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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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Albicans | Alcoholemia
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MacFarland? | Information
Request
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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