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4767 Ocean Boulevard, San Diego, CA 92109, US
By Appointment Only
5 Element Health Condition Assessment
Based on Shaping Our Destiny by Seymour Koblin — Isoharts Zenergize Holistic Health Club
Check Now if you currently experience the symptom. Check Chr if it is chronic or recurring. This assessment helps you notice which of the Five Elements are asking for attention. It is educational and wellness-oriented — for a definitive assessment, we welcome you to a discovery call with Seymour or a qualified Isoharts practitioner, where hands-on palpation or personal communication inquiry reveals the precise balance of your elements.
📄 Download Printable PDF Version
The Five Elements Cycle: Water (Winter/Gestation) → Tree (Spring/Birth) → Fire (Summer/Passion) → Earth (Autumn/Grounding) → Metal (Fall/Completion) → returns to Water
Flowing energy — gestation in the dark womb, dream sleep, inward, resting, consolidating reserves
| Now | Chr | Symptom / Condition |
|---|---|---|
| Fatigue / exhaustion | ||
| Frequent and irregular urination | ||
| Weakness and pain in lower legs | ||
| Lower back pain | ||
| Bloating / distension | ||
| Swollen knees and ankles | ||
| Swelling / puffiness under eyes | ||
| Premature ejaculation | ||
| Night sweats | ||
| Hearing loss | ||
| Ringing in ears (tinnitus) | ||
| Lower back and/or spinal pain | ||
| Loss of menstruation | ||
| Cold sensations, cold to touch | ||
| Infertility / Impotence | ||
| Adrenal insufficiency | ||
| False fire (hot flash syndrome) | ||
| Dizziness | ||
| Poor memory | ||
| Incontinence | ||
| Disorientation / deep fatigue | ||
| Fear / anxiety | ||
| Isolation | ||
| Lack of willpower or drive |
Rising energy — birth, new direction, growth reaching upward
| Now | Chr | Symptom / Condition |
|---|---|---|
| Painful menstruation | ||
| Tumors or cysts on ovaries | ||
| Lumps in breasts | ||
| Uterine fibroids | ||
| Cervical dysplasia | ||
| Irregular or suppressed menstruation | ||
| Muscle cramps | ||
| Stabbing, sharp or piercing pains | ||
| Blurred vision | ||
| Genital herpes | ||
| Hepatitis / Jaundice | ||
| Colds and flu (not deep-rooted) | ||
| Sinus problems | ||
| Allergies | ||
| Premenstrual insomnia | ||
| Palsy (Parkinson’s, etc.) | ||
| Migraine or moving headaches | ||
| Pain in eyes or ears | ||
| Wandering / migrating pain | ||
| Headaches (toxicity from constipation) | ||
| Depression driven by anger | ||
| Suppressed and bound emotions | ||
| Agitation / Frustration | ||
| Irritability / quick temper | ||
| Nervous tension / Restlessness | ||
| Emotional inhibitions | ||
| Limited creativity and expressiveness | ||
| Tense muscles (shoulders by ears) | ||
| Prostate problems | ||
| Painful or cloudy ejaculation | ||
| Coronary arteriosclerosis | ||
| Blood in urine, stool, or saliva | ||
| Irritable Bowel Syndrome |
Radiating energy — passion, flourishing, peak expression and connection
| Now | Chr | Symptom / Condition |
|---|---|---|
| Heart failure | ||
| Angina pectoris | ||
| Palpitations | ||
| Raynaud’s syndrome | ||
| Skin: grayish or reddish complexion | ||
| Lips/nose/fingers tinged purple | ||
| Angina or chest pain | ||
| Fullness in chest, abdomen, or head | ||
| Poor circulation | ||
| Cysts, accumulations, or tumors | ||
| Sweating from minimal activity | ||
| Easily bruised | ||
| Varicose veins | ||
| Numb limbs | ||
| Restless sleep / Nightmares | ||
| Exhaustion | ||
| Temporary memory loss | ||
| Disturbed thinking / forgetfulness | ||
| Behavioral changes | ||
| Depression (can’t feel joy) | ||
| Disorientation / agitation | ||
| Epstein-Barr / Chronic Fatigue | ||
| Anemia | ||
| Pale lips or nails | ||
| Chronic bleeding or discharges | ||
| Extremely heavy menstruation | ||
| Reduced thinking capacity | ||
| Lethargy | ||
| Dizziness |
Grounding energy — autumn leaves falling, connecting with others, nourishing, settling
| Now | Chr | Symptom / Condition |
|---|---|---|
| Fullness, bloated/swollen abdomen | ||
| Vomiting / Nausea | ||
| Loss of appetite | ||
| Belching | ||
| Diarrhea | ||
| Hemorrhoids | ||
| Mucus discharges | ||
| Leucorrhea (white discharge) | ||
| Swellings in joints, sinuses, lungs | ||
| Excessive sweating | ||
| Sensitivity to temperature changes | ||
| Heavy / difficult breathing | ||
| Weight gain | ||
| Digestive disorders | ||
| Worry and overthinking | ||
| Mental fixation / obsessive thoughts | ||
| Clouded thinking | ||
| Malignant lumps | ||
| Inflamed gums | ||
| Discharges from mucous membranes |
Completion energy — individualized manifestation, solid as a rock, refined and distilled
| Now | Chr | Symptom / Condition |
|---|---|---|
| Dry, wrinkled skin | ||
| Allergic dermatitis | ||
| Body hair loss | ||
| Hair loss / thinning hair | ||
| Asthma | ||
| Constipation | ||
| Cramping in large intestine | ||
| Stiffness of spine and neck | ||
| Stiffness in chest and shoulders | ||
| Sinus infections or pain | ||
| Bad breath | ||
| Cysts or tumors | ||
| Reduced immunity / infections | ||
| Paleness around eyes | ||
| Headaches (toxicity from constipation) | ||
| Grief and sadness | ||
| Depression (melancholy) | ||
| Emotional blockages | ||
| Limited creativity and expressiveness |
Count your checkmarks for each element. The element with the highest score is your Fullest (excess). The element with the lowest score is your Emptiest (deficiency). Both matter — the fullest element may be overactive and creating ripple effects, while the emptiest element may need the most nourishment.
Chronic symptoms carry more weight — count them as 2 points each, current symptoms as 1 point each.
This questionnaire is a starting point for self-awareness. For a definitive assessment, we welcome you to a discovery call with Seymour or a qualified Isoharts practitioner — where hands-on palpation or personal communication inquiry reveals the precise balance of your elements.
BASED in Vital Health: All health challenges are opportunities to correct and evolve your body, mind, heart, and soul. By harmonizing the Five Elements — moderating the Full-Empty see-saw through dietary, movement, and lifestyle practices — your body runs itself free of stress. In that harmony, you’re naturally drawn to follow your TAO — your Destiny — your Dharma. 🌿
Book a Discovery Call with Seymour
Educational and wellness-oriented assessment — for educational purposes, and discovery of one’s vital health. Consult a licensed healthcare provider for medical concerns.
© Isoharts — Zenergize Holistic Health Club | Shaping Our Destiny by Seymour Koblin