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Anti-Aging Progress Questionnaire

0 no change, 1 little change, 2 moderate change, 3 large change

Psychological
Energy levels 0 1 2 3
Increased Mental Alertness 0 1 2 3
Increased Sense of Well Being 0 1 2 3
Less Anxious 0 1 2 3
Less Depressed 0 1 2 3
Deeper Sleep 0 1 2 3
Dream more 0 1 2 3
Improved Recall 0 1 2 3
More Focused 0 1 2 3
Increased Activity At Work 0 1 2 3
Skin, Hair, Nails
Skin Thicker 0 1 2 3
Skin Less Dry 0 1 2 3
Nails Stronger 0 1 2 3
Nails Growing Faster 0 1 2 3
Hair Growing Faster 0 1 2 3
New Hair in Previously Bald Places 0 1 2 3
Increased Skin Tightening
Under Upper Arms 0 1 2 3
Abdomen 0 1 2 3
Thighs 0 1 2 3
Less Sag Under Chin 0 1 2 3
Facial Area- Take Initial Picture 0 1 2 3
Immune System
Fewer Allergic Reactions 0 1 2 3
Faster Healing (gums, cuts, surgery) 0 1 2 3
Fewer Colds 0 1 2 3
Digestive System
Less Indigestions 0 1 2 3
More Regular Bowel Movements 0 1 2 3
Bulkier Stools 0 1 2 3
Urinary System
less Frequency 0 1 2 3
Less Getting Up At Night 0 1 2 3
Less Urgency 0 1 2 3
Muscles
Stronger Abs 0 1 2 3
Firmer Thigh Muscles 0 1 2 3
More Youthful Body Contour 0 1 2 3
Love Handles and Belly Disappearing 0 1 2 3
Extremities
Hands Appear Younger- Take Initial Picture 0 1 2 3
Brown Spots Fading 0 1 2 3
Veins Less Prominent 0 1 2 3
Feet Appear Younger 0 1 2 3
Sex and Reproduction
Increased Sex Drive 0 1 2 3
Firmer Erections (men) 0 1 2 3
Greater Frequency of Sexual Relations 0 1 2 3
Increased Enjoyment 0 1 2 3
Fewer Problems With Menopause (women) 0 1 2 3

Body Composition

Percent Body Fat
Weight
Height

Strength

Wall Push-up
Push-up
Pull-ups

Lung Function

Vision Accomodation Test

Slowly bring newspaper to yoru eyes until the regular size letters start to blur. Have someone measure the distance between the eyes and the paper with a ruler.

Age 21    4 inches
Age 30    5.5 inches
Age 40    9 inches
Age 50    15 inches
Age 60    39 inches

Static Balance Test

How long you can stand on one leg with your eyes closed before falling over. Close your eyes and stand on left foot if you are right-handed and right foot if you are left-handed. Lift your leg about 6" off the ground and bend your knee to a 45 degree angle. Do the test three times and take an average.

Age 20-30    28 seconds
Age 40-50    18 seconds
Age 60-70    4 seconds

Skin Elasticity Test

Pinch the skin on the back of your hand between the thumb and forefinger for five seconds. Then time how long it takes to flatten out completely.

Age 20-30    0 - 1 seconds
Age 40-50    2 - 5 seconds
Age 60-70    10 - 55 seconds

Blood Work

  1. IGF-1 Serum (Somatomedin C)
  2. IGFBP-3 (Insulinlike Growth Factor Binding Protein 3)
  3. Estrogen
  4. Progesterone
  5. Testosterone
  6. Testorsterone - Free
  7. Dehydroepiandrosterone-sulfate (DHEA-S)

From Growing Young with HGH, by Dr. Ronald Klatz.