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Definition of Candida

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In-depth Questionnaire

   

In-depth Questionnaire

Section B: Major Symptoms

For each symptom that is present, enter the appropriate number in the Point Score column:

  • 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

Total the score for this section, and record it at the end of this section.

Point score

1. Fatigue or lethargy ____________________________________________________

2. Feeling or being "drained" ______________________________________________

3. Poor memory ________________________________________________________

4. Feeling "spacey" or "unreal" ____________________________________________

5. Inability to make decisions _____________________________________________

6. Numbness, burning or tingling ___________________________________________

7. Insomnia ____________________________________________________________

8. Muscle aches ________________________________________________________

9. Muscle weakness or paralysis __________________________________________

10. Pain and/or swelling in joints ___________________________________________

11. Abdominal pain _____________________________________________________

12. Constipation ________________________________________________________

13. Diarrhea ____________________________________________________________

14. Bloating, belching or intestinal gas ______________________________________

15. Troublesome vaginal burning, itching or discharge __________________________

16. Prostatitis __________________________________________________________

17. Impotence __________________________________________________________

18. Loss of sexual desire or feeling _________________________________________

19. Endometriosis or infertility _____________________________________________

20. Cramps and/or other menstrual irregularities ______________________________

21. Premenstrual tension _________________________________________________

22. Attacks of anxiety or crying ____________________________________________

23. Cold hands or feet and/or chilliness _____________________________________

24. Shaking or irritable when hungry ________________________________________

Total Score, Section B _________________________________________________

 

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