by
Marsha Iddings
Copyright 2008
1
2
General Information
Allergy/Sensitivity symptoms do not necessarily occur right
after or within a few hours of exposure. Sometimes symptoms may
not appear for as long as twelve hours to up to several days later. This
is why keeping a record of what you eat, vitamins/herbs you take,
medications, weather/environmental factors, activities etc can be
helpful in tracking hidden allergies.
Keeping this kind of diary can help you find patterns related to
exposure to certain triggers so you can make changes and track
symptoms to find what is helping and what is not.
5
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
6
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
7
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
8
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
9
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
10
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
11
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
12
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
13
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
14
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
15
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
16
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
17
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
18
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
19
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
20
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
21
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
22
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
23
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
24
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
25
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
26
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
27
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
28
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
29
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
30
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
31
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
32
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
33
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
34
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
35
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
36
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
37
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
38
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
39
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
40
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
41
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
42
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
43
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
44
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
45
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
46
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
47
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
48
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
49
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
50
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
51
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
52
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
53
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
54
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
55
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
56
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
57
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
58
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
59
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
60
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
61
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
62
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
63
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
64
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
65
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
66
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
67
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
68
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
69
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
70
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
71
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
72
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
73
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
74
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
75
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
76
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
77
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
78
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
79
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
80
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
81
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
82
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
83
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
84
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
85
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
86
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
87
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
88
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
89
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
90
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
91
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
92
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
93
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
94
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
95
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
96
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
