Clinical Signs of Imbalances

Physical signs that may indicate nutritional imbalances are often visible on the skin, hair, nails, eyes, mouth, and other areas. It can help practitioners identify potential deficiencies or excesses in key nutrients.

Skin

• Pallor: Iron, folate, or vitamin B12 deficiency.

• Hyperpigmentation: Vitamin B12 deficiency, adrenal insufficiency.

• Dry, flaky skin: Essential fatty acid, vitamin A, or zinc deficiency.

• Bruising or slow wound healing: Vitamin C, vitamin K, zinc, or protein deficiency.

• Rashes or dermatitis: Zinc, vitamin B2 (riboflavin), or biotin deficiency; food sensitivities.

• Yellowish tint: Excessive beta-carotene or liver dysfunction.

Hair

• Thinning or hair loss: Iron, biotin, zinc, or protein deficiency.

• Dry, brittle hair: Essential fatty acid, vitamin A, or zinc deficiency.

• Premature graying: Copper deficiency or oxidative stress.

• Alopecia: Biotin or iron deficiency.

Nails

• Spoon-shaped nails (koilonychia): Iron deficiency anemia.

• White spots: Zinc deficiency.

• Brittle nails: Protein, magnesium, or calcium deficiency.

• Ridged nails: B vitamin or protein deficiency.

• Clubbing of nails: Chronic hypoxia or systemic disease (not directly nutritional).

Eyes

• Pale conjunctiva: Iron or B12 deficiency.

• Dry eyes: Essential fatty acid deficiency, vitamin A deficiency.

• Bitot’s spots: Vitamin A deficiency.

• Night blindness: Vitamin A deficiency.

• Dark under-eye circles: Allergies, adrenal fatigue, or poor sleep.

Mouth and Lips

• Cracked lips (cheilitis): Riboflavin (B2), niacin (B3), or iron deficiency.

• Glossitis (red, swollen tongue): Iron, folate, or B vitamin deficiencies.

• Magenta tongue: Riboflavin deficiency.

• Bleeding gums: Vitamin C deficiency.

• Angular stomatitis: Riboflavin or iron deficiency.

Teeth

• Cavities or tooth decay: Excessive sugar intake or vitamin D deficiency.

• Erosion: Gastric reflux, which could be associated with nutrient malabsorption.

• Loose teeth: Vitamin C deficiency (scurvy).

Other Physical Signs

• Muscle cramps or twitching: Magnesium, calcium, or potassium imbalance.

• Peripheral neuropathy: Vitamin B12, B6, or thiamine deficiency.

• Edema: Protein deficiency or sodium/potassium imbalance.

• Fatigue or weakness: Iron, B12, folate, or vitamin D deficiency.

Functional Medicine Approach

In a functional medicine evaluation, these physical signs are combined with:

• Detailed patient history (diet, symptoms, medical history).

• Laboratory tests (micronutrient panels, serum levels of vitamins/minerals, inflammation markers).

• Assessment of gut health (as it impacts nutrient absorption).

By correlating physical signs with laboratory data, practitioners develop personalized nutrition and lifestyle interventions aimed at correcting imbalances and optimizing health.