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Questionnaires - Yeast Related Illness

A study was undertaken to see how well the results of this questionnaire compared to stool analysis for the presence of Candida albicans. The degree of Candida albicans growth on stool culture correlated well with the symptom scores revealed by the questionnaire. Filling out and scoring this questionnaire should help you and your practitioner evaluate the possible role of Candida in contributing to your health problems. This questionnaire was designed by William Crook for adults; the scoring system is not appropriate for children. It addresses factors in your medical history (Section A) as well as the symptoms commonly found in individuals with yeast connected illness (Sections B and C). You can print out the questionnaire for completion. Please refer to the book 'The Food Intolerance Bible' for your interpretation and Action Plan. A copy may be purchased on this website if you do not already have one.

Have I Got A Yeast Overgrowth?

Have I Got A Yeast Overgrowth? For each 'Yes' answer in Section A, circle the Point Score in that section. Total your score and record it at the end of the section. Then move on to Sections B and C and score as directed.

Section A: History
Have you taken tetracycline (or other antibiotics) for 2 months (or longer)? 25
Have you, at any time in your life, taken other 'broad-spectrum'antibiotics (including Keflex®, ampicillin, amoxicillin, Ceclor®, Bactrim®, and Septra®*) for respiratory, urinary or other infections for two months or longer, or in shorter courses four or more times in a one-year period? 20
Have you, at any time in your life, been troubled by persistent vaginal problems or had three or more episodes of vaginitis in a year? 25
Have you been pregnant more than twice? 5
Have you been pregnant once? 3
Have you taken birth control pills for more than two year? 15
For six months to two years? 18
Have you taken prednisone, Decadron® or other cortisone-type drugs for more than two weeks? 15
For less than two weeks? 6
Does exposure to perfumes, insecticides, fabric shop odours and other chemicals provoke... Moderate to severe symptoms? 20
Mild symptoms? 5
Are your symptoms worse on damp, muggy days or in mouldy places? 20
Have you had persistent athlete's foot, 'jock itch' or other chronic fungal infections of the skin or nails? Have such infections been ... Severe or persistent? 20
Mild to moderate? 10
Do you crave sugar? 10
Do you crave breads? 10
Do you crave alcohol 10
Does tobacco smoke really bother you? 10

Section B: Major Symptoms

For each symptom which is present, enter the appropriate figure in the Point Score column:

If a symptom is mild, score 3 points
If a symptom is moderate, score 6 points
If a symptom is severe or disabling, score 9 points

  1. Fatigue or lethargy.
  2. Feeling of being 'drained'
  3. Poor memory
  4. Depression
  5. Numbness, burning or tingling
  6. Muscle aches
  7. Muscle weakness or paralysis
  8. Pain and/or swelling in joints
  9. Abdominal pain
  10. Constipation
  11. Diarrhoea.
  12. Bloating
  13. Troublesome vaginal discharge
  14. Persistent vaginal burning or itching
  15. Prostatitis (inflamed, enlarged prostate)
  16. Impotence
  17. Loss of sexual feeling
  18. Endometriosis
  19. Dysmenorrhea (painful periods)
  20. Premenstrual tension
  21. Spots in front of eyes
  22. Erratic Vision

Total Score Section B =

Section C: Other Symptoms

For each symptom which is present, enter the appropriate figure in the Point Score column:

If a symptom is mild, score 3 points
If a symptom is moderate, score 6 points
If a symptom is severe or disabling, score 9 points

While the symptoms in this section occur commonly in patients with yeast-connected illness, they also occur commonly in patients who do not have an overgrowth of Candida.

  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 or arthritis
  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 of breath
  27. Urgency or urinary frequency
  28. Burning on urination
  29. Failing vision
  30. Burning or tearing eyes
  31. Recurrent ear infections
  32. Fluid in ears
  33. Ear pain or deafness
  34. Tubes in ears
  35. Tubes in ears
  36. Other symptoms:

Total Score Section C =

Section A ........................
Section B.........................
Section C.........................
Total ................................