Candida Questionnaire and Score Sheet

If you’d like to know if your health problems are yeast connected, take this comprehensive questionnaire.

Questions in Section A focus on your medical history—factors that promote the growth of Candida albicans and that frequently are found in people with yeast-related health problems. Score for YES.

In Section B you’ll find a list of 23 symptoms that are often present in patients with yeast-related health problems. Section C consists of 33 other symptoms that are sometimes seen in people with yeast-related problems—yet they also may be found in people with other disorders.

Doing this questionnaire should help you evaluate the possible role Candida albicans contributes to your

health problems. If you feel you may have Candida please call for a test.

1. Have you taken tetracyclines or other antibiotics for acne for 1 month (or longer)?   Score 35 

2. Have you at any time in your life taken broad spectrum antibiotics or other antibacterial medication for respiratory,

urinary or other infections for two months or longer, or in shorter courses four or more times in a one-year period?  35

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3. Have you taken a broad-spectrum antibiotic drug—even in a single dose? 6

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4. Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis or other problems affecting

your reproductive organs? 25

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5. Are you bothered by memory or concentration problems—do you sometimes feel spaced out? 20

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Point Score

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6. Do you feel ‘‘sick all over’’ yet, in spite of visits to many different physicians, 

the causes haven’t been found? 20

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7. Have you been pregnant Two or more times? 5 One time? 3

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8. Have you taken birth control pills...

For more than two years? 15

For six months to two years? 8

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9. Have you taken steroids orally, by injection or inhalation?

For more than two weeks? 15

For two weeks or less? 6

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10. Does exposure to perfumes, insecticides, fabric shop

odors and other chemicals provoke . . . 20

Moderate to severe symptoms? 5

Mild symptoms?

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11. Does tobacco smoke really bother you? 10

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12. Are your symptoms worse on damp, muggy days

or in moldy places? 20

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13. Have you had athlete’s foot, ring worm, ‘‘jock itch’’ or

other chronic fungous infections of the skin or nails?

Have such infections been...

Severe or persistent? 20

Mild to moderate? 10

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14. Do you crave sugar? 10

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TOTAL SCORE, Section A

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For each of your symptoms, enter the appropriate figure in the Point Score

column:

If a symptom is occasional or mild .............................… 3 points

If a symptom is frequent and/or moderately severe ......... 6 points

If a symptom is severe and/or disabling .......................... 9 points

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1. Fatigue or lethargy

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2. Feeling of being ‘‘drained’’

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3. Depression or manic depression

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4. Numbness, burning or tingling

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5. Headache

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6. Muscle aches

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7. Muscle weakness or paralysis

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8. Pain and/or swelling in joints

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9. Abdominal pain

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10. Constipation and/or diarrhea

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11. Bloating, belching or intestinal gas

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12. Troublesome vaginal burning, itching or discharge

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13. Prostatitis

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14. Impotence

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15. Loss of sexual desire or feeling

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16. Endometriosis or infertility

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17. Cramps and/or other menstrual irregularities

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18. Premenstrual tension

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19. Attacks of anxiety or crying

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20. Cold hands or feet, low body temperature

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21. Hypothyroidism

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22. Shaking or irritable when hungry

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23. Cystitis or interstitial cystitis

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TOTAL SCORE, Section B

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For each of your symptoms, enter the appropriate figure in the Point Score

column:

If a symptom is occasional or mild ................................. 1 point

If a symptom is frequent and/or moderately severe ......... 2 points

If a symptom is severe and/or disabling ........................... 3 points

1. Drowsiness, including inappropriate drowsiness

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2. Irritability

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3. Bad coordination

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4. Frequent mood swings

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5. Insomnia

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6. Dizziness/loss of balance

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7. Pressure above ears . . . feeling of head swelling

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8. Sinus problems . . . tenderness of cheekbones or forehead

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9. Tendency to bruise easily

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10. Eczema, itching eyes

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11. Psoriasis

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12. Chronic hives (urticaria)

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13. Indigestion or heartburn

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14. Sensitivity to milk, wheat, corn or other common foods

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15. Mucus in stools

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16. Rectal itching

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17. Dry mouth or throat

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18. Mouth rashes, including ‘‘white’’ tongue

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19. Bad breath

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20. Foot, hair or body odor not relieved by washing

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21. Nasal congestion or postnasal drip

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22. Nasal itching

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23. Sore throat

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24. Laryngitis, loss of voice

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25. Cough or recurrent bronchitis

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26. Pain or tightness in chest

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27. Wheezing or shortness of breath

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28. Urinary frequency or urgency

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29. Burning on urination

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30. Spots in front of eyes or erratic vision

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31. Burning or tearing eyes

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32. Recurrent infections or fluid in ears

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33. Ear pain or deafness

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TOTAL SCORE, Section C

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Total Score, Section A

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Total Score, Section B

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The Grand Total Score will help you and your healthcare practitioner decide if your health problems are yeast-connected. Scores in women will run higher, as seven items in the questionnaire apply exclusively to women, while only two apply exclusively to men.

Yeast-connected health problems are almost certainly present in women with

scores more than 180, and in men with scores more than 140.

Yeast-connected health problems are probably present in women with scores

more than 120, and in men with scores more than 90.

Yeast-connected health problems are possibly present in women with scores

more than 60, and in men with scores more than 40.

With scores of less than 60 in women and 40 in men, yeasts are less apt to

cause health problems.