Draft Questionnaire for DataBETA. (Your answers will not be recorded.)

This questionnaire is not "live"

Any answers you provide here don't count, and the staff at DataBETA will not even see them. This version of the survey is a rough draft which we're using to collect comments from users like you. Where is the wording unclear? What have we neglected to ask? Email <aging.advice@gmail.com> with your suggestons.

Thank you!

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* 1. Pick a user name (real name or pseudonym)

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* 2. Do you have any of the following diseases? (check all that apply)

Cancer

Have had a heart attack

Have had an ischemic stroke

Have had an embolism

Alzheimer's Disease

Dementia

Parkinson's Disease

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* 3. email

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* 4. Date of Birth

Date / Time

Date

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* 5. What is your sex?

Male

Female

Non-binary

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* 6. Height in feet and inches? (For example, 5 foot 4 would be 5’4”)

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* 7. Weight in pounds

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* 8. Lifetime maximum weight

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* 9. Mother still living?

Yes

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* 10. Mother's age at death, or present age

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* 11. Father still living?

Yes

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* 12. Father's age at death (or present age)

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* 13. How many of your grandparents lived past age 90?

All 4

None

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* 14. Present work status

Full-time, busy

Full-time, comfortable

Part-time, by choice

Part-time, wish I had more work

Self-employed - busy

Self-employed - not so busy

Looking for work, comfortably

Looking for work, a little anxious

Not employed and that's the way I want it

Retired

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* 15. Income level

struggling

anxious

frugal

middle class

comfortable

wealthy

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* 16. Shift work?

regular hours

night shift

variable hours, including some night shift

irregular hours, but it doesn't affect my sleep

I keep my own schedule

Not applicable

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* 17. Is your life stressful?

Yes, it causes me anxiety

Yes, but it's a good kind of pressure and I like it that way

About average

There are stressors, but I remain calm because that's who I am

No major stress in my life

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* 18. Are you caring for an ailing relative or friend?

Yes

Sometimes

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* 19. Tobacco use?

Never

Former heavy smoker

Former moderate smoker

Former light smoker

Present smoker

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* 20. Marijuana use?

Never

Former heavy smoker

Former moderate smoker

Former light smoker

Present smoker

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* 21. Alcohol use?

Never drink, or rarely

Heavy drinking in the past, none now

Presently 1 to 5 drinks a week

Presently more than 5 drinks a week

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* 22. Have you ever used narcotics?

Never

Only with prescription

Formerly they were a problem for me

Currently, recreationally

Currently a problem for me

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* 23. Have you ever used hallucinogens or psychedelic drugs?

Never

Occasionally in the past

Often in the past

Occasionally in the present

Regularly in the preent

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* 24. How many hours sleep do you usually get?

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* 25. Do you snore or have apnea?

Snoring only

Mild apnea

Severe apnea

Apnea controlled with CPAP or other device

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* 26. How often do you have insomnia?

Rarely or never

Occasionally

Sometimes have trouble falling asleep

Sometimes have trouble staying asleep

Have trouble both falling asleep and waking up during the night

Insomnia is a major issue for my health and wellbeing

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* 27. Which best describes your dreaming?

I never remember my dreams

I sometimes recall dreams

I sometimes have vivid dreams or lucid dreams

I sometimes have disturbed, frightful dreams

My sleep is disturbed or fitful more often than not

Nightmares awaken me more than once a month

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* 28. Do you take anything at bedtime to help you sleep?

Melatonin only

Glycine

Herbal teas or sleep aids

Prescription sleep aids

Prescription + melatonin or herbals

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* 29. Who do you live with?

I live alone

Spouse or partner

Housemate(s)

Child(ren)

Parent(s)

Siblings or other relative(s)

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* 30. Do you engage regularly in any of these community activities?

Coaching

Mentoring

Volunteer service

Church or non-profit

Board

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* 31. Is this kind of service a big part of your life?

Yes

In between

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* 32. Social life - check all that apply

I spend most of my time alone by choice

I spend most of my time alone and wish I had more connections

I have many friends

I have a few close friends

I have close friends out of town, and take time to visit them when I can

I have close friends out of town, and keep up with them by email or phone or social media

I feel lonely a good deal of the time

I enjoy talking with the people I work with every day

I enjoy getting together with people from my work in off-time

I work alone

I'm not close to the people I work with

I have a deep and rewarding relationship with a life partner

I wish I had a partner or spouse

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* 33. Relationship status - check all that apply

I am married

I have been married and divorced

I have been divorced more than once

I have had live-in partner(s) without being married

I think of myself as monogamous

I think of myself as serially monogamous

I think of myself as polyamorous

I currently have a partner whom I feel pretty good about

I'm in a mature relationship, but I still feel "in love"

I live with a partner

I have a partner who does not live with me

I have an out-of-town, long-term partner

I have little current interest in sex

I am looking for a long-term partner

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* 34. Sitting meditation?

