For each “yes” answer in Section A, circle the point score next to the question. Total your score and record it at the end of the section. Then move on to Sections B and C and score as directed. At the end of the questionnaire, you will add your scores to get your grand total, which will help determine the approximate time to remain on a candida-clear program.
Section A: History
1 Have you taken any tetracyclines (Sumycin, Panmycin, Vibramycin, Minocin,etc.) or other antibiotics for acne for one month (or longer)? _____50 points
2 Have you at any time in your life taken other “broad spectrum” antibiotics for
respiratory, urinary, or other infections for two months or longer, or for shorter periods four or more times in a one-year span? _____50 points
3 Have you taken an antibiotic drug—even for one round? _____6 points
4 Have you at any time in your life been bothered by persistent prostatitis, vaginitis, or other problems affecting your reproductive organs? _____25 points
5 Have you been pregnant two or more times? _____5 points
One time? _____3 points
6 Have you taken birth control pills for more than two years? _____15 points
For six months to two years? _____8 points
7 Have you taken prednisone, Decadron, or other cortisone-type drugs by mouth or inhalation for more than two weeks?* _____15 points
For two weeks or less? _____6 points
8 Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke moderate to severe symptoms? _____20 points
Or Mild symptoms? _____5 points
9 Are your symptoms worse on damp, muggy days or in moldy places? _____20 points
10 Have you had athlete’s foot, ringworm, “jock itch,” or other chronic fungus infections of the skin or nails? If so, Have such infections been severe or persistent? _____20 points
Or Mild to moderate? _____10 points
11 Do you crave sugar? _____10 points
12 Do you crave breads? _____10 points
13 Do you crave alcoholic beverages? _____10 points
14 Does tobacco smoke really bother you? _____10 points
Total Score, Section A: _____ points
*The use of nasal or bronchial sprays containing cortisone and/or other steroids promotes overgrowth in the respiratory tract.
Section B: Major Symptoms
For each of your symptoms, enter the appropriate point score:
If a symptom is occasional or mild: score 3 points
If a symptom is frequent and/or moderately severe: score 6 points
If a symptom is severe and/or disabling: score 9 points
Add your total score and record it in the box at the end of this section.
Fatigue or lethargy _____points
Feeling of being "drained" _____points
Poor memory _____points
Feeling "spacey" or "unreal" _____points
Depression _____points
Numbness, burning or tingling _____points
Muscle aches _____points
Muscle weakness or paralysis _____points
Pain and/or swelling in joints _____points
Abdominal pain _____points
Constipation _____points
Diarrhea _____points
Bloating _____points
Troublesome vaginal discharge _____points
Persistent vaginal burning or itching _____points
Prostatitis _____points
Impotence _____points
Loss of sexual desire _____points
Endometriosis _____points
Cramps, and/or other menstrual irregularities _____points
Premenstrual tension _____points
Spots in front of eyes _____points
Erratic vision _____points
Total Score, Section B _____
Section C: Other Symptoms* While the symptoms in this section commonly occur in people with yeast-related illness they are also found in other individuals.*
For each of your symptoms, enter the appropriate point score:
If a symptom is occasional or mild: score 1 point
If a symptom is frequent and/or moderately severe: score 2 points
If a symptom is severe and/or disabling: score 3 points
Add your total score and record it in the box at the end of this section.
Drowsiness _____points
Irritability or jitteriness _____points
Incoordination _____points
Inability to concentrate _____points
Frequent mood swings _____points
Headache _____points
Dizziness/loss of balance _____points
Pressure above ears . . . feeling of head swelling & tingling _____points
Itching _____points
Other rashes _____points
Heartburn _____points
Indigestion _____points
Belching and intestinal gas _____points
Mucus in stools _____points
Hemorrhoids _____points
Dry mouth _____points
Rash or blisters in mouth _____points
Bad breath _____points
Joint swelling or arthritis _____points
Nasal congestion or discharge _____points
Post nasal drip _____points
Nasal itching _____points
Sore or dry throat _____points
Cough _____points
Pain or tightness in chest _____points
Wheezing or shortness of breath _____points
Urgency or urine frequency _____points
Burning on urination _____points
Failing vision _____points
Burning or tearing of eyes _____points
Recurrent infections or fluid in ears _____points
Ear pain or deafness _____points
Total Score, Section A _____
Total Score, Section B _____
Total Score, Section C _____
GRAND TOTAL SCORE _____
The Grand Total Score will help you and your physician decide if your health problems are yeast-related. Scores in women will run higher as 7 items in the questionnaire apply exclusively to women, while only 2 apply exclusively to men.
Severe yeast-related health problems are almost certainly present in women with scores over 180, and in men with scores over 140.
Serious yeast-related health problems are probably present in women with scores over 120 and in men with scores over 90.
Moderate yeast-related 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 and other causes should be investigated.
What to do Next
If you’re suffering from possible candida overgrowth and want to regain your health in just 30 days or less with a clinically proven program by Dr. Varela, a world-renowned expert in candida clearance, let us know what your score is + schedule your first appointment today. With her guidance, uncover the underlying causes of your concerns, receive targeted dietary + lifestyle suggestions, + enhance your healing process with supplements to in-office therapies, like IV therapy. In this holistic way, you will gain clarity and control to clear candida + its recurrence for good.