HELTH Foundation Intake

Welcome to HELTH Foundation

This resource shares general nutrition education to help adults understand common vitamin and mineral needs.

Important: HELTH Foundation does not provide medical advice, diagnosis, or treatment. This information is not a substitute for care from a licensed healthcare professional.
Question 1 of 15

Have you ever been diagnosed with serious kidney disease, liver disease, or are you currently undergoing active cancer treatment?

Includes: CKD, cirrhosis, active hepatitis, chemotherapy, or radiation

Question 2 of 15

Are you currently pregnant, trying to conceive, or breastfeeding?

Question 3 of 15

Do you take prescription blood thinners?

Blood thinners like warfarin/Coumadin interact with Vitamin K. We’ll adjust your recommendations to avoid complications.

Common blood thinners: Warfarin, Coumadin, Eliquis, Xarelto, Plavix

Question 4 of 15

Do you need to avoid or limit iodine?

Some thyroid conditions (hyperthyroidism, Graves’ disease) require limiting iodine. We’ll ensure your multivitamin is safe for you.

Question 5 of 15

Do you have a fish or shellfish allergy?

Many Omega-3, glucosamine, and collagen supplements are fish-derived. We’ll recommend plant-based alternatives for you.

Question 6 of 15

Do you require strictly vegan supplements?

Question 7 of 15

Do you eat eggs OR red meat regularly?

Choline is critical for brain health, liver function, and cell membranes. Best sources: eggs (150mg per egg) and red meat (100mg per 3oz).

You need 425-550mg daily. If you eat fewer than 2 eggs OR 2 servings of red meat per week, you likely need supplementation.

Question 8 of 15

Do you perform physically demanding work or athletics that stress your joints?

Question 9 of 15

Do you experience any of these?

Magnesium supports 300+ enzymatic reactions and is often deficient in modern diets. It’s especially important for sleep quality, stress management, and muscle recovery.

Signs you may need magnesium: Poor sleep, muscle cramps, high stress, or coffee intake (which depletes magnesium).

Question 10 of 15

Have you ever had calcium kidney stones?

If you’ve had calcium-based kidney stones, we’ll adjust your calcium recommendations to prevent recurrence while still supporting bone health.

Question 11 of 15

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Question 12 of 15

Are you 35 years of age or older?

Your body’s CoQ10 production drops by 50% by age 40. CoQ10 powers your cells’ energy production (especially heart muscle) and declines naturally with age.

If you’re 35+, we’ll recommend CoQ10 to support cellular energy, heart health, and exercise recovery.

Question 13 of 15

Are you 50 years of age or older?

Age 50+ brings specific nutritional gaps that basic supplementation doesn’t address:

Vitamin E: Antioxidant protection for your cardiovascular system
Lutein: Eye protection against macular degeneration (leading cause of vision loss after 50)
Collagen: Your body’s collagen production drops 25-40% by age 50. We’ll help you rebuild bone, joint, and skin structure.

Question 14 of 15

Do any of these apply to you?

Blue light from screens damages your macula (central vision) over time. Lutein and zeaxanthin are carotenoids that filter harmful blue light and protect against macular degeneration.

Most people don’t eat enough lutein-rich foods (kale, spinach) to offset modern screen exposure. Select all that apply:

Question 15 of 15

Do you take any of these medications regularly?

Common medications deplete essential nutrients—a phenomenon called Drug-Induced Nutrient Depletion (DIND). We’ll ensure you’re replenishing what your medications are taking away.

Select all that apply (or select “none” if you don’t take any of these):

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