No experience

I've tried meditation

I used to have a meditation practice

I have an occasional meditation practice

I have a regular meditation practice

I meditate more than 3 hours total in a typical week

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* 35. Psychotherapy

I have little or no experience as a psychotherapy or group therapy client

I have had periods of psychotherapy in the past

I was formerly in individual therapy or a therapy group

I presently see a therapist or go to a group

I see a therapist, individual or group, more than once a week

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* 36. Do you think of yourself as an artist, writer, or musician?

In the past, it was a major part of my life

I am an amateur artist (or musician or creative writer)

I am an professional artist (or musician or creative writer)

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* 37. Have you donated blood in the last year?

Once

More than once

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* 38. Do you take saunas or steam baths?

Never

A few times a year

Monthly

Weekly

More than once a week

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* 39. How many hours do you spend in a typical week watching TV or Youtube or Netflix or going out for a movie?

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 40. How's your mobility?

No problem

I walk with a cane or crutch

I use a wheelchair

I am confined to bed

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* 41. Do you get headaches?

Never

Once in a while

Once a month or so

Once a week or so

More than once a week

I am in chronic pain

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* 42. Mood question - check all that apply

I'm generally in a good mood

I have high highs and low lows

I am occasionally depressed

I am frequently depressed

I have been hospitalized for depression in the past

I am often nervous

I have been diagnosed with an anxiety disorder

I take prescription drugs for depression or anxiety

I take herbs for depression or anxiety

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* 43. Your diet profile

	Big part of my diet	Regular part of my diet	Eat sometimes	Eat occasionally	Never eat
Fruits	Fruits Big part of my diet	Fruits Regular part of my diet	Fruits Eat sometimes	Fruits Eat occasionally	Fruits Never eat
Root vegetables (including potatoes)	Root vegetables (including potatoes) Big part of my diet	Root vegetables (including potatoes) Regular part of my diet	Root vegetables (including potatoes) Eat sometimes	Root vegetables (including potatoes) Eat occasionally	Root vegetables (including potatoes) Never eat
Green vegetables	Green vegetables Big part of my diet	Green vegetables Regular part of my diet	Green vegetables Eat sometimes	Green vegetables Eat occasionally	Green vegetables Never eat
Legumes (beans, peas)	Legumes (beans, peas) Big part of my diet	Legumes (beans, peas) Regular part of my diet	Legumes (beans, peas) Eat sometimes	Legumes (beans, peas) Eat occasionally	Legumes (beans, peas) Never eat
Nuts (including peanuts)	Nuts (including peanuts) Big part of my diet	Nuts (including peanuts) Regular part of my diet	Nuts (including peanuts) Eat sometimes	Nuts (including peanuts) Eat occasionally	Nuts (including peanuts) Never eat
Bread	Bread Big part of my diet	Bread Regular part of my diet	Bread Eat sometimes	Bread Eat occasionally	Bread Never eat
Pasta	Pasta Big part of my diet	Pasta Regular part of my diet	Pasta Eat sometimes	Pasta Eat occasionally	Pasta Never eat
Rice, bulghur, quinoa, other grains	Rice, bulghur, quinoa, other grains Big part of my diet	Rice, bulghur, quinoa, other grains Regular part of my diet	Rice, bulghur, quinoa, other grains Eat sometimes	Rice, bulghur, quinoa, other grains Eat occasionally	Rice, bulghur, quinoa, other grains Never eat
Seafood	Seafood Big part of my diet	Seafood Regular part of my diet	Seafood Eat sometimes	Seafood Eat occasionally	Seafood Never eat
Poultry	Poultry Big part of my diet	Poultry Regular part of my diet	Poultry Eat sometimes	Poultry Eat occasionally	Poultry Never eat
Red meat	Red meat Big part of my diet	Red meat Regular part of my diet	Red meat Eat sometimes	Red meat Eat occasionally	Red meat Never eat
Eggs	Eggs Big part of my diet	Eggs Regular part of my diet	Eggs Eat sometimes	Eggs Eat occasionally	Eggs Never eat
Dairy	Dairy Big part of my diet	Dairy Regular part of my diet	Dairy Eat sometimes	Dairy Eat occasionally	Dairy Never eat
Sweets and desserts	Sweets and desserts Big part of my diet	Sweets and desserts Regular part of my diet	Sweets and desserts Eat sometimes	Sweets and desserts Eat occasionally	Sweets and desserts Never eat
Artificial sweeteners	Artificial sweeteners Big part of my diet	Artificial sweeteners Regular part of my diet	Artificial sweeteners Eat sometimes	Artificial sweeteners Eat occasionally	Artificial sweeteners Never eat
Mushrooms, other fungi	Mushrooms, other fungi Big part of my diet	Mushrooms, other fungi Regular part of my diet	Mushrooms, other fungi Eat sometimes	Mushrooms, other fungi Eat occasionally	Mushrooms, other fungi Never eat
Chocolate	Chocolate Big part of my diet	Chocolate Regular part of my diet	Chocolate Eat sometimes	Chocolate Eat occasionally	Chocolate Never eat

