Candida Self-Test

Candida Self-Test

For Each of the Following Questions, Click on the Appropriate Circle in the Point Score Column.
Never=0 Rarely=1 Sometimes=2 Often=3

Have you taken birth control pills over the past 2 years?
Have you experienced nail fungus, athlete's foot or jock itch?
Do you crave sugar?
Do you crave breads?
Do you crave alcoholic beverages?
Do you feel drained?
Fatigue or lethargy
Poor memory
Feeling "spacey"
Depression
Muscle aches
Pain or swelling in joints
Abdominal pain
Abdominal bloating
Constipation
Persistent vaginal itch
Persistent vaginal burning
Prostatis (inflammation of prostate)
Diarrhea
Impotence
Loss of sexual desire
Premenstrual tension
Drowsiness
Irritability
Inability to concentrate
Frequent mood swings
Headaches
Dizziness
Itchy skin
Rashes
Belching and intestinal gas
Hemorrhoids
Dry mouth
White coating on tongue
Bad breath
Nasal congestion or discharge
Sore or dry throat
Urinary urgency or frequency
Burning on urination
Recurrent infection or fluid in ears
Ear pain

For the Following Question, Click on the Appropriate Circle in the Point Score Column

Never 1-2 Times=5 Points 3-5 Times=10 Points 6 Times or More=20 Points

How many times have you taken antibiotics over the past 10 years?
(Required)