Candida Questionnaire

Sluggish? Digestive issues? Bloated or carrying extra weight? Weakened immune system?

You may have Candida. Take our candida quiz now and find out.

Section A: History
1. Have you taken tetracyclines (Sumycin®, Panmycin®, Vibramycin®,Minocin®, etc.) or other antibiotics for acne for 1 month (or longer)?	NoYes
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 for shorter periods 4 or more times in a 1-year span?	NoYes
3. Have you taken a broad spectrum antibiotic drug – even for one period?	NoYes
4. Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis, or other problems affecting your reproductive organs?	NoYes
5. How many times have you been pregnant?	Never1 time2 or more times
6. For how long have you ever taken birth control pills?	Never6 months – 2 YearsMore than 2 Years
7. For how long have you ever taken prednisone, Decadron®, or other cortisone-type drugs by mouth or inhalation**?	Never2 weeks or lessMore than 2 weeks
8. Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke mild, moderate or severe symptoms?	No SymptomsMild SymptomsModerate to Severe Symptoms
9. Are your symptoms worse on damp, muggy days or in moldy places?	NoYes
10.Have you had athlete’s foot, ringworm, “jock itch” or other chronic fungus infections of the skin or nails?	NoYes, Mild/ModerateYes, Severe/Persistent
11. Do you crave sugar?	NoYes
12. Do you crave breads?	NoYes
13. Do you crave alcoholic beverages?	NoYes
14. Does tobacco smoke really bother you?	NoYes

Section B: Major Symptoms
Symptom	No Symptoms	Occasional/Mild	Frequent/Moderately Severe	Severe/Disabling
1. Fatigue or lethargy
2. Feeling of being “drained”
3. Poor memory
4. Feeling “spacey” or “unreal”
5. Inability to make decisions
6. Numbness, burning or tingling
7. Insomnia
8. Muscle aches
9. Muscle weakness or paralysis
10. Pain and/or swelling in joints
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

Section C: Other Symptoms
Symptom	No Symptoms	Occasional/Mild	Frequent/Moderately Severe	Severe/Disabling
1. Drowsiness
2. Irritability or jitteryness
3. Incoordination
4. Inability to concentrate
5. Frequent mood swings
6. Headaches
7. Dizziness/loss of balance
8.Pressure above ears, feeling of head swelling
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. 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, 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

* Filling out and scoring this
questionnaire should help you and your physician evaluate how
Candida Albicans may be contributing to your health problems. Yet
it will not provide an automatic yes or no answer. A
comprehensive history and physical examination are important. In
addition, laboratory studies, x-rays, and other types of tests
may also be appropriate.

** The use of nasal or bronchial sprays containing cortisone and/or other
steroids promotes overgrowth in the respiratory tract.

This questionnaire is available in
quantity from Professional Books, Inc., P.O. Box 3246, Jackson,
TN 38302. Prices upon request. Copyright 1984. The Yeast
Connection by William G. Crook, M.D. Reprinted with permission.