97
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
98
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
99
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
100
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
101
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
102
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
103
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
104
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
105
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
106
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
107
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
108
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
109
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
110
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
111
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
112
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
113
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
114
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
115
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
116
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
117
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
118
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
119
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
120
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
121
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
122
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
123
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
124
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
125
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
126
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
127
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
128
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
129
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
130
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
131
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
132
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
133
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
134
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
135
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
136
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
137
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
138
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
139
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
140
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
141
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
142
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
143
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
144
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
145
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
146
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
147
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
148
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
149
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
150
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
151
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
152
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
153
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
154
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
155
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
156
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
157
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
158
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
159
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
160
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
161
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
162
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
163
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
164
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
165
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
166
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
167
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
168
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
169
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
170
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
171
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
172
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
173
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
174
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
175
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
176
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
177
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
178
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
179
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
180
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
181
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
182
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
183
Date:___________Day___________How Slept Last Night__________
Time Food Time Vits./Herbs Time Meds
Morning 6am-12noon
Afternoon 12pm-5pm
Evening 5pm-10pm
Night 10pm-6am
184
Slept how many hours?_________Restful?___Restless?____
Time Activity Time Weather/Environment Time Symptoms
185
Botanical Food Family List
The following lists give common foods and the botanical family to
which they belong.
FAQ:
B
187
Bamboo Shoots -----Cereals Family
Banana Pepper -----Nightshade Family
Banana ------Banana Family
Barley ------Cereals Family
Barley, Malt -----Cereals Family
Basil ------Mint Family
Bass ------Fresh Water Fish
Bass ------Salt Water Fish
Bay Leaves -----Laurel Family
Beet, Sugar -----Goosefoot (Beet) Family
Bell Pepper -----Nightshade Family
Blackberry -----Rose Family
Black-eyed pea -----Legumes Family
