Candida/Intestinal Imbalance Self-Test

1. Have you taken tetracyclines or another antibiotic for acne for one month or longer?..........................50
2. 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
3. Have you ever taken one course of antibiotics?..............................................................................6
4. Have you had persistent prostatitis/vaginitis, or other problems affecting reproductive organs?..............25
5. 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.

1. Fatigue or lethargy............................................................................................................______
2. Feeling of being "drained"....................................................................................................______
3. Poor memory....................................................................................................................______
4. Feeling "spacey" or "unreal".................................................................................................______
5. Depression.......................................................................................................................______
6. Numbness, burning, or tingling.............................................................................................______
7. Insomnia.........................................................................................................................______
8. Muscle aches.................................................................................................................._______
9. Muscle weakness or paralysis............................................................................................._______
10. Joint pain or swelling........................................................................................................_______
11. Abdominal pain................................................................................................................_______
12. Constipation..................................................................................................................._______
13. Diarrhea........................................................................................................................________
14. Bloating, belching, intestinal gas........................................................................................________
15. Vaginal or anal burning, itching or discharge........................................................................________
16. Prostatitis.....................................................................................................................________
17. Impotence....................................................................................................................________
18. Loss of sexual desire or feeling.........................................................................................________
19. Endometriosis or infertility...............................................................................................________
20. Cramps and/or menstrual irregularities/sx's.........................................................................________
21. Premenstrual tension.....................................................................................................________
22. Anxiety attacks or crying jags.........................................................................................________
23. Cold hands or feet, and/or chilliness.................................................................................________
24. 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.

1. Drowsiness..................................................................................................................._______
2. Irritability....................................................................................................................._______
3. Incoordination..............................................................................................................._______
4. Inability to concentrate.................................................................................................._______
5. Frequent mood swings...................................................................................................._______
6. Headaches..................................................................................................................._______
7. Dizziness/loss of balance................................................................................................________
8. Pressure above ears/feeling of head swelling/tingling...........................................................________
9. Tendency to bruise easily..............................................................................................________
10. Chronic rashes or itching...............................................................................................________
11. Psoriasis or chronic hives...............................................................................................________
12. Indigestion, and/or heartburn.........................................................................................________
13. Food sensitivity/intolerance..........................................................................................._________
14. Mucus in stools..........................................................................................................._________
15. Hemmorrhoids/rectal itching.........................................................................................._________
16. Dry mouth or throat...................................................................................................._________
17. Rash or blisters in mouth.............................................................................................._________
18. Bad breath................................................................................................................_________
19. Foot, hair or body odor not relieved by washing..............................................................._________
20. Nasal congestion/discharge/postnasal drip......................................................................_________
21. Nasal itching............................................................................................................._________
22. Sore or dry throat......................................................................................................_________
23. Laryngitis, loss of voice..............................................................................................__________
24. Cough or recurrent bronchitis......................................................................................__________
25. Pain or tightness in chest...........................................................................................__________
26. Wheezing or shortness of breath.................................................................................__________
27. Urinary urgency, frequency or incontinence..................................................................__________
28. Burning on urination.................................................................................................__________
29. Spots in front of eyes, erratic vision...........................................................................__________
30. Burning or tearing of eyes........................................................................................___________
31. Recurrent infections or fluid in ears...........................................................................___________
32. 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.