This candida questionnaire is designed for adults and the scoring system isn’t appropriate for children 12 and under. It lists factors in your medical history which promote the growth of Candida Albicans (Section A), and symptoms commonly found in individuals with yeast-connected illness (Sections B and C).For each “Yes” answer in Section A, circle the point score in that section. Record your total score in the box at the end of the section. Then move on to Sections B and C and score as directed.Filling out and scoring this questionnaire should help you and your doctor evaluate the possible role of Candida in contributing to your health problems. Yet it will not provide an automatic “Yes” or “No” answer.
Click here to print and fill out the questionnaire
| Section A: History | Points |
| 1. Have you taken tetracyclines (Symycin, Panmycin, Vibramycin, Minocin, etc.) or other antibiotics for acne for one month or longer? | 25 |
| 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 in shorter courses 4 or more times in a 1-year period? | 20 |
| 3. Have you taken a broad spectrum antibiotic* — even in a single course? * Including Keflex, ampicillin, amoxicillin, Ceclor, Bactrim, and Septra. Such antibiotics kill off “good germs” while they are killing off those which cause infection. |
6 |
| 4. Have you, at anytime in your life, been bothered by persistent prostatitis, vaginitis, or other problems affecting your reproductive organs? | 25 |
| 5. Have been pregnant 2 or more times? 1 time? |
5 3 |
| 6. Have you taken birth control pills for more than 2 years? for 6 months to 2 years? |
15 8 |
| 7. Have you taken Prednisone, Decadron or other cortisone-type drugs for more than 2 weeks? For 2 weeks or less? |
15 6 |
| 8. Does exposure to perfumes, insecticides, fabric shop odors, and other chemicals provoke moderate to severe symptoms? Mild symptoms? |
20 5 |
| 9. Are your symptoms worse on damp, muggy days or in moldy places? | 20 |
| 10. Have you had athlete’s foot, ring worm, jock itch, or other chronic fungus infections of the skin or nails? Have such infections been severe or persistent? Mild to moderate? |
– 20 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 |
| Point Score |
| Section B: Major Symptoms For each of your symptoms, enter the appropriate figure in the point score column: 3 points – for occasional or Mild 6 points – for frequent and/or Moderately Severe 9 points – for severe and/or Disabling Add total score and record it in the box at the end of this section: |
Points |
| 1. Fatigue or lethargy | |
| 2. Feeling of being “drained” | |
| 3. Poor memory | |
| 4. Feeling “spacey” or “unreal” | |
| 5. Depression | |
| 6. Numbness, burning, or tingling | |
| 7. Muscle aches | |
| 8. Muscle weakness or paralysis | |
| 9. Pain and/or swelling in joints | |
| 10. Abdominal pain | |
| 11. Constipation | |
| 12. Diarrhea | |
| 13. Bloating | |
| 14. Troublesome vaginal discharge | |
| 15. Persistent vaginal burning or itching | |
| 16. Prostatitis | |
| 17. Impotence | |
| 18. Loss of sexual desire | |
| 19. Endometriosis | |
| 20. Cramps and/or other menstrual irregularities | |
| 21. Premenstrual tension | |
| 22. Spots in front of the eyes | |
| 23. Erratic vision | |
| Point Score |
| Section C: Other Symptoms For each of your symptoms, enter the appropriate figure in the point score column: 1 point for occasional or Mild 2 points for frequent and/or Moderately Severe 3 points for severe and/or Disabling Add total score and record it in the box at the end of this section: |
Points |
| 1. Drowsiness | |
| 2. Irritability or jitteriness | |
| 3. Incoordination | |
| 4. Inability to concentrate | |
| 5. Frequent mood swings | |
| 6. Headache | |
| 7. Dizziness/loss of balance | |
| 8. Pressure above ears, feeling of head swelling and tingling | |
| 9. Itching | |
| 10. Other rashes | |
| 11. Heartburn | |
| 12. Indigestion | |
| 13. Belching and intestinal gas | |
| 14. Mucus in stools | |
| 15. Hemorrhoids | |
| 16. Dry mouth | |
| 17. Rash or blister in mouth | |
| 18. Bad breath | |
| 19. Joint swelling or arthritis | |
| 20. Nasal congestion or discharge | |
| 21. Postnasal drip | |
| 22. Nasal itching | |
| 23. Sore or dry throat | |
| 24. Cough | |
| 25. Pain or tightness in chest | |
| 26. Wheezing or shortness of breath | |
| 27. Urinary urgency or frequency | |
| 28. Burning or tearing of eyes | |
| 29. Failing vision | |
| 30. Burning on urination | |
| 31. Recurrent infections or fluid in ears | |
| 32. Ear pain or deafness | |
| Point Score |
| Total Point Score, Section A: | |
| Total Point Score, Section B: | |
| Total Point Score, Section C: | |
| GRAND TOTAL POINT SCORE |
| The Grand Total Point Score will help you and your doctor decide if your health problems are yeast-connected. Scores in women will run higher as 7 items in the questionnaire apply exclusively to women, while only 2 apply exclusively to men. |
| If your Point Score is: | Symptoms are: |
| 180 (women) | Almost Certainly |
| 140 (men) | Yeast Connected |
| 120 (women) | Probably |
| 90 (men) | Yeast Connected |
| 60 (women) | Possibly |
| 40 (men) | Yeast Connected |
| Less Than: 60 (women) 40 (men) |
Probably Not Yeast Connected |
Note:This test is not for diagnosing illness. If you have a serious health Problem consult with your health practitioner.