Candida questionnaire and score sheet

THE YEAST CONNECTION
Persons with frequent gastrointestinal bloating and gas, recurrent yeast infections, or mental confusion often believe they have “The Yeast Connection.” This is a condition of hypersensitivity or allergy to the common Candida albicans yeast that usually inhabits the human bowel. People with the above symptoms often have an overgrowth of yeast in the intestines with multiple food allergies and “leaky gut.” If you feel you may have this “connection,” then complete and score the questionnaire and score sheet below for yourself. If the score indicates you may have a problem, then stool and urine tests can identify the overgrowth of yeast (or molds) and intra-dermal allergy skin testing can confirm the hypersensitivity state to yeasts or molds. Anti-fungal (anti-mold) therapy and allergy shots may help control this “connection.” CANDIDA QUESTIONNAIRE AND SCORE SHEET
This questionnaire is designed for adults and the scoring system isn't appropriate for children. It lists factors in your medical history which promote the growth of Candida albicans, and symptoms commonly found in individuals with yeast-connected illness. 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. Filing out and scoring this questionnaire should help you and your physician evaluate the possible role of candida in contributing to your health problems. Yet it will not provide an automatic "Yes" or "No" answer. SECTION A: HISTORY
1. Have you taken tetracyclines (Sumycin, Panmycin, Vibramycin, Minocin, etc.) or other antibiotics for acne for one month or longer? 2. Have your, at any time in your life, taken other "broad spectrum" antibiotics1 for respiratory, urinary, or other infections (for 2 months or longer, or in shorter courses four or more times in a one year period?) 3. Have you taken a broad spectrum antibiotic drug - even a single course? 4. Have your, at any time in your life, been bothered by persistent prostatitis, vaginitis or other problems affecting your reproductive organs? 7. Have you taken prednisone, Decadron or other cortisone-type drugs: 1Including Keflex, ampicillin, amoxicillin, augmentin, Ceclor, Suprax, Bactrim, and Septra. Such antibiotics kill off “good germs” while they’re killing off those which cause infection. 8. Does exposure to perfumes, insecticides, fabric shop odors and other 9. Are your symptoms worse on damp, muggy days or in moldy places? 10. Have you had athlete's foot, ring worm, "jock itch" or other chronic fungus infections of the skin or nails? Severe or persistent? Total Score, Section A …………………………………………………………………………… ________ SECTION B: MAJOR SYMPTOMS
For each of your symptoms, enter the appropriate figure in the Point Score column: If a symptom is frequent and/or moderately severe Add total score and record it in the box at the end of this section. Cramps, and/or other menstrual irregularities Total Score, Section B………………………………………………………………… _____ SECTION C: OTHER SYMPTOMS: 2
For each of your symptoms, enter the appropriate figure in the Point Score column: If a symptom is frequent and/or moderately severe Add total score and record it in the box at the end of this section. Pressure above ears . . . feeling of head swelling & tingling Total Score, Section C………………………………………………………………… _____ Total Score, Section A………………………………………………………………… _____ Total Score, Section B………………………………………………………………… _____ GRAND TOTAL SCORE………………………………………………………………………. _____ 2While the symptoms in this section commonly occur in people with yeast-connected illness they are also found in other individuals. The Grand Total Score will help you and your physician 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. 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 Yeast-connected health problems are possibly present in women with scores over 60 With scores of less than 60 in women and 40 in men, yeasts are less apt to cause health problems. Reference: Crook, William G. “Chronic Fatigue Syndrome and The Yeast Connection.” Jackson, Tennessee: Professional Books, 1992.

Source: http://www.francisholisticmedicalcenter.com/images/CANDIDA_QUESTIONNAIRE_AND_SCORE_SHEET.pdf