Nutritional Deficiency - clinical features of

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Diagnosing deficiencies are best done by tests. But there are useful clinical pointers!

Hands and nails

  • Cold hands - magnesium deficiency
  • White spots on nails - almost any mineral deficiency but typically zinc
  • Ridges on nails - poor blood supply, zinc deficiency
  • Soft or brittle nails - and mineral deficiency especially magnesium
  • Bitten nails - general mineral deficiency

So often people comment that nails get tough when they start taking Nutritional Supplements - what everybody should be taking all the time even if nothing is wrong. Many of the raw materials for nails are the same for bone and connective tissue - so nail health reflects bone and connective tissue health!

Skin

  • Stretch marks indicate zinc deficiency. They are common in pregnancy not because the skin is stetched but because demands for zinc are high!
  • Follicular hyperkeratosis (rough skin, especially on the heels)- vitamin A deficiency
  • Spontaneous haemorrhages - lack of vitamins C or K. See Vitamin K
  • Dry scaly skin with hair follicles plugged with coiled distorted hairsand a red halo - vitamin C deficiency
  • Yellow palms - excessive beta carotene intake. But can be due to eating lots of coloured vegetables!
  • Pimply rough skin at the back of the upper arms (chicken flesh) - essential fatty acid deficiency See VegEPA
  • Greasy red scaly skin of face and sides of nose - vitamin B2 deficiency
  • Seborrhoeic dermatitis around nose and an acne like forehead rash - vitamin B6 deficiency

Mouth and gums

  • Pale fissured tongue - iron (Fe) deficiency
  • Sore painful fissured tongue - vitamin B3 deficiency
  • Sore burning tongue and lips and peeling of lips - vitamin B2 deficiency
  • Swollen tongue with lateral teeth indentations - food intolerance. Also myxoedema - see Hypothyroidism.
  • Painful sore tongue with a smooth appearance - folic acid deficiency
  • Angular cheilosis (splits in lips) - vitamin B2 deficiency, thrush
  • Gum disease and pyorrhoea - Co Q 10 deficiency, folic acid deficiency.
  • Bleeding gums - vitamin C deficiency

Eyes

  • Cataracts - chronium deficiency or excess free radicals
  • Bags or dark rings under eyes - allergies or food intolerances
  • Blue eyes and blond hair are often seen in hyperactive male children - zinc, magnesium, B6 and essential fatty acids deficiencies
  • Blue eyes and premature grey hair - vitamin B12 deficiency - a feature of pernicious anaemia

Neck

  • Goitre, thyroid swelling - iodine deficiency

Legs

  • Tender calf muscles - magnesium deficiency
  • Brisk knee reflexes - magnesium deficiency
  • Restless legs - mineral deficiency, tendency to be acidic - see Acid-Alkali balance

Clinical histories of nutritional relevance

  • Nasal polyps - salicylate sensitivity, catarrh, sinusitis, history of removal of Ts and As for good clinical reasons, milk intolerance
  • Poor healing - zinc deficiency
  • Poor dream recall - vitamin B6 deficiency
  • Blood sugar swings with obvious low blood sugar episodes - chronium deficiency
  • Pre-menstrual syndrome - progesterone, magnesium, zinc and essential fatty acid deficiencies
  • Glandular fever - inadequate liver detoxification mechanisms
  • Sensory symptoms - B12, B1, magnesium deficiencies
  • Mental symptoms - B12 deficiency
  • Parkinsonism/Multiple sclerosis - glutathione deficiency
  • Cervical dysplasia - vitamin B6 and folic acid deficiency, papilloma/wart virus. Heals well with DMSO on the end of a tampax
  • Arthritis - Boron and sulphur (MSM) deficiency
  • Measles - vitamin A deficiency
  • Persistent diarrhoea leading to fatigue - magnesium and potassium deficiencies
  • Many diuretics cause magnesium and potassium deficiencies
  • Muscle cramps - magnesium deficiency
  • Shaking hands - magnesium and vitamin B1 deficiencies
  • Hypertension - magnesium deficiency
  • Dysphagia - magnesium deficiency
  • Sensitivity to light - magnesium deficiency
  • Osteoporosis - don't forget to think about magnesium
  • PET - magnesium deficiency
  • Hair loss - thyroid, iron (Fe), biotin, zinc and essential fatty acid deficiencies (must measure serum ferritin to check iron stores)
  • Frequent colds - zinc and vitamin C deficiencies
  • Infertility, miscarriages and premature labour - zinc deficiency
  • Poor sense of smell and taste - zinc deficiency
  • Poor vision or night blindness - zinc and vitamin A deficiencies
  • Dry eyes - vitamin A deficiency
  • The contraceptive pill and HRT can cause an increase in copper levels and zinc, magnesium and vitamin B6 deficiencies
  • Blocked nose with red wine - molybdenum deficiency
  • Bowel cancer - selenium deficiency
  • Mercury amalgams in teeth - selenium and glutathione deficiencies
  • Cardiomyopathies (Keshan Disease) - selenium deficiency
  • Heart attacks - vitamin E deficiency (Shute brothers)
  • Hair loss, dandruff, eczema, excessive ear wax production, poor wound healing, excessive thirst (especially in hyperactive children), pre-menstrual symptoms of any sort - essential fatty acid deficiency
  • Carpal tunnel syndrome - vitamin B6 deficiency
  • Vegans - vitamin B12, zinc and Fe deficiencies
  • Gastrectomy - vitamin B12 and HCI (stomach acid) deficiencies
  • Diabetic peripheral neuropathy - vitamin B12 deficiency
  • Elderly - low everything, especially vitamin Bs and HCI deficiencies
  • Persistent infections - vitamin C and zinc deficiencies

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