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* 44. Characterize your diet (check all that apply)

Regular Western diet

Low-carb

Gluten-free

Mostly vegetarian

Mostly vegan

Strictly vegetarian (including dairy)

Strictly vegan (no animal products)

Kosher

Halal

Dairy-free

Low-fat

Mediterranean

Calorie restriction

Ketogenic

Atkins

Pritikin

Ornish

Paleo

MIND

Organic (or mostly organic)

Natural

High fiber

Raw

Fast food

Restaurants for lunch, frequently

Eat in restaurants more than twice a week

Mostly prepared food and restaurants

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* 45. Coffee, tea, and soft drinks

	Rarely or never	Less than 1 cup per day	1 to 2 cups per day	3 or more cups per day
Coffee	Coffee Rarely or never	Coffee Less than 1 cup per day	Coffee 1 to 2 cups per day	Coffee 3 or more cups per day	Coffee
Decaf	Decaf Rarely or never	Decaf Less than 1 cup per day	Decaf 1 to 2 cups per day	Decaf 3 or more cups per day	Decaf
Tea	Tea Rarely or never	Tea Less than 1 cup per day	Tea 1 to 2 cups per day	Tea 3 or more cups per day	Tea
Decaf Tea	Decaf Tea Rarely or never	Decaf Tea Less than 1 cup per day	Decaf Tea 1 to 2 cups per day	Decaf Tea 3 or more cups per day	Decaf Tea
Caffeinated soft drinks	Caffeinated soft drinks Rarely or never	Caffeinated soft drinks Less than 1 cup per day	Caffeinated soft drinks 1 to 2 cups per day	Caffeinated soft drinks 3 or more cups per day	Caffeinated soft drinks
Sweet soft drinks	Sweet soft drinks Rarely or never	Sweet soft drinks Less than 1 cup per day	Sweet soft drinks 1 to 2 cups per day	Sweet soft drinks 3 or more cups per day	Sweet soft drinks
Artificially sweetened soft drinks	Artificially sweetened soft drinks Rarely or never	Artificially sweetened soft drinks Less than 1 cup per day	Artificially sweetened soft drinks 1 to 2 cups per day	Artificially sweetened soft drinks 3 or more cups per day	Artificially sweetened soft drinks

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* 46. If you have had a recent reading of A1C please record it here

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* 47. On a typical day, what time do you finish your last meal before bed?

Date / Time

Time

AM/PM

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* 48. On a typical day, what time do you breakfast in the morning?

Date / Time

Time

AM/PM

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* 49. Do you practice intermittent fasting?

Yes

Sometimes

Occasionally

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* 50. Do you fast for multiple days?

More than once a year

About once a year

Occasionally

Never

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* 51. Have you tried the Longo 5-day Fasting-Mimicking Diet?

Once

More than once

Regularly

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* 52. What time do you usually go to bed at night?

Date / Time

Time

AM/PM

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* 53. What time do you usually wake in the morning?

Date / Time

Time

AM/PM

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* 54. Physical activity:
(Most of us have irregular schedules--make your best estimate and don't worry.)

