Guest guest Posted April 20, 2002 Report Share Posted April 20, 2002 Candida Questionaire This questionnaire lists factors in your medical history that promote the growth of the common yeast, Candida Albicans and symptoms commonly found in individuals with yeast-connected illnesses. For your ease in taking this self-scoring questionnaire, first hit your browser's print key, making a hard copy of this survey. Follow the instructions of each section. At the end, total up your scores for each section and review it against the key at the end. If you find that you are currently suffering from Candida, and would like help in eliminating it from you body, schedule a session to find out what you can do to live a better, healthier life! Section A: History Instructions: 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, scoring as directed. 1. Have you taken tetracylines (Sumycin, Panmycin, Vibramycin, Minocin, etc.) or other antibiotic for acne for 1 month or longer? 50 2. Have you ever taken other " broad spectrum " antibiotics for urinary, respiratory or other infections for 2 months or longer, or in shorter courses 4 or more times in a 1 year period? 50 3. Have you ever taken a " broad spectrum " antibiotic drug – even for one period? 6 4. Have you ever been bothered by persistent prostatitis, vaginitis, or other problems that affect your reproductive organs? 25 5. Have you ever been pregnant – 2 or more times? 5 - 1 time? 3 6. Have you taken birth control pills for - more than 2 years? 15 - 6 months to 2 years? 8 7. Have you taken prednisone, Decadron or other cortisone type drugs for… - more than 2 weeks? 15 - 2 weeks or less? 6 8. Does exposure to perfumes, insecticides, fabric shop odors or other chemicals provoke… - Moderate to severe symptoms? 20 - Mild symptoms? 5 9. Are symptoms worse on damp, muggy days or in moldy places? 20 10. Have you had athlete's foot, ring worm, " jock itch " or other chronic fungous infections of the skin or nails? - Moderate to severe symptoms? 20 - - Mild to moderate symptoms? 10 11. Do you crave sugar? 10 12. Do you crave breads or other foods high in carbohydrates? 10 13. Do you crave alcoholic beverages? 10 14. Does tobacco smoke really bother you? 10 Total Score – Section A Section B: Major Symptoms Instructions: For each symptom that is present, enter the appropriate number 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. Total the score for this section and record it in the box at the end of this section. Point Score 1. Fatigue or lethargy 2. Feeling of being " drained " 3. Poor memory 4. Feeling " spacey " or " unreal " 5. Depression 6. Numbness, burning or tingling 7. Insomnia 8. Muscle aches 9. Muscle weakness or paralysis 10. Joint pain or swelling 11. Abdominal pain 12. Constipation 13. 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 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 Instructions: For each symptom that is present, enter the appropriate number 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 persistent………………...score 9 points. Total the score for this section and record it in the box at the end of this section. Point Score 1. Drowsiness 2. Irritability or jitteryness 3. Incoordination 4. Inability to concentrate 5. Frequent mood swings 6. Headache 7. Dizziness/loss of balance 8. Pressure above ears, feeling of head swelling/tingling 9. Tendency to bruise easily 10. Chronic rashes or itching 11. Psoriasis or recurrent hives 12. Indigestion or heartburn 13. Food sensitivity or intolerance 14. Mucus in stools 15. Hemorrhoids or 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, discharge or post nasal drip 21. Nasal itching 22. Sore or dry throat 23. Laryngitis, loss of voice 24. Cough or recurrent bronchitis 25. Pain or tightness in chest 26. Wheezing or shortness of breath 27. Urgency frequency, urgency or incontinence 28. Burning on urination 29. Spots in front of 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 Test Scoring & Results Total Score – Section A Total Score – Section B Total Score – Section C Grand Total Score (add sections A, B & C) The Grand Total Score will help you and your health care provider decide if your health problems are yeast-connected. Scores for woman will typically run higher. Yeast-connected health problems are almost certainly present in woman with scores over 180, and in men with scores over 140. Yeast-connected health problems are probably present in woman with scores over 120 and in men with scores over 90. Yeast-connected health problems are possibly present in woman with scores over 60 and in men with scores over 40. With scores less than 60 for woman and 40 for men, yeast are less apt to cause health problems. Quote Link to comment Share on other sites More sharing options...
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