1.866.510.0691

CANDIDA TEST Rogers Medical Clinic Robert J. Rogers, MD, FAAMP Clinical Director This questionnaire is designed for adults and the scoring system is not appropriate for children. It lists factors in your medical history which promote the growth of candida albicans (Section A) and symptoms commonly found in Individuals with yeast connected illness (Section B and C.) For each "YES" answer In Section A, circle the Point Score In that section. Total your score and record it In the box at the end of the section. Then move on to Sections B and C and score as directed. Filling out and scoring this questionnaire should help you and your physician evaluate the possible role of candida In contributing to your health problems. Yet It will not provide an automatic "YES" or "NO" answer. SECTION A: HISTORY 1. Have you taken tetracycline (Sumycin, Parmycin, Vibramycin, rylinocin, etc.) or other antibiotics for acne for 1 month (or longer)? 35 2. Have you, at any time In your life, taken other "broad spectrum" antibiotics" for respiratory, urinary or other Infections (for 2 months or longer, or in shorter courses 4 or more-times In a 1 year perlod?) 35. 3. Have you uaken a broad spectrum antibiotic drug even a single course? 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. Have you been pregnant 2 or more times? 5 1 time? 3 6. Have you taken birth control pills for more than 2 years? 15 For 6 months to 2 years? 8 7. Have you taken Prednisone, Decadron, or other cortisone type drugs? For more than 2 weeks? 15 For 6 months to 2 years? 6 8. Does exposure to perfumes, Insecticides, fabric shop odors and other chemicals provoke: Moderate to severe symptoms? 20 Mild symptoms? 5 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 fungous Infections of the skin or nails? Have such Infections been: Severe or persistent? 20 Mild to moderate? 5 11. Do you crave sugar? 10 12. Do you crave breads? 10 13. Do you crave alcoholic beverages? 10 14. Does tobacco smoke"really" bother you? 10 TOTAL SCORE, SECTION A: _______ points SECTION 'B: MAJOR SYMPTOMS For each of your symptoms, enter the appropriate figure in the point Score Column Add total score and record it In the box at the end of this section QUESTIONS OCCASIONAL MILD SCORE 3 FREQUENT NOT TOO SEVERE SCORE 6 SEVERE DISABLING SCORE 9 1. Fatigue or lethargy 2. Feeling or being "drained" 3. Poor memory 4. Feeling "spacey" or "unreal" 5. Depression 6. Numbness, burning or tingling 7. Muscle aches 8. Muscle weakness or paralysis 9. Pain and/or swelling in joints 10. Abdominal pain 11. Constipation 12. Diarrhea 13. BloatIng 14. Troublesome vaginal discharge 15. Persistent vaginal burning 16. Prostatitis 17. Impotence 18. Loss or sexual desire 19. Endometriosis 20. Cramps and/or other menstrual lirregularities 21. Premenstrual tension 22. Spots In ftront of the eyes 23. Erratic vision TOTAL SCORE SECTION B: _____ points SECTION C: OTHER SYMPTOMS For each of your symptoms, enter the appropriate figure in the point Score Columns Add total score and record it In the box at the end of this section QUESTIONS OCCASIONAL MILD SCORE 1 FREQUENT NOT TOO SEVERE SCORE 2 SEVERE DISABLING SCORE 3 1. Drowsiness 2. Irritability or jitteriness 3. Incoordination 4. Inability to concentrate 5. Frequent mood swings 6. Headache 7. Dizziness/loss of balance 8. Pressure above ears ...feeling of head swelling and tingling 9. Itching 10. Other rashes 11. Heartburn 12. Indigestion 13. Belching and Intestinal gas 14. Mucus In stools 15. Hemorrhoids 16. Dry mouth 17. Rash or blisters In mouth 18. Bad breath 19. Joint swelling orarthritis 20. Nasal congestion or discharge 21. Postnasal drip 22. Nasal Itching 23. Sore or dry throat 24. Cough 25. Pain or tightness In chest 26. Wheezing or shortness or breach 27. Urgency or urinary frequency 28. Burning on urination 29. Failing vision 30. Burning or tearing of eyes 31. Recurrent Infections or fluid In ears 32. Ear Pain or deafness TOTAL SCORE, SECTION C ____ points TOTAL SCORE, SECTION B ____ points TOTAL SCORE, SECTION A ____ points GRAND TOTAL SCORE:_____ points The Grand Total Score wIll help you and your physician decide If your health problems are yeast-connected. Scores In women will run as high as 7 times In the questionnaire and apply exclusively to women, while only 2 apply exclusively to men. Yeast-connected health problems are almost certainly present in women with scores over 180 and In men with scores over 140. Yeast-connected health problems are probably present In women with scores over 120 and in men with scores over 90. Yeast-connected health problems are possibly present In women with scores over 60 and in men with scores over 40. With scores of less than 60 in women and 40 in men, yeasts are less apt to cause health problems. It seems that I have most symptoms associated with yeast/Candida, what do I do next? Read this page - you will find in it instructions to get rid of parasites FIRST and THEN of Candida.