	Days per week	Minutes per day	How many years have you done it?
Sprint or high-intensity running	Sprint or high-intensity running Days per week menu	Sprint or high-intensity running Minutes per day menu	Sprint or high-intensity running How many years have you done it? menu
High-intensity cycling or spinning	High-intensity cycling or spinning Days per week menu	High-intensity cycling or spinning Minutes per day menu	High-intensity cycling or spinning How many years have you done it? menu
High-intensity swimming	High-intensity swimming Days per week menu	High-intensity swimming Minutes per day menu	High-intensity swimming How many years have you done it? menu
Elliptical trainer, or other high-intensity aerobic	Elliptical trainer, or other high-intensity aerobic Days per week menu	Elliptical trainer, or other high-intensity aerobic Minutes per day menu	Elliptical trainer, or other high-intensity aerobic How many years have you done it? menu
Interval training	Interval training Days per week menu	Interval training Minutes per day menu	Interval training How many years have you done it? menu
Jogging	Jogging Days per week menu	Jogging Minutes per day menu	Jogging How many years have you done it? menu
Competitive sports	Competitive sports Days per week menu	Competitive sports Minutes per day menu	Competitive sports How many years have you done it? menu
Cycling	Cycling Days per week menu	Cycling Minutes per day menu	Cycling How many years have you done it? menu
Walking	Walking Days per week menu	Walking Minutes per day menu	Walking How many years have you done it? menu
Weights, strength, or resistance training	Weights, strength, or resistance training Days per week menu	Weights, strength, or resistance training Minutes per day menu	Weights, strength, or resistance training How many years have you done it? menu
Stretching	Stretching Days per week menu	Stretching Minutes per day menu	Stretching How many years have you done it? menu
Pilates or core strength	Pilates or core strength Days per week menu	Pilates or core strength Minutes per day menu	Pilates or core strength How many years have you done it? menu
Mind/body = yoga, tai chi, chi gong	Mind/body = yoga, tai chi, chi gong Days per week menu	Mind/body = yoga, tai chi, chi gong Minutes per day menu	Mind/body = yoga, tai chi, chi gong How many years have you done it? menu
Kundalini or ashtanga (aerobic yoga)	Kundalini or ashtanga (aerobic yoga) Days per week menu	Kundalini or ashtanga (aerobic yoga) Minutes per day menu	Kundalini or ashtanga (aerobic yoga) How many years have you done it? menu
Breathing / pranayama	Breathing / pranayama Days per week menu	Breathing / pranayama Minutes per day menu	Breathing / pranayama How many years have you done it? menu
Hiking or canoeing	Hiking or canoeing Days per week menu	Hiking or canoeing Minutes per day menu	Hiking or canoeing How many years have you done it? menu
Dance (slow or moderate)	Dance (slow or moderate) Days per week menu	Dance (slow or moderate) Minutes per day menu	Dance (slow or moderate) How many years have you done it? menu
Dance (aerobic)	Dance (aerobic) Days per week menu	Dance (aerobic) Minutes per day menu	Dance (aerobic) How many years have you done it? menu

Other (please specify)

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* 55. Anti-inflammatory drugs and supplements

	Dose (mg)	How often?	How long have you taken this?
Aspirin	Aspirin Dose (mg) menu	Aspirin How often? menu	Aspirin How long have you taken this? menu
Ibuprofen	Ibuprofen Dose (mg) menu	Ibuprofen How often? menu	Ibuprofen How long have you taken this? menu
Naproxen (Alleve)	Naproxen (Alleve) Dose (mg) menu	Naproxen (Alleve) How often? menu	Naproxen (Alleve) How long have you taken this? menu
Celebrex	Celebrex Dose (mg) menu	Celebrex How often? menu	Celebrex How long have you taken this? menu
Curcumin/Turmeric	Curcumin/Turmeric Dose (mg) menu	Curcumin/Turmeric How often? menu	Curcumin/Turmeric How long have you taken this? menu
FIsh oil	FIsh oil Dose (mg) menu	FIsh oil How often? menu	FIsh oil How long have you taken this? menu
Krill oil	Krill oil Dose (mg) menu	Krill oil How often? menu	Krill oil How long have you taken this? menu
Vegetarian Omega-3 source	Vegetarian Omega-3 source Dose (mg) menu	Vegetarian Omega-3 source How often? menu	Vegetarian Omega-3 source How long have you taken this? menu
Other NSAIDs	Other NSAIDs Dose (mg) menu	Other NSAIDs How often? menu	Other NSAIDs How long have you taken this? menu
Astaxanthin or Zeaxanthin	Astaxanthin or Zeaxanthin Dose (mg) menu	Astaxanthin or Zeaxanthin How often? menu	Astaxanthin or Zeaxanthin How long have you taken this? menu

