Candida/Intestinal Imbalance Self-Test
- Have you taken tetracyclines or another antibiotic for acne for one month or longer?..........................50
- Have you ever taken a broad spectrum antibiotic for a urinary/respiratory/or other infection for 2 months or longer or in shorter courses 4 or more times within a single year?....................................................50
- Have you ever taken one course of antibiotics?..............................................................................6
- Have you had persistent prostatitis/vaginitis, or other problems affecting reproductive organs?..............25
- Pregnancies:
One?.....................................................................................................................3
Two or more?...........................................................................5
6. Have you taken birth control pills for >2 years.................................................................................6
6 months-2 years...............................................................15
7. Have you take prednisone or cortisone drugs for <2 weeks................................................................6
2 weeks or longer...............................................................15
8. Does exposure to perfumes, insecticides, dry-cleaners, gasoline or other chemicals provoke?
Mild symptoms....................................................................5
Moderate to Severe Symptoms.............................................20
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 fungal infection of the skin or nails?
Mild to Moderate Symptoms.................................................10
Moderate to Severe Symptoms.............................................20
11. Do you crave sugar?.................................................................................................................10
12. Do you crave breads or other foods high in refined carbohydrates, and/or yeast?.................................10
13. Do you crave alcoholic beverages?..............................................................................................10
14. Does tobacco smoke really bother you?........................................................................................10
Total Score Section I.___________
Section II- Major Symptoms
Instructions: For each symptom that is present, enter the appropriate number in the Point Score Column
If a symptom is occasional and mild....................................................................score 3 pts.
If a symptom is frequent and moderate ..............................................................score 6 pts.
If a symptom is severe and/or disabling...............................................................score 9 pts.
Total the score for this section and record it at the end of this section.
- Fatigue or lethargy............................................................................................................______
- Feeling of being "drained"....................................................................................................______
- Poor memory....................................................................................................................______
- Feeling "spacey" or "unreal".................................................................................................______
- Depression.......................................................................................................................______
- Numbness, burning, or tingling.............................................................................................______
- Insomnia.........................................................................................................................______
- Muscle aches.................................................................................................................._______
- Muscle weakness or paralysis............................................................................................._______
- Joint pain or swelling........................................................................................................_______
- Abdominal pain................................................................................................................_______
- Constipation..................................................................................................................._______
- Diarrhea........................................................................................................................________
- Bloating, belching, intestinal gas........................................................................................________
- Vaginal or anal burning, itching or discharge........................................................................________
- Prostatitis.....................................................................................................................________
- Impotence....................................................................................................................________
- Loss of sexual desire or feeling.........................................................................................________
- Endometriosis or infertility...............................................................................................________
- Cramps and/or menstrual irregularities/sx's.........................................................................________
- Premenstrual tension.....................................................................................................________
- Anxiety attacks or crying jags.........................................................................................________
- Cold hands or feet, and/or chilliness.................................................................................________
- Shaking or irritability when hungry..................................................................................._________
Total Score Section II. ______
Section III. Other Symptoms
Instructions: For each symtpm that is present, enter the appropriate number in the Point Score Column.
If a symptom is occasional or mild...........................................................score 3 pts_______
If a symptom is frequent and/or moderate................................................score 6 pts_______
If a symptom is severe and/or disabling....................................................score 9 pts_______
Total the score for this section, and record it at the end of this section.
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Drowsiness..................................................................................................................._______
-
Irritability....................................................................................................................._______
-
Incoordination..............................................................................................................._______
-
Inability to concentrate.................................................................................................._______
-
Frequent mood swings...................................................................................................._______
-
Headaches..................................................................................................................._______
-
Dizziness/loss of balance................................................................................................________
-
Pressure above ears/feeling of head swelling/tingling...........................................................________
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Tendency to bruise easily..............................................................................................________
-
Chronic rashes or itching...............................................................................................________
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Psoriasis or chronic hives...............................................................................................________
-
Indigestion, and/or heartburn.........................................................................................________
-
Food sensitivity/intolerance..........................................................................................._________
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Mucus in stools..........................................................................................................._________
-
Hemmorrhoids/rectal itching.........................................................................................._________
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Dry mouth or throat...................................................................................................._________
-
Rash or blisters in mouth.............................................................................................._________
-
Bad breath................................................................................................................_________
-
Foot, hair or body odor not relieved by washing..............................................................._________
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Nasal congestion/discharge/postnasal drip......................................................................_________
-
Nasal itching............................................................................................................._________
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Sore or dry throat......................................................................................................_________
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Laryngitis, loss of voice..............................................................................................__________
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Cough or recurrent bronchitis......................................................................................__________
-
Pain or tightness in chest...........................................................................................__________
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Wheezing or shortness of breath.................................................................................__________
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Urinary urgency, frequency or incontinence..................................................................__________
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Burning on urination.................................................................................................__________
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Spots in front of eyes, erratic vision...........................................................................__________
-
Burning or tearing of eyes........................................................................................___________
-
Recurrent infections or fluid in ears...........................................................................___________
-
Ear pain or deafness..............................................................................................___________
Total Score Section III.______________
Grand Total Score: Sections I+II+III=__________
Interpretation of results:
Candida or intestinal dysbiosis are almost certain in scores above 180, women and 140, men.
Candida or intestinal dysbiosis are probably present in scores above 120, women, and 90, men.
Candida or intestinal dysbiosis are possibly present in scores above 60, women, and 40, men.
For a sample program on dealing with Candida, please click here