Symptoms Questionnaire 


Your Fungal Quotient
Symptom Questionnaire - 
How to tell if a Fungus may be at the Root of Your Illness
The following is a self-assessment of fungal exposure risk. A high number of 
positive answers, based on experience, research data from mycology textbooks, 
and observation, increase the likelihood that your problem may be related to a 
fungus. Physicians, when assessing patients, may also use this questionnaire, 
or ones similar to it. 

Medical History
1. At any time in your life, have you taken repeated or prolonged rounds of 
antibiotics? 
a. If so, for what conditions?
2. At any time in your life, have you taken repeated or prolonged courses of 
steroids or cortisone-based pills? 
a. If so, for what?
3. Have you been diagnosed with fibromyalgia?
4. Do you have, or have you ever had asthma?
5. Have you been diagnosed with arthritis?
6. Do you have diabetes?
7. At any time in your life, have you been treated for worms or parasites?
8. Have you traveled outside of the U.S.?
a. When and where?
9. Have you ever had cancer?
a. Have you ever been treated with chemotherapy or radiation for any type of 
cancer or other disease?
10. Do you have, or have you had, ringworm, fingernail or toenail fungus, or “
jock itch?”
11. Have you ever been diagnosed with attention-deficit disorder (ADD or 
ADHD)?
a. Are you currently taking medications for this?
b. If so, which medication/s? ____________________
12. Were you near any construction sites at the time you became ill?
General Medical Health
13. Do you suffer from fatigue? 
a. Based on a 1-10 scale, with 10 being the worst, how bad is your fatigue 
been in the past few weeks?
14. Do you suffer from irritability, memory loss, or a feeling of constantly 
being “spaced out?”
15. Do your muscles, bones, or joints bother you?
a. Would you describe them as aching, weak, stiff, or swollen?
16. Do you get headaches?
a. How long have you suffered with headaches?
b. How many days per month do you have headaches?
c. Do these headaches feel as though they are hormonally driven?
d. What medication do you take for these headaches?
17. Do you have itching, tingling, or burning skin?
18. Do you have hives, psoriasis, dandruff, or chronic skin rashes?
19. Do you have acne?
20. Are you on medications for the skin problems listed in questions 17, 18, 
19?
a. Name the medication/s:__________________
21. Do you suffer from hair falling out, itching inner ears, or vision 
problems?
22. Do you have high blood pressure, low blood pressure, high cholesterol or 
triglycerides?
a. Are you on medications for these problems?
b. If so, how long have you taken these medications?
23. Do you have mitral valve prolapse or heart symptoms, i.e., racing pulse 
or uncontrolled heart beat?
a. Are you on medication for this condition?
b. If so, how long have you taken these medications?
24. Have you ever been diagnosed with an autoimmune disease?
25. Are you bothered by recurrent digestive problems, including bloating, 
belching, gas, constipation, diarrhea, abdominal pain, indigestion, or reflux?
a. Are you on medication for these problems?
b. If so, how long have you taken these medications?
26. Do you have chronic infections for which your doctor keeps prescribing 
antibiotics?
a. What are these infections?
b. How long have they been recurring?
27. Does your condition get worse in response to heat (for example does a 
shower, bath, or very hot weather make it worse?)
28. Do your symptoms get worse on damp days or in musty, moldy environments?
29. On days when the mold/pollen count is elevated, do you feel worse?
30. Do you often feel “blue” or depressed?
a. Are you presently seeing a therapist for depression?
b. Are you on medication for depression?
c. If so, how long have you taken these medications?
31. Do you drink alcoholic beverages?
a. If so, how much?
b. How many years have you drunk alcoholic beverages?
32. Do you smoke?
a. If so, how much?
b. How many years have you smoked?
33. Do you presently or have you ever craved corn, peanuts, or sugar?
34. Have you ever worked on or played around a farm?
35. Have you ever encountered mold-related problems in your home or office?
a. Has your home or office ever been flooded to any degree?
Allergies
36. Do you suffer allergic reactions due to pollens, molds, animal dander, 
dust, mites, perfumes, chemical, smoke, or fabric store odors?
a. Are you presently on allergy injections?
37. Do you suffer allergic symptoms due to any foods?
a. Have you had food allergy tests run?
b. Were these skin tests or blood tests?
For Women Only
38. Have you ever taken birth control pills?
a. Did any problem occur as a result of birth control pill usage?
b. If so, please describe: _______________
39. At any time in your life, have you been bothered by vaginal or urinary 
tract problems?
40. Are your ovaries, thyroid gland, adrenals, and pancreas functioning as 
they should? (Symptoms of hormonal disturbances can include: PMS, menstrual 
irregularities, loss of libido, infertility, sugar cravings, weight problems, and 
constantly feeling hot or cold).
a. Are you on medications for these problems?
b. If so, how long have you taken these medications?
For Men Only
41. Do you now, or have you ever, experienced pain in the testicles unrelated 
to trauma?
42. Have you ever been bothered with prostate problems?
43. Are your testicles, thryoid gland, adrenals, and pancreas functioning as 
they should? (Symptoms of hormonal disturbances can include: loss of libido, 
infertility, impotence, sugar cravings, weight problems, and constantly feeling 
hot or cold.)
a. Are you on medications for any of these conditions?
b. If so, how long have you taken these medications?
Though a numerical score need not be tabulated, your yes~no answers give 
important information that are clues to your encounters with fungus. If you 
suspect fungal infection, a good response is: change.
Study the information on this website and in our books. Try the Initial Phase 
Diet, get adequate exercise as recommended by your physician, and try strong 
natural or prescriptive antifungal medications for a time, as outlined by this 
book and per the discretion of your doctor. If you health improves or you get 
worse for a time before feeling well again, you may have confirmed a fungal 
involvement. Then the work begins. Overcoming fungal infection is many times 
possible.

This article was published on Monday 03 February, 2003.



"The world is a dangerous place to live; not because of the people who are 
evil, but because of the people who don't do anything about it."
 - Albert Einstein 
"
Never doubt that a small group of thoughtful, committed citizens can change 
the world. Indeed, it’s the only thing that ever has."
- Margaret Mead 

"When the government fears the people, you have liberty. When the people fear 
the government, you have tyranny." 
- Thomas Jefferson

"All that is necessary for evil to triumph is for good men to do nothing" 
- Edmund Burke

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