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Candida questionnaire & score sheet*

Candida Questionnaire & Score Sheet*

This questionnaire lists factors in your medical history that promote the growth of the
common yeast, 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. Total your score, and record it in the box
at the end of the section. Then move on to Sections B and C, and score as directed.
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)? 2. Have you, at any time in your life, taken other 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? 3. Have you taken an antibiotic drug – even for one period? 4. Have you, at any time in your life, been bothered by persistent prostates, vaginitis, or other problems affecting your reproductive organs? 5. Have you been pregnant… 2 or more times? 6. Have you taken birth control pills for more than 2 years? 7. Have you taken prednisone, Decadron ®, or other corisone-type drugs by mouth or inhalation for more than 2 weeks? 8. Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke moderate to severe symptoms? 9. Are your symptoms worse on damp, muggy days or in moldy places? 10. Have you had athlete’s foot, ringworm, “jock itch” or other chronic fungus infections of the skin or nails? Have such infections been severe or persistent? 11. Do you crave sugar? 14. Does tobacco smoke really bother you? Total Score, Section A
*Filling out and scoring this questionnaire will help you and your healthcare practitioner evaluate how
Candida albicans may be contributing to your health problems. Yet it will not provide an automatic yes or no
answer. A comprehensive history and physical examination are important. In addition, laboratory studies and
other types of tests may also be appropriate.**The use of nasal or bronchial sprays containing cortisone
and/or other steroids promotes overgrowth in the respiratory tract.
Section B: Major Symptoms
For each symptom that is present, enter the appropriate number in the Point Score column:
score 3 points
If a symptom is frequent and/or moderately severe score 6 points
score 9 points
Total the score for this section, and record it in the box at the end of this section. Point Score
14. Bloating, belching or intestinal gas 15. Troublesome vaginal burning, itching or discharge 20. Cramps and/or other menstrual irregularities 23. Cold hands or feet and/or chilliness Total Score, Section B
Section C: Other Symptoms*
For each symptom that is present, enter the appropriate number in the Point Score column:
score 3 points
If a symptom is frequent and/or moderately severe score 6 points
score 9 points
Total the score for this section, and record it in the box at the end of this section. Point Score
8. Pressure above ears…feeling of head swelling 19. Foot, hair or body odor not relieved by washing 27. Urinary frequency, urgency, or incontinence 29. Spots in front of eyes or erratic vision 31. Recurrent infections or fluid in ears Total Score, Section C
Grand Total Score (add totals from Sections A, B & C)
*While the symptoms in this section occur commonly in patients with yeast-connected illness, they also occur commonly in patients who do not have candida. The Grand Total Score will help you and your practitioner decide if your health problems are yeast-connected. Scores for women will run higher, as 7 items in this questionnaire apply exclusively to women, while only 2 apply exclusively to men. ! Yeast-connected health problems are almost certainly present in women with scores over 180, and in
men with scores over 140.
! Yeast-connected health problems are probably present in women with scores over 120, and in men
with scores over 90.
! Yeast-connected health problems are possibly present in women with scores over 60, and in men
with scores over 40.
With scores less than 60 for women and 40 for men, yeast are less apt to cause health problems.
This questionnaire is taken from William G. Crook, The Yeast Connection Handbook, Professional Books, 2000. Used with
permission.

Source: http://www.webdeb.com/zapper/pdf/candida_question.pdf

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