Candida Questionnaire

Have you taken tetracyclines (Sumycin®, Panmycin®, Vibramycin®,Minocin®, etc.) or other antibiotics for acne for 1 month (or longer)?

Have you, at any time in your life, taken other “broad spectrum” antibiotics for respiratory, urinary or other infections for 2 months or longer, or for shorter periods 4 or more times in a 1-year span?

Have you taken a broad spectrum antibiotic drug – even for one period?

Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis, or other problems affecting your reproductive organs?

How many times have you been pregnant?

For how long have you ever taken birth control pills?

For how long have you ever taken prednisone, Decadron®, or other cortisone-type drugs by mouth or inhalation**?

Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke mild, moderate or severe symptoms?

Have you had athlete’s foot, ringworm, “jock itch” or other chronic fungus infections of the skin or nails?

Do you crave sugar?

Do you crave breads?

Do you crave alcoholic beverages?

Does tobacco smoke really bother you?

Are You Experiencing Fatigue or Lethargy

Are You Experiencing a Feeling of Being “Drained”

Are You Experiencing Poor Memory?

Are You Feeling “Spacey” or “Unreal”

Are You Experiencing an Inability to Make Decisions

Are You Experiencing Numbness, Burning or Tingling

Are You Experiencing Insomnia

Are You Experiencing Muscle Aches

Are You Experiencing Muscle Weakness or Paralysis

Are You Experiencing Muscle Weakness or Paralysis

Are You Experiencing Pain and/or Swelling in Joints

Are You Experiencing Abdominal Pain

Are You Experiencing Abdominal Pain

Are You Experiencing Diarrhea

Are You Experiencing Bloating, Belching or Intestinal Gas

Are You Experiencing Troublesome Vaginal Burning, Itching or Discharge

Are You Experiencing Prostatitis

Are You Experiencing Impotence

Are You Experiencing Loss of Sexual Desire or Feeling

Are You Experiencing Endometriosis or Infertility

Are You Experiencing Cramps and/or Other Menstrual Irregularities

Are You Experiencing Cramps and/or Other Menstrual Irregularities

Are You Experiencing Cramps and/or Other Menstrual Irregularities

Are You Experiencing Cold Hands or Feet and/or Chilliness

Are You Experiencing Shaking or Irritable When Hungry

Are You Experiencing Irritability or Jitteryness

Are You Experiencing Incoordination

Are You Experiencing Incoordination

Are You Experiencing Frequent Mood Swings

Are You Experiencing Headaches

Are You Experiencing Dizziness/Loss of Balance

Are You Experiencing Pressure Above Ears, Feeling of Head Swelling

Are You Experiencing Indigestion or Heartburn

Are You Experiencing Food Sensitivity or Intolerance

Are You Experiencing Rectal Itching

Are You Experiencing Dry Mouth or Throat

Are You Experiencing Rashs or Blisters in Your Mouth

Are You Experiencing Bad Breath

Are You Experiencing Foot, Hair or Body Odor Not Relieved by Washing

Are You Experiencing Nasal Congestion or Post Nasal Drip

Are You Experiencing Nasal Itching

Are You Experiencing Sore Throat

Are You Experiencing Laryngitis, Loss of Voice

Are You Experiencing Cough or Recurrent Bronchitis

Are You Experiencing Pain or Tightness in Chest

Are You Experiencing Wheezing or Shortness of Breath

Are You Experiencing Urinary Frequency, Urgency or Incontinence

Are You Experiencing Burning on Urination

Are You Experiencing Spots in Front of Eyes or Erratic Vision

Are You Experiencing Burning or Tearing of Eyes

Are You Experiencing Recurrent Infections or Fluid in Ears

Are You Experiencing Ear Pain or Deafness