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* 56. Vitamins

	Dose	How often?	How long have you taken this?
Vitamin A or carotenoids (Dosage in IU)	Vitamin A or carotenoids (Dosage in IU) Dose menu	Vitamin A or carotenoids (Dosage in IU) How often? menu	Vitamin A or carotenoids (Dosage in IU) How long have you taken this? menu
Vitamin B12 (Dosage in micrograms mcg)	Vitamin B12 (Dosage in micrograms mcg) Dose menu	Vitamin B12 (Dosage in micrograms mcg) How often? menu	Vitamin B12 (Dosage in micrograms mcg) How long have you taken this? menu
NR or NMN dosage in milligrams mg	NR or NMN dosage in milligrams mg Dose menu	NR or NMN dosage in milligrams mg How often? menu	NR or NMN dosage in milligrams mg How long have you taken this? menu
Other B vitamins dosage in milligrams mg	Other B vitamins dosage in milligrams mg Dose menu	Other B vitamins dosage in milligrams mg How often? menu	Other B vitamins dosage in milligrams mg How long have you taken this? menu
Vit C or Ascorbate dosage in milligrams mg	Vit C or Ascorbate dosage in milligrams mg Dose menu	Vit C or Ascorbate dosage in milligrams mg How often? menu	Vit C or Ascorbate dosage in milligrams mg How long have you taken this? menu
Vitamin D or D3 Dosage in IU	Vitamin D or D3 Dosage in IU Dose menu	Vitamin D or D3 Dosage in IU How often? menu	Vitamin D or D3 Dosage in IU How long have you taken this? menu
Vitamin E Alpha-tocopherol Dosage in IU	Vitamin E Alpha-tocopherol Dosage in IU Dose menu	Vitamin E Alpha-tocopherol Dosage in IU How often? menu	Vitamin E Alpha-tocopherol Dosage in IU How long have you taken this? menu
Vitamin K or K2 dosage in IU	Vitamin K or K2 dosage in IU Dose menu	Vitamin K or K2 dosage in IU How often? menu	Vitamin K or K2 dosage in IU How long have you taken this? menu

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* 57. Minerals

	Dose	How often?	How long have you taken this?
Calcium dosage in milligrams mg	Calcium dosage in milligrams mg Dose menu	Calcium dosage in milligrams mg How often? menu	Calcium dosage in milligrams mg How long have you taken this? menu
Magnesium dosage in milligrams mg	Magnesium dosage in milligrams mg Dose menu	Magnesium dosage in milligrams mg How often? menu	Magnesium dosage in milligrams mg How long have you taken this? menu
Zinc dosage in milligrams mg	Zinc dosage in milligrams mg Dose menu	Zinc dosage in milligrams mg How often? menu	Zinc dosage in milligrams mg How long have you taken this? menu
Iron dosage in milligrams mg	Iron dosage in milligrams mg Dose menu	Iron dosage in milligrams mg How often? menu	Iron dosage in milligrams mg How long have you taken this? menu
Iodine dosage in milligrams mg	Iodine dosage in milligrams mg Dose menu	Iodine dosage in milligrams mg How often? menu	Iodine dosage in milligrams mg How long have you taken this? menu
Selenium dosage in micrograms mcg=ug	Selenium dosage in micrograms mcg=ug Dose menu	Selenium dosage in micrograms mcg=ug How often? menu	Selenium dosage in micrograms mcg=ug How long have you taken this? menu
Chromium dosage in micrograms mcg=ug	Chromium dosage in micrograms mcg=ug Dose menu	Chromium dosage in micrograms mcg=ug How often? menu	Chromium dosage in micrograms mcg=ug How long have you taken this? menu
Multimineral dosage in milligrams mg	Multimineral dosage in milligrams mg Dose menu	Multimineral dosage in milligrams mg How often? menu	Multimineral dosage in milligrams mg How long have you taken this? menu

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* 58. For blood sugar and insulin resistance

	Dose	How often?	How long have you taken this?
Metformin dosage in milligrams mg	Metformin dosage in milligrams mg Dose menu	Metformin dosage in milligrams mg How often? menu	Metformin dosage in milligrams mg How long have you taken this? menu
Berberine dosage in milligrams mg	Berberine dosage in milligrams mg Dose menu	Berberine dosage in milligrams mg How often? menu	Berberine dosage in milligrams mg How long have you taken this? menu
Gynostemma or Jiaogulan or LEF "AMPK Activator" dosage in milligrams mg	Gynostemma or Jiaogulan or LEF "AMPK Activator" dosage in milligrams mg Dose menu	Gynostemma or Jiaogulan or LEF "AMPK Activator" dosage in milligrams mg How often? menu	Gynostemma or Jiaogulan or LEF "AMPK Activator" dosage in milligrams mg How long have you taken this? menu
Gymnema dosage in milligrams mg	Gymnema dosage in milligrams mg Dose menu	Gymnema dosage in milligrams mg How often? menu	Gymnema dosage in milligrams mg How long have you taken this? menu
Acarbose (Precose) dosage in milligrams mg	Acarbose (Precose) dosage in milligrams mg Dose menu	Acarbose (Precose) dosage in milligrams mg How often? menu	Acarbose (Precose) dosage in milligrams mg How long have you taken this? menu