Blueberry -----Heath Family
Boysenberry -----Rose Family
Bran ------Cereals Family
Brandy ------Grape Family
Brazil Nut -----Brazil Nut Family
Breadfruit -----Mulberry Family
Brinjal ------Nightshade Family
Broccoli ------Mustard Family
Brussel Sprouts -----Mustard Family
Buckwheat -----Buckwheat Family
Butternut -----Walnut Family
C
Cabbage ------Mustard Family
Cactus ------Cactus Family
Chamomile -----Composite Family (Aster)
Camphor -----Laurel Family
Cane ------Cereals Family
Cane, Sugar -----Cereals Family
Cantaloupe ----- Gourd Family (Melon)
Capers ------Capers Family
Capsicum -----Nightshade Family
Caraway ------Parsley Family
Cardamon -----Ginger Family
Carob (St. John's Bread) ----Legumes Family
Carob ------Legumes Family
Carrots ------Parsley Family
Casaba ------Gourd Family (Melon)
Cashew ------Cashew Family
Cassia ------Legumes Family
Catfish ------Fresh Water Fish
Cauliflower -----Mustard Family
Cayenne ------Nightshade Family
188
Celeriac ------Parsley Family
Celery Cabbage -----Mustard Family
Celery Seed -----Parsley Family
Celery ------Parsley Family
Celtuse ------Composite Family
(Aster) Champagne -----Grape Family
Chard ------Goosefoot (Beet) Family
Cherry ------Plum Family
Chestnut, Ling nut ----Cereals Family
Chestnut, Singhara nut ----Cereals Family
Chestnut, Water -----Cereals Family
Chick Pea -----Legumes Family
Chicory ------Composite Family (Aster)
Chili Pepper -----Nightshade Family
Chinese Cabbage -----Mustard Family
Chives ------Lily Family
Chocolate (Cocoa) ----Stercula Family
Cinnamon -----Laurel Family
Citrange ------Citrus Family
Citron ------Citrus Family
Clam ------Mollusks
Cloves ------Myrtle Family
Cocoa ------Stercula Family
Coconut ------Palm Family
Cod ------Salt Water Fish
Cola Bean -----Stercula Family
Collard ------Mustard Family
Colza Shoots -----Mustard Family
Coriander -----Parsley Family
Corn cerelose -----Cereals Family
Corn dextrose -----Cereals Family
Corn glucose -----Cereals Family
Corn Meal -----Cereals Family
Corn Oil ------Cereals Family
Corn Starch -----Cereals Family
Corn Sugar -----Cereals Family
Corn syrup -----Cereals Family
Corn ------Cereals Family
Cottonseed Meal -----Mallow Family
Cottonseed Oil -----Mallow Family
Crab ------Crustaceans
Cranberry -----Heath Family
Crayfish ------Crustaceans
Crème of Tartar -----Grape Family
Croaker ------Fresh Water Fish
Cucumber -----Gourd Family (Melon)
Cumin ------Parsley Family
189
Currant ------Gooseberry Family
Curry Powder -----Not one spice, is a blend of spices
D
Dandelion -----Composite Family (Aster)
Dasheen ------Arum Family
Date ------Palm Family
Dewberry -----Rose Family
Dill ------Parsley Family
E
Eggplant -----Nightshade Family
Elderberry -----Honeysuckle Family
Endive ------Composite Family (Aster)
Escarole ------Composite Family (Aster)
Eucalyptus -----Myrtle Family
F
Farina ------Cereals Family
Fennel ------Parsley Family
Field Pea -----Legumes Family
Fig ------Mulberry Family
Filbert ------Birch Family
Flaxseed ----- Flax
Flounder -----Salt Water Fish
G
Garden Sorrel -----Buckwheat Family
Garlic ------Lily Family
Ginger ------Ginger Family
Gluten flour -----Cereals Family
Gooseberry -----Gooseberry Family
Graham flour -----Cereals Family
Grape ------Grape Family
Grapefruit -----Citrus Family
Green Bean -----Legumes Family
Green Pea -----Legumes Family
Green Pepper -----Nightshade Family
Ground Cherry -----Nightshade Family
Guava ------Myrtle Family
Guar Gum - Legume family
190
Gum Guaiac -----Cochliospermum Family
Gum Karaya -----Cochliospermum Family
H
Hazelnut -----Birch Family
Head Lettuce -----Composite Family (Aster)
Herring ------Salt Water Fish
Hickory Nut -----Walnut Family
Honey Dew -----Gourd Family (Melon)
Honey ------Miscellaneous
Hop ------Mulberry Family
Horehound -----Mint Family
Horse Radish -----Mustard Family
Huckleberry -----Heath Family
J
Jack bean -----Legumes Family
Jicama ------Morning Glory Family
Juniper ------Pine Family
K
Kale ------Mustard Family
Karaya Gum -----Legumes Family
Kidney bean -----Legumes Family
Kiwi ------Actinidiaceace Family
Kochia ------Goosefoot (Beet) Family
Kohlrabi ------Mustard Family
Kraut ------Mustard Family
Kumquat -----Citrus Family
L
Lambs Quarters -----Goosefoot (Beet) Family
Laurel ------Laurel Family
Leaf Lettuce -----Composite Family
(Aster) Leek ------Lily Family
Lemon ------Citrus Family
Lentil ------Legumes Family
Lettuce ------Composite Family (Aster)
Licorice ------Legumes Family
Lima bean -----Legumes Family
Lime ------Citrus Family
Linseed ----- Flax
Litchi Nut - Litchi Family
191
Lobster ------Crustaceans
Locust Bean Gum ----Legumes Family
Loganberry -----Rose Family
M
Mace ------Nutmeg Family
Mackerel -----Salt Water Fish
Mango ------Cashew Family
Maple Sugar -----Maple Family
Maple Syrup -----Maple Family
Marjoram -----Mint Family
Mate ------Holly Family
Millet ------Cereals Family
Mint ------Mint Family
Molasses (Cane) -----Cereals Family
Mulberry -----Mulberry Family
Mullet ------Salt Water Fish
Mungo Bean -----Legumes Family
Mushroom -----Fungus Family
Muskmelon -----Gourd Family
(Melon) Mussel ------Mollusks
Mustard Greens -----Mustard Family
Mustard ------Mustard Family
N
Navy Bean -----Legumes Family
Nectarine -----Plum Family
Nutmeg ------Nutmeg Family
O
Oats ------Cereals Family
Okra ------Mallow Family
Olive, and oil -----Olive Family
Onion ------Lily Family
Orange ------Citrus Family
Oregano ------Mint Family
Oyster Plant, Salsify ----Composite Family (Aster)
Oyster ------Mollusks
P
192
Palm Cabbage -----Palm Family
Papain ------Pawpaw Family
Papaya ------Pawpaw Family
Paprika ------Myrtle Family
Paprika ------Nightshade Family
Parsley ------Parsley Family
Parsnips ------Parsley Family
Patent Flour -----Cereals Family
Pawpaw ------Pawpaw Family
Peach ------Plum Family
Peanut oil -----Legumes Family
Peanut ------Legumes Family
