10-49 points)
GI / DIG Score (out of 28 points)
Mind / Emotions Score (out of 48 points)
Moderate Toxicity Score (50-100 points)
Ears Score (out of 16 points)
Heart Score (out of 12 points)
Lungs Score (out of 16 points)
Skin Score (out of 20 points)
Joints / Muscles Score (out of 20 points)
Nose Score (out of 20 points)
Weight Score (out of 24 points)
Energy Level Score (out of 16 points)
Mouth / Throat Score (out of 20 points)
Eyes Score (out of 16 points)
Other Category Score (out of 12 points)
Head Score (out of 16 points)

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