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Is yeast bothering you? Check it out!
Question Yes No
Adult
1. Have you taken antibiotics repeatedly or in a prolonged period of time? 40 0
2. Have you suffered from recurrent vaginal, prostate or urinary infections? 30 0
3. Do you feel sick all over your body without any reason found? 20 0
4. Do you suffered from hormone disturbances (eg. PMS, menstrual irregularities, sexual dysfunction, sugar craving, low body temperature or fatigue)? 20 0
5. Are you unusually sensitive to tobacco smoke, perfume, colognes and other chemical odors? 20 0
6. Are memory or concentration problems bothering you? 20 0
7. Have you taken prednisone or other steroids in a prolonged period of time, or contraceptives for more than 3 years? 20 0
8. Do you have delayed food allergy/ food hypersensitivity? 10 0
9. Are you bothered by constipation, diarrhea, bloating or abdominal pain? 10 0
10. Do you have unusually dry skin, skin rashes and itchy/ tingling skin? 10 0
Children
1. During the 2 years before your child was born, were you bothered by recurrent vaginitis, menstrual irregularities, premenstrual tension, fatigue, headache, depression, digestive disorders or ‘feeling sick all over’? 30 0
2. Did thrush bother your child? (Score: 10=mild, 20=severe) 10 / 20 0
3. Did frequent diaper rashes infancy bother your child? (Score: 10=mild, 20=moderate to serve) 10 / 20 0
4. Did colic & irritability lasting >3 months bother your child during infancy? (Score: 10=mild, 20=severe) 10 / 20 0
5. Will damp says or damp/moldy places worsen your child’s symptoms? 20 0
6. As recurrent or persistent ‘athlete’s foot’ or chronic fungus infections of your child’s skin or nails bothered him/her? 30 0
7. Has recurrent hives, eczema or other skin problems bothered your child? 10 0
8. Has your child received:
a. 4 or more courses of antibiotic drug during the past year? Or has he/she received continuous ‘prophylactic’ courses of antibiotic drugs?
60 0
b. 8 or more courses of ‘board-spectrum’ antibiotics (Such as Amoxicillin, Keflex, Septra, Bactrim or Ceclor) during the past three years? 40 0
9. Has your child experienced recurrent ear problems? 20 0
10. Has your child had tubes inserted in his ears? 10 0
11. Has your child been labeled ‘hyperactive’? (Score: 10=mild, 20=severe) 10 / 20 0
12. Does learning problems bother your child (despite the normal early development history)? 10 0
13. Does your child have a short attention span? 10 0
14. Is your child persistently irritable, unhappy & hard to please? 10 0
15. Has you kid been bothered by persistent or recurrent digestive problems (constipation, diarrhea, bloating or excessive gas)? (Score: 10=mild, 20=moderate, 30=severe) 10 / 20 / 30 0
16. Has your child been bothered by persistent nasal congestion, cough and/ or wheezing? 10 0
17. Is your child unusually tired or unhappy & hard to please? 10 / 20 0
18. Has you kid been bothered recurrent headaches, abdominal pain, or muscle aches? (Score: 10=mild, 20=severe) 10 / 20 0
19. Does your child crave sweets? 10 0
20. Does exposure to perfume, insecticides, gas or other chemicals provoke moderate to severe symptoms in your child? 30 0
21. Does tobacco smoke really bother your child? 20 0
22. Do you feel that your child isn’t well, yet diagnostic tests and studies haven’t revealed the cause? 10 0
Total Score:

If your answer is “yes” to any question, circle the number in the left hand column. Add up the points you have circled. Your score will help you determining the likelihood that your children’s and your health problems are yeast related.

SCORING
Woman: > 90 = Probably yeast connected;
> 120= Almost certainly yeast connected
Man: > 70 = Probably yeast connected;
> 100= Almost certainly yeast connected
Children:> 60 = Possibly yeast connected;
> 100= Probably yeast connected;
> 140= Almost certainly yeast connected.

* Reference: William G. Crook, M.D. The Yeast Connection Handbook. New York: Square One Publishers, 2000. Print.
** This questionnaire only serves as educational purpose. It does not intend to diagnose, treat or cure any disease and cannot replace any doctor¡¦s diagnosis. If you have any health concern, you are advised to consult your family doctor.
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