Aug 1, 2007

A Nutritionally Oriented Physical Exam

Your body is talking to you and showing you things-you just need to learn how to listen to it and look at it.

What you might consider common, everyday problems-such as dandruff, earwax, or itching-can often be signs or symptoms of other problems, or of a need for certain nutrients. A nutritionally oriented physical exam is designed to read signs and symptoms from your body to determine clues to problems and to determine some of your individual nutrient requirements.

Many of the people I work with think that all physical exams are alike. But that's not the case. For example, a cardiologist will pay much more attention to heart sounds, an ophthalmologist will use special instruments to examine your eyes, and so on. In nutritionally oriented medicine, there are many things to look for that frequently go unobserved in a "regular" physical exam. We'll start at the very top of the head and work downward, and I'll discuss observations for men, women, and children.

Figuring out what's causing that thinning-or itching-on top: Nutritional Clues in Our Hair

If you're a relatively young woman and your hair is thinning out, get checked for low stomach acid right away! For most younger women, thinning hair is caused by incomplete protein digestion associated with subnormal stomach acid and pepsin production. Poor protein digestion results in low levels of essential amino acids and essential minerals. Without sufficient essential amino acids, hair starts to thin out. The problem can be stopped by supplementation with hydrochloric acid-pepsin capsules with meals, as well as with individualized essential amino acid and mineral supplements.

Birth control pills and pregnancy can occasionally cause hair loss, too. B-complex vitamins will reverse this effect, especially folate and vitamin B6.

If you're past menopause, thinning hair is often due to the digestive problem just noted, but it can also be caused by low DHEA levels. Ten to 15 milligrams of DHEA daily will usually help, at least to a degree.

Less frequently, thinning hair can be caused by subnormal thyroid functioning--especially if you're losing substantial hair from the outer half of each eyebrow.

Sorry, men, none of these ideas work for hair loss due to male pattern baldness. But sometimes saw palmetto can help men regrow a little fuzz.

Is your hair dull and lifeless? If so, it's not from a deficiency of a certain high-priced brand-name shampoo. Instead, it's most likely a deficiency in essential fatty acids, with perhaps a smaller need for B-complex vitamins, especially vitamin B6. Try 1 to 2 tablespoons of flaxseed oil daily for several weeks. (Always remember to take vitamin E as mixed tocopherols when you take essential fatty acid supplements.) Taking 2 to 3 tablespoons of freshly ground flaxseed daily would be even better, though not quite as convenient. Include an average amount of B-complex supplementation each day, containing at least 50 milligrams of B6. When your hair regains its luster, you'll probably be able to cut back on your supplementation and still maintain the sheen you want. (This works for animals, too-ask any owner of a champion show horse or show dog.)

If it's painful to pull on or brush your hair, you need more vitamin D. (Small children have this problem more often than adults.) Children can safely use 400 to 1,000 IU daily; adults, 2,000 to 3,000 IU daily. Grandma's "tablespoonful of cod liver oil daily" is an even better idea, since cod liver contains both vitamin D and omega-3 fatty acids.

Infrequently, the premature graying of hair can be slowed down or even reversed with gram-sized quantities of the B-vitamin para-aminobenzoic acid (PABA) or the Chinese botanical "Fo-ti" (ho-shou-wu).

What about that dandruff? It isn't caused by a special shampoo deficiency either. To solve the problem, eliminate all refined sugars and carbohydrates from your diet, eat more food sources of essential fatty acids (low-mercury fish, free-range organic meats, omega eggs, unroasted nuts and seeds), take some flaxseed or cod liver oil, and use a multiple vitamin with at least 50 milligrams of vitamin B6 and a little selenium (200 to 300 micrograms). You'll be surprised at how rapidly your dandruff disappears.

Infants with what appears to be heavy dandruff (frequently called cradle cap) can be helped by having their nursing mothers follow the instructions just noted. In addition, infants often need 540 mg of biotin daily. You can also rub flaxseed oil or a similar oil into the infant's skin. Both options are quite safe.

If Dumbo had only known…: Nutritional Clues from Our Ears

Do you have too much, or really dried-out, earwax? That's just another sign of insufficient essential fatty acids. If the skin behind your ears is cracking, you'll need to add zinc. Meats, nuts, and seeds, especially sunflower and pumpkin seeds, are good sources of zinc. You may need 30 extra milligrams of zinc per day for a while. (Zinc picolinate is best.)

Do your ears get red suddenly for no apparent reason? Although this rarely happens to adults, it isn't unusual in children--especially small children. It's almost always a sign of food allergies. Detecting and eliminating food allergies will usually eliminate not only sudden ear redness, but also a variety of other symptoms, particularly recurrent infections.