Pear ------Rose Family - Apple Family
Pecan ------Walnut Family
Pepper, Black -----Pepper Family
Pepper, White -----Pepper Family
Peppermint -----Mint Family
Perch ------Fresh Water Fish
Persian Melon -----Gourd Family (Melon)
Persimmon -----Ebony Family
Pike ------Fresh Water Fish
Pimento ------Myrtle Family
Pimento ------Nightshade Family
Pineapple -----Pineapple Family
Pinion Nut -----Pine Family
Pinto Bean -----Legumes Family
Pistachio -----Cashew Family
Plantain ------Banana Family
Plum ------Plum Family
Poi ------Arum Family
Pomegranate -----Pomegranate Family
Poppy seed -----Poppy Family
Potato ------Nightshade Family
Prawns ------Crustaceans
Prickly Pear -----Cactus Family
Prune Plum -----Plum Family
Pumpkin -----Gourd Family (Melon)
Q
Quince ------Rose Family - Apple Family
R
Radish ------Mustard Family
Raisin ------Grape Family
Raspberry -----Rose Family
193
Red Pepper -----Nightshade Family
Rhubarb ------Buckwheat Family
Rice ------Cereals Family
Rosemary -----Mint Family
Rutabaga -----Mustard Family
Rye ------Cereals Family
S
Saffron ------Iris Family
Sage ------Mint Family
Sago ------Palm Family
Salmon ------Fresh Water Fish
Salmon ------Salt Water Fish
Sassafras -----Laurel Family
Savory ------Mint Family
Savoury ------Mint Family
Scallop ------Mollusks
Sesame Seed Oil -----Composite Family (Aster)
Shrimp ------Crustaceans
Smelt ------Fresh Water Fish
Sorghum -----Cereals Family
Soybean -----Legumes Family
Soybean flour -----Legumes Family
Soybean Lecithin -----Legumes Family
Soybean oil -----Legumes Family
Sparsparilla -----Lily Family
Spearmint -----Mint Family
Spinach ------Goosefoot (Beet) Family
Split Pea ------Legumes Family
Squash ------Gourd Family (Melon)
Squid ------Mollusks
Strawberry -----Rose Family
String Bean -----Legumes Family
Sugar (Beet) -----Goosefoot (Beet) Family
Sugar (Cane) -----Cereals Family
Sunflower and Seeds ----Composite Family (Aster)
Sunflower Oil -----Composite Family (Aster)
Sweet Cicily -----Parsley Family
Sweet Pepper -----Nightshade Family
Sweet Potato -----Morning Glory Family
T
Tabasco ------Nightshade Family
Talca Gum -----Legumes Family
Tamarind -----Legumes Family
194
Tangerine -----Citrus Family
Tapioca ------Spurge Family
Taro ------Arum Family
Tea ------Tea Family
Tequila ------Cactus family
Thistle ------Goosefoot (Beet) Family
Thorn Apple -----Nightshade Family
Thyme ------Mint Family
Tobacco ------Nightshade Family
Tomato ------Nightshade Family
Tonka bean -----Legumes Family
Tragancanth Gum ----Legumes Family
Trout ------Fresh Water Fish
Turmeric - Ginger Family
Turnips ------Mustard Family
U
Urd Flour -----Legumes Family
V
Vanilla ------Orchid Family
Vegetable Marrow ----Gourd Family (Melon)
Vermouth (Pyrethrum) ----Composite Family (Aster)
Vermouth (Ragweed) ----Composite Family (Aster)
Vermouth -----Composite Family (Aster)
W
Walnut - Black -----Walnut Family
Walnut - English -----Walnut Family
Water Celery -----Parsley Family
Water Melon -----Gourd Family (Melon)
Waterchestnut (Chinese) - Cyperaceae Family (Sedge)
Watercress -----Mustard Family
Wheat (whole) flour ----Cereals Family
Wheat flour -----Cereals Family
Wheat Germ -----Cereals Family
Wheat ------Cereals Family
Whitefish -----Fresh Water Fish
Wild Rice -----Cereals Family
Wine Vinegar -----Grape Family
Wine ------Grape Family
Wintergreen -----Heath Family
195
Y
Yam ------Morning Glory Family
Yarrow ------Composite Family (Aster)
Yeast/Antibiotics -----Fungus Family
Youngberry -----Rose Family
Arrowroot: Arrowroot
Buckwheat: Buckwheat, Garden Sorrel, Rhubarb (Ed note: these are not grains)
Capers: Capers
Cereals: Bamboo Shoots; Barley; Barley, Malt; Bran (wheat); Cane sugar; Cane
Molasses; Chestnut, Water; Chestnut, Ling nut; Chestnut, Singhara nut; Corn ; Corn
Meal ; Corn Starch ; Corn Oil ; Corn Sugar; Corn syrup; Corn dextrose; Corn
glucose ; Corn cerelose; Farina (wheat); Graham flour (wheat) ; Gluten flour (wheat)
; Millet; Patent Flour (wheat); Oats; Rice; Rye; Sorghum; Wheat; Wheat flour;
Wheat Germ; Wheat (whole) flour; Wild Rice.
196
Citrus: Angostura; Citrange; Citron; Grapefruit; Kumquat; Lemon; Lime; Orange;
Tangerine
Ebony: Persimmon
Fresh Water Fish: Bass, Catfish, Croaker, Perch, Pike, Salmon, Smelt, Trout,
Whitefish.
Goosefoot (Beet): Beet, Sugar; Chard, Kochia, Lambs Quarters, Spinach, Thistle.
Grape: Brandy; Champagne; Crème of Tartar; Grape; Raisin; Wine; Wine Vinegar.
Holly: Mate.
Honeysuckle: Elderberry.
Iris: Saffron.
197
Laurel: Avocado, Bay Leaves, Camphor, Cinnamon, Laurel, Sassafras.
Legume:Acacia; Acacia Gum; Alfalfa; Arabic; Black-eyed pea; Carob; Carob (St.
John's Bread); Cassia; Chick Pea; Field Pea; Green Bean; Green Pea; Guar gum;
Jack bean; Karaya Gum; Kidney bean; Lentil; Licorice; Lima bean; Locust Bean
Gum; Mungo Bean; Navy Bean; Peanut; Peanut oil; Pinto Bean; Soybean; Soybean
oil/flour/lecithin; Split Pea; String Bean; Talca Gum; Tamarind; Tonka bean;
Tragancanth Gum; Urd Flour.
Orchid: Vanilla
198
Palm: Coconut, Date, Palm Cabbage, Sago.
Pineapple: Pineapple.
Pomegranate: Pomegranate.
Salt Water Fish: Bass, Cod, Flounder, Herring, Mackerel, Mullet, Salmon.
Spurge: Tapioca.
Tea: Tea.
199
Symptoms List
201
Genital itching Short-tempered Sensitive teeth
202
Wheezing Cuts, bruises Insomnia
203
Product Ingredient Lists
Use these pages to write out favorite product ingredient lists so you
don’t have to re-write them or hunt them down all the time.
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
204
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
205
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
206
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Product/Company/Phone____________________________________
_________________________________________________________
Ingredients:_______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
207