Candida: Questionnaire and Score Sheet

If you would like to know if your health problems are yeast connected, take this comprehensive questionnaire.   Filling out and scoring this questionnaire should help you and your physician evaluate the possible role Candida albicans contributes towards your health problems. Yet, it will not provide an automatic ‘yes’ or ‘no’ answer.   Section A – history   Points Tick Tick the relevant box and add up your score at the end.

35. __ 1. Have you taken tetracycline’s or other antibiotics for acne for 1 month

Or longer?   35 __ 2. Have you at any time in your life taken broad-spectrum antibiotics or Other antibacterial medication for respiratory, urinary or other Infections for 2 months or longer, or in shorter courses 4 or more times In a 2-year period?   6 __ 3. Have you taken a broad-spectrum antibiotic drug – even in a single dose?   25 __ 4. Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis or other problems affecting your reproductive organs? 20 __ 5. Are you bothered by memory or concentration problems – do you sometimes feel spaced out? 20 __ 6. Do you feel ‘sick all over’ yet, in spite of many different physicians, the causes haven’t been found?   7. Have you been pregnant? 5 __ Two or more times? 3 __ One time?   8. Have you taken birth control pills? 15 __ For more than 2 years? 8 __ For 6 months to 2 years?   9. Have you taken steroids orally, by injection or inhalation? 15 __ For more than 2 weeks?   6 __ For 2 weeks or less?   10. Does exposure to perfumes, insecticides, fabric shop odours and other chemicals provoke 20 __ Moderate to severe symptoms? 5 __ Mild symptoms?   20 __ 11. Does tobacco smoke really bother you?   20 __ 12. Are your symptoms worse on damp, muggy days or in mould places?   13. Have you had athlete’s foot, ring worm, ‘jock itch’ or other chronic fungal infections of the skin or nails?   20 __ Have suck infections been severe or persistent? 10 __ Mild to moderate?   10 __ 14. Do you crave sugar?   __________ TOTAL SCORE, Section A     Section B – major symptoms   For each of your symptoms, enter the appropriate figure in the point score column: If a symptom is * occasional or mild – 13 points * frequent and/or moderately severe – 6 points * severe and/ or disabling – 9 points   Add total score and record it at the end if this section.   _____ 1. Fatigue or lethargy _____ 2. Feeling of being ‘drained’ _____ 3. Depression or manic depression _____ 4. Numbness, burning or tingling _____ 5. Headache _____ 6. Muscle aches _____ 7. Muscle weakness or paralysis _____ 8. Pain and/or swelling in joints _____ 9. Abdominal pain _____ 10. Constipation and/or diarrhea _____ 11. Bloating, belching or intestinal burning _____ 12. Troublesome vaginal burning, itching or discharge _____ 13. Prostatitis _____ 14. Impotence _____ 15. Loss of sexual desire or feeling _____ 16. Endometriosis or infertility _____ 17. Cramps and/or other menstrual irregularities _____ 18. Premenstrual tension _____ 19. Attacks of anxiety or crying _____ 20. Cold hands or feet, low body temperature _____ 21. Hypothyroidism (underactive thyroid) _____ 22. Shaking or irritable when hungry _____ 23. Cystitis or interstitial cystitis   ________ TOTAL SCORE, Section B     Section C – other symptoms   For each of your symptoms, enter the appropriate figure in the point score column: If symptom is * occasional or mild – 1 point * frequent and/or moderately severe – 2 points * severe and/or disabling – 3 point   Add total score and record it at the end of this section.   ­­­­_____ 1. Drowsiness, including inappropriate drowsiness _____ 2. Irritability _____ 3. Inco-ordination _____ 4. Frequent mood swings _____ 5. Insomnia _____ 6. Dizziness/loss of balance _____ 7. Pressure above ears, or feeling of head swelling _____ 8. Sinus problems, or tenderness of cheekbones or forehead _____ 9. Tendency to bruise easily _____ 10. Eczema, itching eyes _____ 11. Psoriasis _____ 12. Chronic hives (urticaria) _____ 13. Indigestion or heartburn _____ 14. Sensitivity to milk, wheat, corn or other common foods _____ 15. Mucus in stools _____ 16. Rectal itching _____ 17. Dry mouth or throat _____ 18. Mouth rashes, including ‘white’ tongue _____ 19. Bad breath _____ 20. Foot, hair or body odour not relieved by washing _____ 21. Nasal congestion or postnasal drip _____ 22. Nasal itching _____ 23. Sore throat _____ 24. Laryngitis, loss of voice _____ 25. Cough or recurrent bronchitis _____ 26. Pain or tightness in chess _____ 27. Wheezing or shortness of breath _____ 28. Urinary frequency or urgency _____ 29. Burning on urination _____ 30. Spots in front of eyes or erratic vision _____ 31. Burning or tearing eyes _____ 32. Recurrent infections or fluid in ears _____ 33. Ear pain or deafness   _____ TOTAL SCORE, Section C     Total scores: Section A _____ Section B _____ Section C _____   GRAND TOTAL SCORE __________     The grand total score will help you and your physician decides if your health problems are yeast-connected. Scores in women will run higher, as seven items in the questionnaire apply to women, while only two apply exclusively to men.   WOMEN MEN Yeast-connected health problems are With scores more with scores more ALMOST CERTAINLY present than 180 than 140     WOMEN MEN Yeast-connected health problems are With scores more with scores more PROBABLY present than 120 than 90     WOMEN MEN Yeast-connected health problems are With scores more with scores more POSSIBLY present than 60 than 40     With scores of less than 60 in women and 40 in men, yeast is less apt to cause health problems.