Candida Questionnaire

(From W. G. Crook, M.D., The Yeast Connection Handbook , Professional Books, Jackson, Tennessee.  Used with permission.)

If you'd like to know if your health problems are yeast-connected, complete 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.

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.

Your score on this questionnaire should help you and your physician evaluate the possible role Yeast/Candida contributes to your health problems. Dr. Crook created four categories of Yeast related illness, your score will determine the category he would place you in.

Instructions - this web based version auto-scores your answers when you have completed the questionnaire. Select the most appropriate answer for each question, then click on the submit button at the end of the list of questions to see your results. You must choose an answer(so we know the question was not just overlooked), if you do not experience the symtom choose "Not present", etc.



Section A:
This section focuses on your medical history-factors that promote the gowth of Candida albicans and that frequently are found in people with yeast-related health problems.

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

35

2. Have you at any time in your life taken 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

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

6

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

25

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

20

6. Do you feel "sick all over" yet, in spite of visits to many different physicians, the causes haven't been found?

20

7. Have you been pregnant…

3-5

8. Have you taken birth control pills…

8-15

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

6-15

10. Does exposure to perfumes, insecticides, fabric shop odors and other chemicals provoke…

5-20

11. Does tobacco smoke really bother you?

10

12. Are your symptoms worse on damp, muggy days or in moldy places?

20

13. Have you had athelete's foot, ring worm, "jock itch", or other chronic fungous infections of the skin or nails? Have such infections been . . .

10-20

14. Do you crave sugar?

10

Section B: A list of 23 symptoms that are often present in patients with yeast-related health problems.

1. Fatigue or lethargy

3-6-9

2. Feeling of being "drained"

3-6-9

3. Depression or manic depression

3-6-9

4. Numbness, burning or tingling

3-6-9

5. Headache

3-6-9

6. Muscle aches

3-6-9

7. Muscle weakness or paralysis

3-6-9

8. Pain and/or swelling of the joints

3-6-9

9. Abdominal pain

3-6-9

10. Constipation and/or diarrhea

3-6-9

11. Bloating, belching or intestinal gas

3-6-9

12. Troublesome vaginal burning, itching or discharge

3-6-9

13. Prostatitis

3-6-9

14. Impotence

3-6-9

15. Loss of sexual desire or feeling

3-6-9

16. Endometriosis or infertility

3-6-9

17. Cramps and/or other menstrual irregularities

3-6-9

18. Premenstrual tension

3-6-9

19. Attacks of anxiety or crying

3-6-9

20. Cold hands or feet, low body temperature

3-6-9

21. Hypothyrodism

3-6-9

22. Shaking or irritable when hungry

3-6-9

23. Cystitis or interstitial cystitis

3-6-9

Section C: A list 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.

1. Drowsiness, including inappropriate drowsiness

1-2-3

2. Irritability

1-2-3

3. Incoordination

1-2-3

4. Frequent mood swings

1-2-3

5. Insomina

1-2-3

6. Dizziness/loss of balance

1-2-3

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

1-2-3

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

1-2-3

9. Tendency to bruise easily

1-2-3

10. Eczema, itching eyes

1-2-3

11. Psorais

1-2-3

12. Chronic hives (uricaria)

1-2-3

13. Indigestion or heartburn

1-2-3

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

1-2-3

15. Mucus in stools

1-2-3

16. Rectal itching

1-2-3

17. Dry mouth or throat

1-2-3

18. Mouth rashes, including ""white"" tongue

1-2-3

19. Bad breath

1-2-3

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

1-2-3

21. Nasal congestion or postnasal drip

1-2-3

22. Nasal itching

1-2-3

23. Sore throat

1-2-3

24. Laryngitis, loss of voice

1-2-3

25. Cough or recurrent bronchitis

1-2-3

26. Pain or tightness in chest

1-2-3

27. Wheezing or shortness of breath

1-2-3

28. Urinary frequency or urgency

1-2-3

29. Burning on urination

1-2-3

30. Spots in front of eyes or erratic vision

1-2-3

31. Burning or tearing eyes

1-2-3

32. Recurrent infections or fluid in ears

1-2-3

33. Ear pain or deafness

1-2-3
 

I am

M - F