Candida Questionnaire: Are your health problems yeast connected?

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Candida Questionnaire: Are your health problems yeast connected? The following questionnaire can be given to your clients if you suspect candida is a problem. YES NO Have you taken repeated courses of antibiotic drugs? Have you been troubled by premenstrual tension, abdominal pain, menstrual problems, vaginitis, prostatitis, or loss of sexual interest? Does exposure to tobacco, perfume, or other chemical odors provoke moderate to severe symptoms? Do you crave sugar, breads, and alcoholic beverages? Are you bothered by recurrent digestive problems? Does fatigue or symptoms of depression bother you? Do hives, psoriasis, or other chronic skin rashes bother you? Have you ever taken birth control pills? Do headaches, muscle and joint pains, or lack of coordination of movement bother you? Do you feel bad all over, yet the cause has not been found? If you have three or four YES answers, yeasts probably play a role in your illness. If you have five to seven YES answers, yeasts probably cause your symptoms. If you have more than eight YES answers, yeasts almost certainly are involved. Section A: History Possible Your Have you ever taken antibiotics for a month or more? 35 Have you at any time in your life taken "broad-spectrum" antibiotics for respiratory, urinary, or other infections (for two months or longer, or in shorter courses four or more times in a year)? 35 Have you taken a "broad-spectrum" antibiotic drug? Even a single course? 6

Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis, or other problems affecting reproductive organs? 25 Have you been pregnant two or more times? 5 One pregnancy? 3 Have you taken Prednisone, Decadron, or another cortisone-type drug for more than two weeks? 15 For two weeks or less? 6 Have you taken birth control pills for more than two years? 15 Have you taken birth control pills from six months to two years? 8 Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke moderate to severe symptoms? 20 Mild symptoms? 5 Are your symptoms worse on damp, muggy days or in moldy places? 20 Have you had athlete's foot, ringworm, jock itch, or other chronic fungus infections of the skin or nails? Have such infections been severe or persistent? 20 Mild to moderate? 10 Do you crave sugar or sweet foods? 10 Do you crave breads? 10 Do you crave alcoholic beverages? 10 Does tobacco smoke really bother you? 10 TOTAL SCORE FROM SECTION A (Maximum 278) SECTION B: MAJOR SYMPTOMS For each of your symptoms, enter the score figure in the column. If a symptom is occasional or mild, assign three points. If a symptom is frequent and/or moderately severe, assign six points. If a symptom is severe and/or disabling, assign nine points.

Fatigue or lethargy Feeling of being drained Poor memory Feeling spacey or unreal Depression Numbness, burning, or tingling Muscle aches Muscle weakness or paralysis Pain and/or swelling in joints Abdominal pain Constipation Diarrhea Bloating Troublesome vaginal discharge Persistent vaginal burning or itching Prostatitis Impotence Loss of sexual desire Cramps and/or other menstrual irregularities Premenstrual tension Spots in front of the eyes Erratic vision TOTAL SCORE FROM SECTION B (Maximum 207) SECTION C: OTHER SYMPTOMS

For each of your symptoms, enter the score figure in the column. If a symptom is occasional or mild, assign one point; If a symptom is frequent and/or moderately severe, assign two points; or If a symptom is severe and/or disabling, assign three points. Drowsiness Lack of coordination Irritability or jitteriness Inability to concentrate Frequent mood swings Headaches Dizziness/loss of balance Pressure above ears, feeling of head swelling or tingling Itching Other rashes Heartburn Indigestion Belching and intestinal gas Mucus in stools Hemorrhoids Dry mouth Rash or blisters in mouth Bad breath Joint swelling or arthritis Nasal congestion or discharge

Postnasal drip Nasal itching Sore or dry throat Cough Pain or tightness in chest Wheezing or shortness of breath Urgency or urinary frequency Burning on urination Burning or watering of the eyes Failing vision Recurrent infections or fluid in the ears Ear pain or deafness TOTAL SCORE, SECTION A TOTAL SCORE, SECTION B TOTAL SCORE, SECTION C GRAND TOTAL /278 /207 /96 /581 Interpreting your results: A score of over 100 indicates yeasts may play a part in the client's ill health. A score of over 150 indicates that yeasts are likely to play a significant role in the client's ill health, and you should consider using the methods discussed above to address this imbalance.!

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