This questionnaire is provided as an indicator.
Print and Add up your score to determine the possibility of Candida.
LIST
1.
_____ 1. Have you ever taken antibiotics?
_____ 2. Have you ever taken steroid drugs such as Prednisone or Cortisone?
_____ 3. Have you ever taken contraceptive medication?
_____ 4. Have you been pregnant more than once?
LIST
2. - MAJOR SYMPTOM HISTORY
______ 1. Have you had itching or burning of the Vagina, Cvstitis or Thrush (Female) or "Jock itch"
(Male)?
______ 2. Have you ever had athlete's foot, skin rashes or fungal infections of nails or skin?
______ 3. Are you affected by chemical fumes, perfumes, tobacco smoke etc?
______ 4. Do you crave sugary foods, bread, beer or alcohol and are your
symptoms worse after taking these?
______ 5. Do you suffer from a variety of allergies?
______ 6. Do you suffer from intestinal gas, abdominal gas bloating or discomfort, belching or
wind?
______ 7. Do you suffer from pre-menstrual syndrome (fluid retention, irritability, cramp or
pain)?
______ 8. Do you suffer from depression, fatigue, lethargy! or mood swings?
______ 9. Pire you often irritable, easily angered, anxious or nervous?
______ 10. Do you have trouble thinking clearly, suffer occasional
memory losses or have difficulty concentrating?
______ 11. Are you ever dizzy or light headed?
______ 12. Do you have muscle aches, tingling, numbness or burning or
joints that swell and ache with normal activity?
______ 13. Do you have erratic vision or spots before the eyes?
______ 14. Have you had an unexpected weight gain without a change of diet?
______ 15. Are you bothered by constipation, diarrhoea or alternating constipation and diarrhoea especially
when taking antibiotics?
LIST
3. SECONDARY SYMPTOMS
_____ 1. Do you feel worse on damp days
_____ 2. Do you experience persistent drowsiness?
_____ 3. Do you have a lack of co-ordination or loss of balance
_____ 4. Have you experienced regular headaches?
_____ 5. Is your mouth or throat often dry?
_____ 6. Do you suffer from bad breath?
_____ 7. Are you bothered by a post-nasal drip, nasal itch and/or congestion?
_____ 8. Do you experience any tightness in the chest?
_____ 9. Do you experience ear sensitivity or fluid in the ears?
_____ 10. Do you regularly experience
heartburn or indigestion?
TOTAL SCORE
LIST 1. __________
LIST 2. __________
LIST 3. __________
Now total your score.
If you have one or more ticks in List 1,
Two or more in List 2
Any in List 3- Candida is possibly involved.
This
questionnaire is provided for general
information only and is not intended
to be used for self diagnosis. Some
of the symptoms could indicate a more
serious condition which could require
the assistance of a health
professional. If you consider Candida
to be a problem we encourage you to
discuss your condition with
knowledgeable health professionals
familiar with this subject. Candida Page
Disclaimer: All Information is provided for
educational purposes only and not intended
to be used for any therapeutic purpose, neither is it intended to diagnose,
prevent, treat or cure any disease. Please consult a health care
professional for diagnosis and treatment of medical conditions.
While all attempts have been made to ensure the accuracy of this information,
The Health Information Network does not accept any responsibility for any errors or
omissions.