Candida Questionnaire

For each yes answer, circle the Point Score, Total your scores and record it in the box at the end of the Section. Then move to Sections B and C and score.

Section A: History
Point Score
1.Have you taken tetracyclines( Sumycin, Panmycin, Vibramycin, Minocin, etc.) or other antibiotics for acne for 1 month (or longer)?
50
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?
50
3. Have you taken a broad spectrum antibiotic drug-even for one period?
6

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

5. Have you been pregnant ...................................2 or more times

..............................................................................1 time?

25

5

3
6. Have you taken birth control pills....for more than 2 years?
15
.........................................................6 months to 2 years?
8
7. Have you taken prednisone, Decadron, or other cortisone-type drugs by mouth or inhalation ( promotes respiratory tract overgrowth) more than 2 weeks?
15
8. Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke .............................moderate to severe symptoms?
20
.................................................................................mild symptoms?
5
9. Are your symptoms worse on damp, muggy days or in moldy places?
20

10. Have you had athelete's foot, ringworm, "jock itch" or other chronic fungus infections of the skin or nails?
Have such infections been......................................severe or persistant?

 

20
...............................................................................mild or moderate?
10
11. Do you crave sugar?
10
12. Do you crave breads?
10
13. Do you crave alcoholic beverages?
10
14. Does tobacco smoke really bother you?
10
...................................................................................Total Score, Section A  

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