CANDIDA QUESTIONAIRE Point

CANDIDA QUESTIONAIRE

Point Major Symptoms Point Score History Score For each of your symptoms, enter the appropriate figure 1. Have you taken tetracycline or other in the point Score Column. antibiotics for acne for one month If symptom is occasional or mild score 3 points or longer? 25 If symptom is frequent and/or 2. Have you at any time in your life taken moderately severe score 6 points other “Broad-spectrum” antibiotics for If a symptom is severe and/or respiratory, urinary, or other infections disabling score 9 points for two months or longer, or in short courses four or more times in a one-year 1. Fatigue or lethargy period? 20 2. Feeling of being drained 3. Have you ever taken a broad-spectrum 3. Poor Memory antibiotic (even a single course)? 6 4. Feeling “spacey” or “unreal” 4. Have you at anytime in your life been 5. Depression bothered by persistent prostatitis, vaginitis, 6. Numbness, burning, or tingling or other problems affecting your 7. Muscle aches reproductive organs? 25 8. Muscle weakness or paralysis 5. Have you been pregnant….. 9. Pain and/or swelling in joints One time? 3 10. Abdominal pain Two or more times? 5 11. Constipation 6. Have you taken birth control pills… 12. Diarrhea For six months to two years? 8 13. Bloating For more than two years? 15 14. Persistent vaginal itch 7. Have you taken prednisone or other 15. Persistent vaginal burning cortisone type drugs…. 16. Prostatitis For two weeks or less? 6 17. Impotence For more than two weeks? 15 18. Loss of sexual desire 8. Does exposure to perfumes, insecticides, 19. Endometriosis fabric shop odors, and other chemicals 20. Cramping and other menstrual provoke… irregularities Mild symptoms? 5 21. Premenstrual tension Moderate to severe symptoms? 20 22. Spots in front of eyes 9. Are your symptoms worse on damp, 23. Erratic vision muggy days or moldy places? 20 10. Have you had athlete’s foot, ringworm, TOTAL SCORE FOR THIS SECTION “jock itch,” or other chronic infections of the skin or nails? Mild to moderate? 10 Severe or persistent? 20 11. Do you crave sugar? 10 12. Do you crave breads? 10 13. Do you crave alcoholic beverages? 10 14. Does tobacco smoke really bother you? 10

TOTAL SCORE FOR THIS SECTION TOTOTAL SCORE FOR THIS SECTION Other Symptoms

For each of your symptoms, enter the appropriate figure in the point Score Column. Total Score from section one If symptom is occasional or mild score 1 point Total score from section two If symptom is frequent and/or Total score for section three Moderately severe score 2 points If a symptom is severe and/or TOTAL ALL SECTIONS Disabling score 3 points Women Men 1. Drowsiness Yeast- connected health problems 2. Irritability are almost certainly present >180 >140 3. Lack of coordination 4. Inability to concentrate Yeast-connected health problems 5. Frequent mood swings are probably present 120-180 90-140 6. Headache 7. Dizziness/loss of balance Yeast-connected health problems 8. Pressure above ears, feeling of head are possibly present 60-119 40-89 swelling and tingling 9. Itching Yeast-connected health problems 10. Other rashes are less likely to be present <60 <40 11. Heartburn  12. Indigestion Although the candida questionnaire can help, 13. Belching and intestinal gas ultimately the best method for diagnosing candidiasis 14. Mucus in stools is clinical evaluation by a physician knowledgeable 15. Hemorrhoids about yeast-related illness. 16. Dry mouth 17. Rash or blisters in mouth 18. Bad breath 19. Joint swelling or arthritis 20. Nasal congestion or discharge 21. Postnasal drip This questionnaire is from W. G. Crook M.D., 22. Nasal itching ThTThe Yeast Connection (Vintage Books.) 23. Sore or dry throat 24. Cough 25. Pain or tightness in chest 26. Wheezing or shortness of breath 27. Urinary urgency or frequency 28. Burning on urination 29. Failing Vision 30. Burning or tearing of eyes 31. Recurrent infections or fluid in ears 32. Ear pain or deafness