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* 59. Anti-aging pills

	Dose	How often?	How long have you taken this?
Glutathione dosage in milligrams mg	Glutathione dosage in milligrams mg Dose menu	Glutathione dosage in milligrams mg How often? menu	Glutathione dosage in milligrams mg How long have you taken this? menu
N-Acetyl Cysteine (NAC) dosage in milligrams mg	N-Acetyl Cysteine (NAC) dosage in milligrams mg Dose menu	N-Acetyl Cysteine (NAC) dosage in milligrams mg How often? menu	N-Acetyl Cysteine (NAC) dosage in milligrams mg How long have you taken this? menu
Resveratrol dosage in milligrams mg	Resveratrol dosage in milligrams mg Dose menu	Resveratrol dosage in milligrams mg How often? menu	Resveratrol dosage in milligrams mg How long have you taken this? menu
Pterostilbene dosage in milligrams mg	Pterostilbene dosage in milligrams mg Dose menu	Pterostilbene dosage in milligrams mg How often? menu	Pterostilbene dosage in milligrams mg How long have you taken this? menu
Rapamycin dosage in milligrams mg	Rapamycin dosage in milligrams mg Dose menu	Rapamycin dosage in milligrams mg How often? menu	Rapamycin dosage in milligrams mg How long have you taken this? menu
Spermidine dosage in milligrams mg	Spermidine dosage in milligrams mg Dose menu	Spermidine dosage in milligrams mg How often? menu	Spermidine dosage in milligrams mg How long have you taken this? menu
SAMe=S-Adenosyl Methionine dosage in milligrams mg	SAMe=S-Adenosyl Methionine dosage in milligrams mg Dose menu	SAMe=S-Adenosyl Methionine dosage in milligrams mg How often? menu	SAMe=S-Adenosyl Methionine dosage in milligrams mg How long have you taken this? menu

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* 60. Asian Herbs

	Dose	How often?	How long have you taken this?
Ashwagandha dosage in milligrams mg	Ashwagandha dosage in milligrams mg Dose menu	Ashwagandha dosage in milligrams mg How often? menu	Ashwagandha dosage in milligrams mg How long have you taken this? menu
Ginseng dosage in milligrams mg	Ginseng dosage in milligrams mg Dose menu	Ginseng dosage in milligrams mg How often? menu	Ginseng dosage in milligrams mg How long have you taken this? menu
Bacopa dosage in milligrams mg	Bacopa dosage in milligrams mg Dose menu	Bacopa dosage in milligrams mg How often? menu	Bacopa dosage in milligrams mg How long have you taken this? menu
Gotu Kola dosage in milligrams mg	Gotu Kola dosage in milligrams mg Dose menu	Gotu Kola dosage in milligrams mg How often? menu	Gotu Kola dosage in milligrams mg How long have you taken this? menu
Rhodiola dosage in milligrams mg	Rhodiola dosage in milligrams mg Dose menu	Rhodiola dosage in milligrams mg How often? menu	Rhodiola dosage in milligrams mg How long have you taken this? menu
Ginkgo biloba dosage in milligrams mg	Ginkgo biloba dosage in milligrams mg Dose menu	Ginkgo biloba dosage in milligrams mg How often? menu	Ginkgo biloba dosage in milligrams mg How long have you taken this? menu

Other (please specify)

