Carboception

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Food Diary - Add an Entry

Meal Type

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Date

Time

Entry Title

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MOOD AT CONSUMPTION

(Select one that best describes you)

Calm / Neutral

Happy / Content

Stressed / Overwhelmed

Irritable / Frustrated

Low / Sad

SYMPTOMS AT CONSUMPTION

(Select all that apply)

Abdominal pain

Bloating

Diarrhea

Flushing

Runny or blocked nose

Rapid heartbeat

Low blood pressure, dizziness

Asthma-like symptoms

Menstrual cramps worse than usual

Brain fog

Nausea

Flatulence (Gas)

Headaches

Skin problems

Swelling of face, lips or hands

Fatigue

Tingling or numbness in hands/feet

Joint or muscle pain

Anxiety or irritability

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