Aug 18, 2017
Questionnaire to Determine Ayurvedic Constitution
RIVERWALK NATURAL HEALTH CLINIC
Deborah A. Wiancek, N.D.
This questionnaire is provided to help you determine your Ayurvedic constitution. Select one answer for each question. If more than one answer is applicable, choose the one that applies the most. Some answers will be obvious (such as hair color, height, dry skin, etc.). Others will be more subjective and variable. If in doubt, answer according to how you have been for most of your life, especially for the past few years. At the end of the questionnaire, add the number of A’s, B’s, and C’s to determine your body-mind constitution.
A.£ Taller or shorter than average, thin and slender, with prominent joints and thin muscles. B.£ Medium build, with good muscle development. C.£ Large, round, solid body frame, with a heavy bone structure.
A.£ Low; difficulty gaining weight. B.£ Moderate; it’s easy to gain weight or lose weight if I put my mind to it. C.£ Heavy; I gain weight easily and have difficulty losing it.
Hair – two or more of the following options:
A.£ Dry, coarse, kinky, curly, brown, black. B.£ Fine, soft, red, light brown, blonde, prematurely graying or balding. C.£ Abundant, thick, oily, wavy, brown, black.
A.£ Small, dry, brown, active. B.£ Sharp, penetrating, green, blue, gray, with reddish or yellowish sclera. C.£ Large, attractive, brown or deep blue, with white sclera.
A.£ Crooked, uneven or with large spaces, sensitive to hot or cold, need for braces. B.£ Medium-sized, yellowish, gums bleed easily. C.£ Large, straight, white.
A.£ Dry, rough, thin, darker (relative to family), tans easily. B.£ Fair skin, sunburns easily, warm, reddish in color, prone to irritation. C.£ Moist, thick, smooth.
A.£ Cold hands and feet, dislikes cold weather, prefers warm environments. B.£ Usually warm regardless of season, sweats easily, prefers cooler environments. C.£ Cool (not cold) and clammy, adaptable to most temperatures but dislikes cool, wet weather.
A.£ Unpredictable and variable; sometimes not hungry at mealtimes and hungry between meals. B.£ Strong; acutely aware of mealtimes, irritable when delaying or missing a meal, can digest large quantities of food. C.£ Moderate; can comfortably miss a meal, feels best with smaller quantities of food.
A.£ Irregular, tends toward constipation, hard and dry stool, accompanied by gas. B.£ Regular, two or more bowel movements per day, loose/soft stools, occasional burning. C.£ Regular pattern, usually one large, full bowel movement per day.
A.£ Light or interrupted, insomnia, 5-7 hours per night. B.£ Sound, 6-8 hours per night. C.£ Deep, uninterrupted, love to sleep, slow to waken
A.£ Flying, running, fear, searching, traveling. B.£ Fire, conflict, anger, vivid colors, passion, jealousy. C.£ Water, romance, sadness, ocean, clouds, short dreams.
A.£ Selfless, often volunteers to help out. B.£ Works intensely, especially to achieve personal goals. C.£ Procrastinates, sometimes lazy, takes time to complete projects.
A.£ Performs activities very quickly, energy levels fluctuate and come in bursts, often multi-tasks, easily distracted and may not complete projects. B.£ Performs activities intensely and efficiently, perfectionist mindset, likely to become aggravated if interrupted or encounter difficulties. C.£ Performs activities slowly, calmly, and deliberately, steady energy level with good endurance and stamina.
A.£ Very quick learner, but forgets things easily. B.£ Moderately quick learner, clear on details, average memory. C.£ Slow learner, but never forgets information once it is learned.
A.£ Joint aches, low back pain, indigestion, intestinal gas, constipation, insomnia, anxiety, fatigue, weakness, dryness. B.£ Skin conditions (rashes, acne), ulcers, inflammations, fevers. C.£ Respiratory conditions, cough with mucus, sinus/nose/throat congestion, benign growths, obesity, diabetes, fluid retention.
A.£ Lively, easily excitable, changeable moods, enthusiastic. B.£ Perfectionist, driven, intense, opinionated. C.£ Easy-going, calm, satisfied, accepting.
Reaction to Stress
A.£ Fearful, anxious and/or worried. B.£ Anger, irritability, and/or aggressive. C.£ Withdrawn and/or reclusive.
A.£ Noise. B.£ Bright lights. C.£ Strong odors.
My family and friends might prefer me to be:
A.£ Settled. B.£ Tolerant. C.£ Enthusiastic.
This questionnaire made me feel:
A.£ Indecisive. B.£ Annoyed. C.£ Sleepy.
Final Score: A._____ B._____ C._____
Vata Pitta Kapha
The letter A corresponds to Vata.
B corresponds to Pitta.
C corresponds to Kapha.
Your predominant dosha(s) determine your Ayurvedic constitution. Some individuals have one predominant dosha (either vata, pitta, or kapha). Some individuals have two equally predominant doshas (for example, pitta-vata or kapha-pitta). Rarely, a few individuals will have equal proportions of all three doshas. While not an exact tool, this questionnaire should give you a good idea of your unique Ayurvedic constitution. A better and more exact determination of your constitution requires the insight and skill-set (including face, tongue, and pulse diagnosis) of a trained Ayurvedic practitioner.
Deborah Wiancek, N.D. The Inequality in Treatment of Women with Heart Disease