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* 61. Telomerase Activators

	Dose	How often?	How long have you taken this?
Cycloastragenol or TA-65 dosage in milligrams mg	Cycloastragenol or TA-65 dosage in milligrams mg Dose menu	Cycloastragenol or TA-65 dosage in milligrams mg How often? menu	Cycloastragenol or TA-65 dosage in milligrams mg How long have you taken this? menu
Astragaloside dosage in milligrams mg	Astragaloside dosage in milligrams mg Dose menu	Astragaloside dosage in milligrams mg How often? menu	Astragaloside dosage in milligrams mg How long have you taken this? menu
Other forms of astragalus dosage in milligrams mg	Other forms of astragalus dosage in milligrams mg Dose menu	Other forms of astragalus dosage in milligrams mg How often? menu	Other forms of astragalus dosage in milligrams mg How long have you taken this? menu
TAM 818	TAM 818 Dose menu	TAM 818 How often? menu	TAM 818 How long have you taken this? menu
Silymarin dosage in milligrams mg	Silymarin dosage in milligrams mg Dose menu	Silymarin dosage in milligrams mg How often? menu	Silymarin dosage in milligrams mg How long have you taken this? menu
Cat's Claw dosage in milligrams mg	Cat's Claw dosage in milligrams mg Dose menu	Cat's Claw dosage in milligrams mg How often? menu	Cat's Claw dosage in milligrams mg How long have you taken this? menu
Horny Goat Weed dosage in milligrams mg	Horny Goat Weed dosage in milligrams mg Dose menu	Horny Goat Weed dosage in milligrams mg How often? menu	Horny Goat Weed dosage in milligrams mg How long have you taken this? menu

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* 62. Hormones

	Dose	How often?	How long have you taken this?
DHEA dosage in milligrams mg	DHEA dosage in milligrams mg Dose menu	DHEA dosage in milligrams mg How often? menu	DHEA dosage in milligrams mg How long have you taken this? menu
Melatonin dosage in milligrams mg	Melatonin dosage in milligrams mg Dose menu	Melatonin dosage in milligrams mg How often? menu	Melatonin dosage in milligrams mg How long have you taken this? menu
Pregnenolone dosage in milligrams mg	Pregnenolone dosage in milligrams mg Dose menu	Pregnenolone dosage in milligrams mg How often? menu	Pregnenolone dosage in milligrams mg How long have you taken this? menu
Testosterone dosage in milligrams mg	Testosterone dosage in milligrams mg Dose menu	Testosterone dosage in milligrams mg How often? menu	Testosterone dosage in milligrams mg How long have you taken this? menu
HRT (prescription) dosage in milligrams mg	HRT (prescription) dosage in milligrams mg Dose menu	HRT (prescription) dosage in milligrams mg How often? menu	HRT (prescription) dosage in milligrams mg How long have you taken this? menu
HRT (bioidentical) dosage in milligrams mg	HRT (bioidentical) dosage in milligrams mg Dose menu	HRT (bioidentical) dosage in milligrams mg How often? menu	HRT (bioidentical) dosage in milligrams mg How long have you taken this? menu
HGH dosage in micrograms mcg=ug	HGH dosage in micrograms mcg=ug Dose menu	HGH dosage in micrograms mcg=ug How often? menu	HGH dosage in micrograms mcg=ug How long have you taken this? menu
Progesterone dosage in milligrams mg	Progesterone dosage in milligrams mg Dose menu	Progesterone dosage in milligrams mg How often? menu	Progesterone dosage in milligrams mg How long have you taken this? menu

Question Title

* 63. Peptides

	Dose	How often?	How long have you taken this?
Epitalin or Epithalamin or Endoluten dosage in milligrams mg	Epitalin or Epithalamin or Endoluten dosage in milligrams mg Dose menu	Epitalin or Epithalamin or Endoluten dosage in milligrams mg How often? menu	Epitalin or Epithalamin or Endoluten dosage in milligrams mg How long have you taken this? menu
Thymalin dosage in milligrams mg	Thymalin dosage in milligrams mg Dose menu	Thymalin dosage in milligrams mg How often? menu	Thymalin dosage in milligrams mg How long have you taken this? menu
Other Russian peptides dosage in milligrams mg	Other Russian peptides dosage in milligrams mg Dose menu	Other Russian peptides dosage in milligrams mg How often? menu	Other Russian peptides dosage in milligrams mg How long have you taken this? menu
Carnitine dosage in milligrams mg	Carnitine dosage in milligrams mg Dose menu	Carnitine dosage in milligrams mg How often? menu	Carnitine dosage in milligrams mg How long have you taken this? menu
Carnosine dosage in milligrams mg	Carnosine dosage in milligrams mg Dose menu	Carnosine dosage in milligrams mg How often? menu	Carnosine dosage in milligrams mg How long have you taken this? menu
Glycine dosage in milligrams mg	Glycine dosage in milligrams mg Dose menu	Glycine dosage in milligrams mg How often? menu	Glycine dosage in milligrams mg How long have you taken this? menu
BCAAs (taurine, glutamine...) dosage in milligrams mg	BCAAs (taurine, glutamine...) dosage in milligrams mg Dose menu	BCAAs (taurine, glutamine...) dosage in milligrams mg How often? menu	BCAAs (taurine, glutamine...) dosage in milligrams mg How long have you taken this? menu

