Is Candida playing a role in your symptoms? Take this simple questionnaire to find out!

Candida Questionnaire And Score Sheet

This questionnaire is designed for adults and the scoring system isn't appropriate for children.  It lists factors in your medical history which promote the growth of Candida albicans (Section A), and symptoms commonly found in individuals with yeast-connected illness (Section B and C).

For each “Yes” answer in Section A, Circle the Point Score in that section. Total your score and record it in the box at the end of the section. Then move on to Sections B and C and score as directed.

Filling out and scoring this questionnaire should help you and your physician evaluate the possible role of candida in contributing to your health problems. Yet it will not provide an automatic “Yes” or “No” answer.

Section A: History

Point

Score

1. Have you taken tetracyclines or other antibiotics for acne for 1 month (or longer)?	35
2. Have you, at any time in your life, taken other “broad spectrum” antibiotics for respiratory, urinary or other infections (for 2 months or longer, or in shorter courses 4 or more times in a 1-year period?)	35
3. Have you taken a broad spectrum antibiotic drug- even a single course?	6
4. Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis or other problems affecting your reproductive organs?	25
5. Have you been pregnant... 2 or more times? 1 time?	5 or 3
6. Have you taken birth control pills... For more than 2 years? For 6 months to 2 years?	15 or 8
7. Have you taken prednisone, Decadron or other cortisone-type drugs... For more than 2 weeks? or For 2 weeks or less?	15    6
8. Does exposure to perfumes, insecticides, fabric shop odors and other chemicals provoke... Moderate to severe symptoms? Mild symptoms?	20 or 5
9. Are your symptoms worse on damp, muggy days or in moldy places?	20
10. Have you had athlete’s foot, ringworm, “jock itch” or other chronic fungous infections of the skin or nails? Severe or persistent? Mild to moderate?	20 or 10
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, 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.................................score 3 points

If a symptom is frequent and/or moderately severe......score 6 points

If a symptom is severe and/or disabling........................score 9 points

Add total score and record it in the box at the end of this section.

           Point score

1. Fatigue or lethargy
2. feeling of being “drained”
3. Depression
4. Poor memory
5. Feeling “spacy” or “unreal”
6. Inability to make decisions
7. Numbness, burning or tingling
8. Headache
9. Muscle aches
10. Muscle weakness or paralysis
11. Pain and/or swelling in joints
12. Abdominal pain
13. Constipation and/or diarrhea
14. Bloating, belching or intestinal gas
15. Troublesome vaginal burning, itching or discharge
16. Prostatitis
17. Impotence
18. Loss of sexual desire or feeling
19. Endometriosis or infertility
20. Cramps and/or other menstrual irregularities
21. Premenstrual tension (PMS)
22. Attacks of anxiety or crying
23. Cold Hands or feet and/or chilliness
24. Shaking or irritable when hungry
TOTAL SCORE, Section B...................................................................

SECTION C: OTHER SYMPTOMS

For each of your symptoms, enter the appropriate figure in the Point Score column:

If a symptom is occasional or mild.................................score 1 points

If a symptom is frequent and/or moderately severe......score 2 points

If a symptom is severe and/or disabling........................score 3 points

Add total score and record it in the box at the end of this section.

Point Score

1. Drowsiness
2. Irritability or jitteriness
3. Incoordination
4. Inability to concentrate
5. Frequent mood swings
6. Insomnia
7. Dizziness/loss of balance
8. Pressure above ears.... feeling of head swelling
9. Tendency to bruise easily
10. Chronic rashes or itching
11. Numbness, tingling
12. Indigestion or heartburn
13. Food sensitivity or intolerance
14. Mucus in stools
15. Rectal itching
16. Dry mouth or throat
17. Rash or blisters in mouth
18. Bad breath
19. Foot, hair or body odor not relieved by washing
20. Nasal congestion or post nasal drip
21. Nasal itching
22. Sore throat
23. Laryngitis, loss of voice
24. Cough or recurrent bronchitis
25. Pain or tightness in chest
26. Wheezing or shortness of breath
27. Urinary frequency
28. Burning on urination
29. Spots in from of the eyes or erratic vision
30. Burning or tearing of eyes
31. Recurrent infections or fluid in ears
32. Ear pain or deafness

Total Score, Section C.........................................................._________

Total Score, Section A........................................................._________

Total Score, Section B.........................................................__________

GRAND TOTAL SCORE.................................................................__________

The Grand Total Score will help you and your physician decide if your health problems are yeast-connected. Scores in women will run higher as 7 items in the questionnaire apply exclusively to women, while only 2 apply to exclusively to men.

Yeast-connected health problems are almost certainly present in women with scores over 180, and in men with scores over 140.

Yeast-connected health problems are probably present in women with scores over 120, and in men with scores over 90.

Yeast-connected health problems are possibly present in women with scores over 60, and in men with scores over 40.

With scores of less that 60 in women and 40 in men, yeasts are less apt to cause health problems.

This test was taken out of The Yeast Connection: A Medical Breakthrough. By William G. Crook, M.D.