Now here's an "ear sign" used in conventional medicine, too: a diagonal crease across the earlobe may indicate increased risk of cardiovascular disease. To guard against this, you may want to have a cardiovascular risk panel of blood tests done. Such a panel includes serum lipids (cholesterol, HDL and LDL cholesterol, and triglycerides), homocysteine, C-reactive protein (CRP), fibrinogen, lipid peroxides, free and total testosterone (for men), white cell magnesium (red cell magnesium is OK, but not quite as good), and perhaps other cardiovascular markers.

Now let's take a look inside the ears. Children with recurrent ear infections may have fluid behind their eardrums. If the infection is acute, the eardrum may be red and swollen. Regardless of severity, the underlying causes are almost always food allergies and consumption of refined sugar and carbohydrates. Eliminate both, and add supplemental zinc (15 to 30 milligrams daily), vitamin A (not beta-carotene, 10,000 to 30,000 IU daily), and vitamin C (500 to 1,500 milligrams daily). The recurrent ear infections and/or the fluid behind the eardrums will very likely disappear.

If those "baby blues" look more like Old Glory: Nutritional Clues from Our Eyes

Chronic red and itchy eyes can be caused by a chronic allergy or a low-grade infection. You'll need to treat the problem with eye drops, but make sure you don't use eye drops containing steroids because prolonged use will increase your chances of getting cataracts. Talk to a compounding pharmacist about eye drops containing vitamins A and C. In this case, there's no actual deficiency of vitamins A and C. But when you apply them directly in a drop, they strengthen the surface tissues of the eye so much that the symptoms of allergy disappear, and viral infection is successfully resisted. Most of the time, the problem will be controlled or eliminated in a few days. If it's a bacterial infection, these vitamins may not work as well. In that case, colloidal silver will usually help you get rid of it. (Of course silver isn't really a "nutrient.")

Cataracts in the lens of your eye? I frequently recommend a glucose tolerance insulin resistance test. If your test is positive, or if you have a personal or family history of diabetes or low blood sugar, you can slow down cataract development by totally eliminating all sugar and refined carbohydrates and by adopting a higher protein, lower carbohydrate diet. Since some cataracts are due to galactose, it's best to eliminate milk and dairy products, too. A diabetes-related cataract can be partially attributed to over-activity of the enzyme aldose reductase. Using 500 to 1,000 milligrams daily of supplemental quercitin (a flavonoid that inhibits this enzyme) may be helpful.

Early cataracts can often be stopped where they are or even reversed with 40,000 IU daily of vitamin A (not beta-carotene), bilberry (80 to 160 milligrams of a standardized extract three times daily), and the Chinese botanical combination Hachimijiogan (offered as "Clinical Nutrients for the Eyes," by Phytopharmica). Try three tablets daily. Recently, research has shown that some early cataracts are stopped or reversed by N-acetyl carnosine eyedrops (available as a product called "Can-C") used twice daily. It's also possible that vitamin B2, selenium, zinc, and vitamin C may slow cataract progression.

I usually can't see floaters in your eyes, but if you have them, you certainly can. Years ago, the Physician's Desk Reference (PDR) told us that a combination of choline, inositol, and methionine would reduce their severity. Try approximately 1,000 milligrams of choline, 500 milligrams of inositol, and 200 milligrams of methionine daily, and be patient. You may not see a difference for several months.

The back of the eye, the retina, can occasionally be hyperpigmented, or blackish in color. Dr. Arthur Alexander Knapp, an ophthalmologist practicing in New York City from the 1930s to the 1950s, found that high doses of calcium and vitamin D were helpful in fighting this problem. He also found that these nutrients reduced the severity of keratoconus, a cone-shaped deformity of the cornea of the eye.

If there's a burst blood vessel leaving a bold-red area in the white of the eye (a condition known as a scleral hemorrhage), you might have high blood pressure. If that's not the problem, then increasing the intake of flavonoids will strengthen all blood vessels, large and small, and prevent spontaneous blood pressure rupture. Flavonoids are found particularly in red, blue, and purple-colored foods, as well as in citrus fruit. In addition, it's best to increase your intake of dark green vegetables for their vitamin K content, or use supplemental vitamin K, to make sure that your blood clots normally. (Don't do this if you're presently taking Coumadin.)

Many children (and some adults) have persistent dark circles under their eyes. In both adults and children, crying and lack of sleep can be causes, but in children the most likely cause is a food allergy. As noted before, detecting, eliminating, and desensitizing food allergies can not only make dark circles vanish or lessen dramatically, but can also help eliminate other associated symptoms of food allergy, such as recurrent infection. In children, pupils dilated more than a quarter of an inch usually indicate an allergy, too. Dairy products are the most frequent offenders, but other foods can also be problems.

Let's pull the lower eyelid down gently. Is the color a healthy pinkish red, or a much more pale pink? If it's pale, check for anemia, which is usually, though not always, associated with low iron levels. Remember the usual causes of low iron: insufficient iron-containing food, poor digestion and assimilation of iron (frequently low stomach acid), or excess iron loss from overly heavy menstrual periods or hidden gastrointestinal bleeding.

