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                        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?.....................................................................................................................

                                                        Two or more?...........................................................................5

 

   6. Have you taken birth control pills for >2 years.................................................................................

                                                             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.

 

For a sample program on dealing with Candida, please click here

 

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