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Common Diseases > CANDIDA ALBICANS QUESTIONNAIRE This questionnaire is provided as an indicator. Print and Add up your score to determine the possibility of Candida. LIST 1. _____ 1. Have you ever taken antibiotics? _____ 2. Have you ever taken steroid drugs such as Prednisone or Cortisone? _____ 3. Have you ever taken contraceptive medication? _____ 4. Have you been pregnant more than once? LIST 2. - MAJOR SYMPTOM HISTORY ______ 1. Have you had itching or burning of the Vagina, Cvstitis or Thrush (Female) or "Jock itch" (Male)? ______ 2. Have you ever had athlete's foot, skin rashes or fungal infections of nails or skin? ______ 3. Are you affected by chemical fumes, perfumes, tobacco smoke etc? ______ 4. Do you crave sugary foods, bread, beer or alcohol and are your symptoms worse after taking these? ______ 5. Do you suffer from a variety of allergies? ______ 6. Do you suffer from intestinal gas, abdominal gas bloating or discomfort, belching or wind? ______ 7. Do you suffer from pre-menstrual syndrome (fluid retention, irritability, cramp or pain)? ______ 8. Do you suffer from depression, fatigue, lethargy! or mood swings? ______ 9. Pire you often irritable, easily angered, anxious or nervous? ______ 10. Do you have trouble thinking clearly, suffer occasional memory losses or have difficulty concentrating? ______ 11. Are you ever dizzy or light headed? ______ 12. Do you have muscle aches, tingling, numbness or burning or joints that swell and ache with normal activity? ______ 13. Do you have erratic vision or spots before the eyes? ______ 14. Have you had an unexpected weight gain without a change of diet? ______ 15. Are you bothered by constipation, diarrhoea or alternating constipation and diarrhoea especially when taking antibiotics? LIST 3. SECONDARY SYMPTOMS _____ 1. Do you feel worse on damp days _____ 2. Do you experience persistent drowsiness? _____ 3. Do you have a lack of co-ordination or loss of balance _____ 4. Have you experienced regular headaches? _____ 5. Is your mouth or throat often dry? _____ 6. Do you suffer from bad breath? _____ 7. Are you bothered by a post-nasal drip, nasal itch and/or congestion? _____ 8. Do you experience any tightness in the chest? _____ 9. Do you experience ear sensitivity or fluid in the ears? _____ 10. Do you regularly experience heartburn or indigestion? TOTAL SCORE LIST 1. __________This questionnaire is provided for general information only and is not intended to be used for self diagnosis. Some of the symptoms could indicate a more serious condition which could require the assistance of a health professional. If you consider Candida to be a problem we encourage you to discuss your condition with knowledgeable health professionals familiar with this subject. Candida Page |
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