What the nose knows: Nutritional Clues from Our Noses

Are there a number of small, red, dilated veins visible on or adjacent to your nose? Perhaps there are similar veins apparent in the skin of your cheeks? The more visible the veins, the greater the odds that you have low stomach acid. Sometimes excessive alcohol use may also be responsible for dilated veins on or near the nose. Some individuals have both problems: low stomach acid and too much alcohol.

Is your nose stuffy all the time? Even mainstream medicine knows that such a problem can be caused by inhalant allergies, but food allergies are often overlooked. Chronic problems can be caused by an infection. If that is the cause of your problem, antibiotics might not be effective because a surprising number of chronic infection-associated stuffiness problems are caused by fungi.

The natural sugar-alcohol xylitol is sometimes helpful for treating stuffy noses. A spray or two as far as possible into the nostrils twice daily can reduce stuffiness. This harmless spray works by reducing the ability of allergens to stick to the lining of the nose and sinuses. But much nasal stuffiness is difficult to eliminate, requiring the help of a physician skilled and knowledgeable in nutritional and natural medicine.

A child with a horizontal crease above the end of the nose is a child with allergies. The crease is caused by the child's repeatedly pushing up against the end of the nose with the palm of the hand, termed the "allergic salute" by Dr. Doris Rapp.

Have you been told you have polyps inside your nose? They're frequently associated with sensitivity to salicylates, including aspirin, artificial colors and flavors, and foods containing salicylates, such as raisins, grapes, berries, cucumbers, peppers, and other foods and beverages. (For more complete details, check www.feingold.org.) You can prevent or slow down polyp growth by avoiding all salicylates, but you can rarely reverse them.

The strongest muscle in your body is full of clues to your health: Nutritional Clues from Our Tongues

Now say "Aaah"! Take a look at your tongue. Is it all cracked and grooved? If so, that means you need more folic acid (folate) and/or vitamin B12 (perhaps 1,000 micrograms daily of each) and/or zinc (30 milligrams daily). You may as well use all three essential nutrients until all the cracking clears up and the tongue is smooth again. Be patient-it'll take months. A lack of the same nutrients can also make the tongue look like a map of the world, a condition termed "geographic tongue." If your tongue looks white-coated, it may have a coating of Candida albicans--a yeast that can cause considerable trouble in some cases. The implications and treatment are too lengthy to discuss here. For treatment, check with a doctor skilled and knowledgeable in nutritional and natural medicine.

Does your tongue look scalloped from indentations made by the teeth around the edges of the tongue? There's a high probability of food allergy again. Less often, the condition is caused by thyroid weakness.

A pale pink tongue instead of a darker-toned one is another sign of anemia, just like a pale inner eyelid. Check for the same things.

Oriental medicine can rely quite heavily on tongue diagnosis and use it to guide treatment of problems far removed from the tongue itself. For in-depth information on the topic, see Dr. Chi's Method of Fingernail and Tongue Diagnosis.

Healthy choppers mean a lot more than just a white smile: Nutritional Clues from Our Teeth

Do you have silver fillings in your teeth? You probably know they're an amalgam containing the very toxic element - mercury. Even the FDA has issued warnings about eating fish high in toxic mercury, and more mercury than that leaks into your tissues (especially in your brain and nervous system) from just one or two amalgam fillings. If you have a silver/mercury filling, you should make plans to have it removed by a dentist skilled and knowledgeable in natural techniques.

Do you have tooth decay? In comparative studies, the natural sugar-alcohol xylitol has been found to prevent tooth decay better than the toxic water additive fluoride (which is almost always a different molecular form than naturally occurring fluoride in water). Xylitol is readily available in toothpaste, chewing gum, and breath mints. (For complete details about xylitol and prevention of tooth decay, see the December 2001 issue of Nutrition & Healing.)

What about those gums? If they're unhealthy, 30 to 60 milligrams daily of coenzyme Q10 can make a difference. Folic acid can also improve gum health. Use a folic acid mouthwash, such as "Foli-rinse," in the morning and evening.

Do you have recurrent canker sores (sometimes called apthous ulcers)? If so, there's a high probability that identification, elimination, and desensitization of food allergies will lessen or even eliminate recurrences. Sodium lauryl sulfate, an ingredient in some toothpastes, can contribute to canker sore formation, too. You can also eliminate or reduce canker sores by using Lactobacillus acidophilus, iron, B12, and folate.

If the tonsils are larger than usual in a child or teenager, the culprit is probably, once again, a food allergy, sometimes complicated by recurrent infection. The same principles apply (eliminating sugar and refined carbohydrates and identifying, eliminating, and desensitizing allergies).

Editor's Note: This article is the first of a 4-part series that originally appeared in Dr. Jonathan V. Wright's Nutrition & Healing. To read the entire series free go to www.WrightNewsletter.com/Directory/.