Candida Albicans Questionnaire


Candida Albicans symptoms are listed by category. As Candida is accumulative, this applies to the present and your entire past life. Score 1 if occasional, 2 if frequent, or 3 if severe.


DIGESTIVE SYSTEM

_____ Gas w/most foods, not just one food		_____ Indigestion
_____ Intestine pain, colitis				_____ Mucus in stools
_____ Bloating with or w/o gas				_____ Hemorrhoids
_____ Belching w/most foods				_____ Dry mouth
_____ Constipation, stool hard-difficult to move	_____ Bad Breath
_____ Diarrhea, stool watery over long period		_____ Crave sugars
_____ Heartburn, chronic				_____ Crave breads
_____ Hiatal Hernia conditions				_____ Crave alcoholic beverages

				Total Score _____


NERVES AND STRESS

_____ Headaches, occasional but constant		_____ Schizophrenia
_____ Migraine headaches				_____ Psychiatric drugs
_____ Depression					_____ Shock treatment
_____ Lethargic						_____ Dizziness, vertigo
_____ Laziness, consistent				_____ Insomnia
_____ Hyper-agitation					_____ Hyper-activity
_____ Memory, loss or poor				_____ Fatigue
_____ Concentration, noticeable less/loss		_____ Drained
_____ Energy loss					_____ Spacey feeling

				Total Score _____


GENITOURINARY

_____ Vaginal, yeast outbreak, discharge,		_____ Urinary infection reoccurring low
	burning or itching					grade
_____ Penis, Scrotum, yeast outbreak, fungi		_____ Bladder infection reoccurring low
	jock itch					_____ Endometriosis
_____ Mensuses, irregularities, cramping		_____ Prostatitis
_____ Premenstrual, anxiety, depression problems	_____ Loss of sexual desire
_____ Impotence						_____ Premenstrual tension
_____ Urethritis					_____ Urinary frequency/urgency
_____ Cystitis						_____ Urinary Burning

				Total Score _____


ALLERGY-MUCUS SYMPTOMS

_____ Hayfever						_____ Ear Pain
_____ Ear, draining, aches, infections			_____ Chest congestion
_____ Hives						_____ Wheezing
_____ Asthma						_____ Headaches
_____ Chemicals, sensitivity				_____ Head fullness, pressure above ears
_____ Food, sensitivity					_____ Itching, ears, nose, body
_____ Odors, fragrances, sensitivity			_____ Rashes, allergic
_____ Heat/cool sensitivity				_____ Blister, rash in mouth
_____ Mucus, chronic body, nose, throat, etc.		_____ Mucus congestion or nasal discharge
_____ Five sense disturbances				_____ Dry throat
_____ Tobacco smoke sensitivity				_____ Cough
_____ Eyes burning/tearing

				Total Score _____


GENERAL, POTENTIAL CONTRIBUTING CAUSES FOR:

_____ Chrohn's disease					_____ Multiple Sclerosis
_____ Anorexia Nervosa					_____ Hypoglycemia
_____ Systemic Lupus Erythematosis			_____ Hyperactivity
_____ Sarcoidosis					_____ Psychosomatic disorders
_____ Myasthenia Gravis					_____ Asthma
_____ Alcoholism, especially wine & beer		_____ Allergies
_____ Drug addiction

				Total Score _____


GENERAL SYMPTOMS - ENVIRONMENTAL

_____ Fatigue						_____ Muscle aches
_____ Molds, exposure to, moldy house, close		_____ Numbness, tingling, burning
	to ground					_____ Muscle weakness, paralysis
_____ Fungus conditions, between toes/fingers,		_____ Joints, pain or swelling
	under finger nails or in skin folds		_____ Spots in front of eyes
_____ Infection, chronic reoccurring			_____ Vision is erratic/failing
_____ Eye matting, infection, mucus discharge		_____ Drowsiness
_____ Mouth infection/thrush				_____ Lack of coordination when needed
_____ Rashes, body/diaper				_____ Arthritis/joint swelling

				Total Score _____


Antibiotics kill both good and bad bacteria in the body creating a bacterial imbalance and the increase of Candida. Birth control pills historically add to Candida emergency. Consequently, these drug uses are weighed heavily.

					Used less than		1 month or
DRUG					1 month - Score 25	continued use - Score 50

Tetracyclines ______________ _________________ Antibiotics ______________ _________________ Prednisone or other cortisone type ______________ _________________ Birth control pills ______________ _________________ Drug Total ______________ _________________ Combined Drug Total ______________ Combined Category Total ______________ Your Total ______________


Candida can run from mildly irritating to severe, even life threatening. Even a low score then would require treatment if bothersome. A three in headache, yeast infection, etc., would invite corrective measures.


SCORES

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