Candida Clear Questionnaire

For each “yes” answer in Section A, check the point score next to the question. At the end of the questionnaire, you will get your grand total, which will help determine the approximate time to remain on a candida-clear program. (For mobile screens, you may need to turn your device to sideways for optimal viewing.)

SECTION A: HISTORY

	Yes
Have you taken any tetracyclines (Sumycin, Panmycin, Vibramycin, Minocin,etc.) or other antibiotics for acne for one month (or longer)?
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?
Or have you taken an antibiotic drug—even for one round?
Have you at any time in your life been bothered by persistent prostatitis, vaginitis, or other problems affecting your reproductive organs?
Have you been pregnant two or more times?
...Or pregnant one time?
Have you taken birth control pills for more than two years?
...Or 6 months to 2 years?
Have you taken prednisone, Decadron, or other cortisone-type drugs by mouth or inhalation for more than two weeks?*
...Or two weeks or less?
Does exposure to perfumes, insecticides, fabric shop odors, or other chemicals provoke moderate to severe symptoms?
...Or Mild symptoms?
Are your symptoms worse on damp, muggy days or in moldy places?
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?
...Or Mild to moderate?
Do you crave sugar?
Do you crave breads?
Do you crave alcoholic beverages?
Does tobacco smoke really bother you?

Total Score, Section A

*The use of nasal or bronchial sprays containing cortisone and/or other steroids promotes overgrowth in the respiratory tract.

SECTION B: MAJOR SYMPTOMS

	OCCASIONAL/MILD	FREQUENT/MODERATE	SEVERE/DISABLING
Fatigue or lethargy
Feeling of being "drained"
Poor memory
Feeling "spacey" or "unreal"
Depression
Numbness, burning or tingling
Muscle aches
Muscle weakness or paralysis
Pain and/or swelling in joints
Abdominal pain
Constipation
Diarrhea
Bloating
Troublesome vaginal discharge
Persistent vaginal burning or itching
Prostatitis
Impotence
Loss of sexual desire
Endometriosis
Cramps, and/or other menstrual irregularities
Premenstrual tension
Spots in front of eyes
Erratic vision

Total Score, Section B

SECTION C: Other Symptoms

	OCCASIONAL/MILD	FREQUENT/MODERATE	SEVERE/DISABLING
Drowsiness _____points
Irritability or jitteriness
Incoordination
Inability to concentrate
Frequent mood swings
Headache
Dizziness/loss of balance
Pressure above ears . . . feeling of head swelling + tingling
Itching
Other rashes
Heartburn
Indigestion
Belching and intestinal gas
Mucus in stools
Hemorrhoids
Dry mouth
Rash or blisters in mouth
Bad breath
Joint swelling or arthritis
Nasal congestion or discharge
Post nasal drip
Nasal itching
Sore or dry throat
Cough
Pain or tightness in chest
Wheezing or shortness of breath
Urgency or urine frequency
Burning on urination
Failing vision
Burning or tearing of eyes
Recurrent infections or fluid in ears
Ear pain or deafness

Total Score, Section C

Grand Total Score, Section A+B+C

The Grand Total Score will help you + 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, + in men with scores over 140.

Serious yeast-related health problems are probably present in women with scores over 120 + in men with scores over 90.

Moderate yeast-related health problems are possibly present in women with scores over 60 + in men with scores over 40.

With scores of less than 60 in women + 40 in men, yeasts are less apt to cause health problems + other causes of your symptoms should be investigated.

source: This questionnaire is adapted from William G. Crook, MD, The Yeast Connection H+book (Jackson, TN: Professional Books, Inc., 2000). Used with permission.

What to do Next

If you’re suffering from possible candida overgrowth + want to regain your health in just 30 days or less with a clinically proven program by Dr. Varela, submit your results with your name + schedule a free 10 minute phone consult to discuss your results + treatment options. With Dr. Varela's 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 + control to clear candida + its recurrence for good.

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