Candida Program


Candida Albicans Questionnaire

Candida Albicans symptoms are listed by category. As Candida is accumulative in nature, this applies to your entire life from birth to the present. Score 1 if occasional, 2 if frequent, or 3 if severe.


DIGESTIVE SYSTEM


_____ Gas w/most foods, not just one food
_____ Intestine pain, colitis
_____ Bloating with or w/o gas
_____ Belching w/most foods
_____ Constipation, stool hard-difficult to move
_____ Diarrhea, stool watery over long period
_____ Heartburn, chronic
_____ Hiatal Hernia conditions

_____ Indigestion
_____ Mucus in stools
_____ Hemorrhoids
_____ Dry mouth
_____ Bad Breath
_____ Crave sugars
_____ Crave breads
_____ Crave alcoholic beverages

Total Score _____

NERVES AND STRESS


_____ Headaches, occasional but constant
_____ Migraine headaches
_____ Depression
_____ Lethargic
_____ Laziness, consistent
_____ Hyper-agitation
_____ Memory, loss or poor
_____ Concentration, noticeable less/loss
_____ Energy loss

_____ Schizophrenia
_____ Psychiatric drugs
_____ Shock treatment
_____ Dizziness, vertigo
_____ Insomnia
_____ Hyper-activity
_____ Fatigue
_____ Drained
_____ Spacey feeling

Total Score _____

GENITO-URINARY


_____ Vaginal, yeast outbreak, discharge
_____ Penis, Scrotum, yeast outbreak, fungi
_____ Endometriosis
_____ Mensuses, irregularities, cramping
_____ Premenstrual, anxiety, depression problems
_____ Impotence
_____ Urethritis
_____ Cystitis

_____ Urinary infection reoccurring, low burning or itching grade
_____ Bladder infection reoccurring, low jock itch
_____ Prostatitis
_____ Loss of sexual desire
_____ Premenstrual tension
_____ Urinary frequency/urgency
_____ Urinary Burning

Total Score _____

ALLERGY-MUCUS SYMPTOMS


_____ Hayfever
_____ Ear, draining, aches, infections
_____ Hives
_____ Asthma
_____ Chemicals, sensitivity
_____ Food, sensitivity
_____ Odors, fragrances, sensitivity
_____ Heat/cool sensitivity
_____ Mucus, chronic body, nose, throat, etc.
_____ Five sense disturbances
_____ Tobacco smoke sensitivity
_____ Eyes burning/tearing

_____ Ear Pain
_____ Chest congestion
_____ Wheezing
_____ Headaches
_____ Head fullness, pressure above ears
_____ Itching, ears, nose, body
_____ Rashes, allergic
_____ Blister, rash in mouth
_____ Mucus congestion or nasal discharge
_____ Dry throat
_____ Cough

Total Score _____

GENERAL, POTENTIAL CONTRIBUTING CAUSES FOR:


_____ Chrohn's disease
_____ Anorexia Nervosa
_____ Systemic Lupus Erythematosis
_____ Sarcoidosis
_____ Myasthenia Gravis
_____ Alcoholism, especially wine & beer
_____ Drug addiction

_____ Multiple Sclerosis
_____ Hypoglycemia
_____ Hyperactivity
_____ Psychosomatic disorders
_____ Asthma
_____ Allergies

Total Score _____

GENERAL SYMPTOMS - ENVIRONMENTAL


_____ Fatigue
_____Molds, exposure to, moldy house, close to ground
_____ Fungus conditions, between toes/fingers, under finger nails or in skin folds
_____ Infection, chronic reoccurring
_____ Eye matting, infection, mucus discharge
_____ Mouth infection/thrush
_____Rashes, body/diaper

_____ Numbness, tingling, burning
_____ Muscle weakness, paralysis
_____ Joints, pain or swelling
_____ Spots in front of eyes
_____ Vision is erratic/failing
_____ Drowsiness
_____ Lack of coordination when needed
_____ Arthritis/joint swelling

Total Score _____

Antibiotics kill both good and bad bacteria in the body, creating a bacterial imbalance and an increase of Candida. Birth control pills historically add to Candida emergency. Consequently, these drug uses are weighed heavily.

DRUG Used less than 1 month
Score 25
Used for 1 month or continued use
Score 50
Tetracyclines ______________ ______________
Antibiotics ______________ ______________
Prednisone or other cortisone type ______________ ______________
Birth control pills ______________ ______________
Drug Totals ______________ ______________
______________ Combined Drug Total ______________
______________ Combined Category Total ______________
______________ Your Total ______________

Candida can run from mildly irritating to severe, even life threatening. Even a low score then would require treatment if bothersome. A 3 in headache, yeast infection, etc., would invite corrective measures.

SCORES

  • 1-30 would indicate Candida is in balance.
  • 31-40 would indicate normal, however, Candida needs to be watched. Use a mild Candida diet and treat irritating symptoms.
  • 41-55 would indicate a moderate Candida diet and treatment of Candida symptoms.
  • 56+ would indicate a severe Candida diet and necessity of Candida treatment.


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    Bruce R. MacFarland, Ph. D., CCN

    Robin Jordan, On-line Assistant,
    (mailto:[email protected],[email protected])

    P.O. Box 2683
    Gardnerville, NV 89410
    Tel. (910) 793-4152
    WWW: http://www.candidaprogram.com

    © 1998-2000 Bruce R. MacFarland

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