Question Title

* 64. Mitochondrial supplements

	Dose	How often?	How long have you taken this?
ALA = Alpha Lipoic Acid dosage in milligrams mg	ALA = Alpha Lipoic Acid dosage in milligrams mg Dose menu	ALA = Alpha Lipoic Acid dosage in milligrams mg How often? menu	ALA = Alpha Lipoic Acid dosage in milligrams mg How long have you taken this? menu
CoQ10 or ubiquinol or ubiquinone dosage in milligrams mg	CoQ10 or ubiquinol or ubiquinone dosage in milligrams mg Dose menu	CoQ10 or ubiquinol or ubiquinone dosage in milligrams mg How often? menu	CoQ10 or ubiquinol or ubiquinone dosage in milligrams mg How long have you taken this? menu
Fullerenes (buckyballs) dosage in milligrams mg	Fullerenes (buckyballs) dosage in milligrams mg Dose menu	Fullerenes (buckyballs) dosage in milligrams mg How often? menu	Fullerenes (buckyballs) dosage in milligrams mg How long have you taken this? menu
PQQ dosage in milligrams mg	PQQ dosage in milligrams mg Dose menu	PQQ dosage in milligrams mg How often? menu	PQQ dosage in milligrams mg How long have you taken this? menu
SkQ or MitoQ dosage in milligrams mg	SkQ or MitoQ dosage in milligrams mg Dose menu	SkQ or MitoQ dosage in milligrams mg How often? menu	SkQ or MitoQ dosage in milligrams mg How long have you taken this? menu

Question Title

* 65. Immune support

	Dose	How often?	How long have you taken this?
Reishi dosage in milligrams mg	Reishi dosage in milligrams mg Dose menu	Reishi dosage in milligrams mg How often? menu	Reishi dosage in milligrams mg How long have you taken this? menu
Lion's mane dosage in milligrams mg	Lion's mane dosage in milligrams mg Dose menu	Lion's mane dosage in milligrams mg How often? menu	Lion's mane dosage in milligrams mg How long have you taken this? menu
Other fungal supplements dosage in milligrams mg	Other fungal supplements dosage in milligrams mg Dose menu	Other fungal supplements dosage in milligrams mg How often? menu	Other fungal supplements dosage in milligrams mg How long have you taken this? menu
Kalonji or black cumin or charnouchka dosage in milligrams mg	Kalonji or black cumin or charnouchka dosage in milligrams mg Dose menu	Kalonji or black cumin or charnouchka dosage in milligrams mg How often? menu	Kalonji or black cumin or charnouchka dosage in milligrams mg How long have you taken this? menu
Spirulina dosage in milligrams mg	Spirulina dosage in milligrams mg Dose menu	Spirulina dosage in milligrams mg How often? menu	Spirulina dosage in milligrams mg How long have you taken this? menu

Question Title

* 66. Stimulants and nootropics

	Dose	How often?	How long have you taken this?
Huperzine dosage in milligrams mg	Huperzine dosage in milligrams mg Dose menu	Huperzine dosage in milligrams mg How often? menu	Huperzine dosage in milligrams mg How long have you taken this? menu
Adderall dosage in milligrams mg	Adderall dosage in milligrams mg Dose menu	Adderall dosage in milligrams mg How often? menu	Adderall dosage in milligrams mg How long have you taken this? menu
Dexedrine or ritalin dosage in milligrams mg	Dexedrine or ritalin dosage in milligrams mg Dose menu	Dexedrine or ritalin dosage in milligrams mg How often? menu	Dexedrine or ritalin dosage in milligrams mg How long have you taken this? menu
Sulforaphane dosage in milligrams mg	Sulforaphane dosage in milligrams mg Dose menu	Sulforaphane dosage in milligrams mg How often? menu	Sulforaphane dosage in milligrams mg How long have you taken this? menu
Microdose LSD dosage in micrograms mcg=ug	Microdose LSD dosage in micrograms mcg=ug Dose menu	Microdose LSD dosage in micrograms mcg=ug How often? menu	Microdose LSD dosage in micrograms mcg=ug How long have you taken this? menu

Question Title

* 67. Do you regularly take probiotics, sauerkraut, kimchee, or yoghurt?

Yes

Occasionally

Question Title

* 68. Do you take a statin drug?

Yes

In the past, not now

Intermittently

Question Title

* 69. Do you take a angiotensin (ACE) inhibitors (e.g., Enalipril, Lotensin)

Yes

In the past, not now

Intermittently