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.

You may have read my report New Secrets for Reading Your Body Like a Book. It’s time to update it a bit, so this is the latest version of what you might expect from a nutritionally oriented 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

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…

Do you have too much, or really dried-out, earwax? That’s just another sign of insufficient essential fatty acids. You know what to do! 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

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

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

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

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).

Natural ways to bring your health a head (and arm) above the rest

As you’ve probably noticed by now, an exam like this can take quite some time—much longer than the kind of “physical” you’re probably used to. But this kind of in-depth attention is what your body deserves and what will truly help you get to the bottom of any health problems you might be experiencing. By observing signs and symptoms in your body, and by being aware of what they are indicating, you can begin to take a more active role in your own health care. So let’s pick up where we left off and continue looking in the mouth for a moment.

Recurrent strep throat can be significantly reduced or even stopped altogether by eliminating—not just reducing, but eliminating—all milk and other dairy products. It works! (I learned that from Don’t Drink Your Milk! by Dr. Frank Oski, former director of the department of pediatrics at Johns Hopkins University School of Medicine.) And we can’t forget to check for cracks in the skin at the corners of your mouth. You can make them go away and stay away by taking in more riboflavin (vitamin B2). 

There’s a “cold sore” right on and above your upper lip. Lots of tiny blisters on an angry red base. Looks painful. And you say it keeps coming back. The dermatologist said it was likely viral, maybe herpes? For now and as long as necessary, cutting back on dietary sources of arginine—chocolate, nuts, seeds, beans—will cut down on recurrences. But, you’re right, those are excellent sources of many other nutrients, so another way of doing the same job is to supplement extra lysine. That’s because it’s the ratio of arginine to lysine that’s important, not the absolute amount of either one. More arginine and less lysine can mean more herpes breakouts—more lysine and less arginine can equal less breakouts.

Other nutrients, such as selenium, low-dose lithium, vitamin C, and flavonoids, can also inhibit the herpes virus. I usually recommend all of these together with lysine in formulas called HPX and HPX2 by BioTech Pharmacal. Many people tell me that ointment containing glycyrrhetinic acid from licorice helps relieve pain from herpes sores and makes them go away more rapidly.

But as with any other recurrent infection, an immune system weakened by sugar, refined carbohydrates, and allergies allows more recurrences, whether it’s herpes, an ear infection, or nearly any other type of infection.

Love the skin you’re in

Let’s take a look at your facial skin. That acne that keeps coming back is probably due to food allergies. Try avoiding some of the more common allergens—dairy products, citrus, corn, wheat, chocolate, soy, and peanuts. If that helps, you should have a complete food allergy test done and pay close attention to the results.

If you’re a teenager with acne, eliminating it is possible but a bit more difficult. You’ll need to absolutely avoid all sugar and refined carbohydrates. (Sorry, but teenage acne rarely clears up completely without this step.) Sometimes food allergies need to be identified and avoided too. Add in foods containing zinc and essential fatty acids. Unroasted sunflower seeds and pumpkinseeds are good for both, and most meats are high in zinc. Often supplements are needed until the acne is controlled. Take 50 to 60 milligrams of zinc daily (balanced with 2 to 4 milligrams of copper) and a tablespoon of flaxseed oil daily. (Remember to take vitamin E as “mixed tocopherols” whenever you take extra essential fatty acids.) For boys in particular, 200 to 500 micrograms of supplemental selenium each day can also be helpful.

Topical 4 percent niacinamide and 10 percent vitamin C creams and ointments can be very helpful too. You’ll probably need a prescription and will have to work with a compounding pharmacist for those. Topical azaleic acid (a naturally occurring fatty acid), pantothenic acid, and tea-tree oil are all good for acne as well.

Remember those dilated capillaries alongside your nose and in your cheeks? If you have those plus a dull-to-bright redness in your cheeks and/or forehead, along with acne-like bumps, you’ve probably been told you have rosacea (also called acne rosacea). Rosacea is very often associated with low stomach acid, so please get a gastric analysis done. If you do have low stomach acid, you can often reduce or even eliminate the rosacea just by taking replacement hydrochloric acid with pepsin along with vitamin B12 and B-complex injections. 

Recent research has linked a high percentage of rosacea cases with a bacterial stomach infection called Helicobacter pylori (or H. pylori). H. pylori causes low stomach acid. (Notice a pattern here?) If you have rosacea, you should also get tested for H. pylori. If the test is positive, you should be aware that there are several effective natural remedies to clear it up. (See the March 2005 issue of Nutrition & Healing: Kerry Bone did an article on natural remedies for Helicobacter that appears on page 7.)

Hmm…you’re over 60 years old. Have you noticed that your facial skin has more yellow than pink tones? You could be deficient in vitamin B12. The new “liposomal” oral form of vitamin B12 absorbs the best, but you could need B12 injections. If you notice pinker skin within a few weeks, it could indicate that your stomach isn’t absorbing vitamin B12 from food very well and that you should get a gastric analysis.

Now look at the skin on the front of your neck. If you’re over 40 and have one or more little “skin tags,” check to see if they’re also under your arms and in your groin. Skin tags are related to a virus, but in the large majority of instances they’re also an indication of insulin resistance and potential Type II diabetes. Have an insulin resistance-glucose tolerance test done. If you also have family members with Type II diabetes, get the test done very soon and be sure to have it interpreted by a physician skilled and knowledgeable in nutritional medicine.

Stick your neck out

Those swollen glands in this child’s neck can develop when she’s coming down with a cold or the flu, but sometimes the glands seem to be swollen for no reason. Very rarely it could be something more serious, but it’s almost always an indication of food allergies. Again. (Oh yes, this can happen in adults too, but much less often.)

Moving around to the back of the neck, press firmly, but not too hard, on each of your vertebral spines, those little “bony bumps” stacked up in the middle of your neck. If you haven’t had any injuries lately, but you find that some of the vertebral spines are more tender than the others, your neck is likely out of alignment. Your best solution is to check with your chiropractor or osteopath to see if you need an adjustment.

Now keep your shoulders still and rotate your head as far as possible in both directions. If you can’t rotate as far to one side as you can to the other, you have a misalignment in your neck vertebrae that probably needs an adjustment too.

Arm yourself against bursitis, psoriasis, and more

While we’re looking at your shoulders, try pressing firmly right at the “point” of your shoulder. Tender? You probably have bursitis, especially if it hurts there even when it’s not pressed, and you’re having trouble raising your arm past shoulder level. A series of daily vitamin B12 injections (or sometimes “liposomal”  B12 orally) will almost always take bursitis away, but you should also have a gastric analysis done. Stomach testing nearly always discloses low stomach acid in individuals with bursitis.

Now down from the shoulder to the skin of the back of this teenager’s upper arms. If his or her skin is rough and bumpy, more vitamin A will usually “smooth it out” in a few weeks to months. Beta-carotene-containing foods—like carrots, squash, sweet potatoes, and yams—will do the job, but at other times, actual vitamin A, from 30,000 to 50,000 IU daily, is needed until the skin is improved. Sometimes sources of essential fatty acids and B vitamins are needed too. Try unroasted nuts and seeds.

If an older person has this condition (which isn’t as common), a thyroid function test and pancreatic enzymes after meals may be needed. Thyroid helps transform beta-carotene into actual vitamin A, and the pancreatic enzymes help fat-soluble nutrients (including vitamin A, beta-carotene and other carotenoids, and essential fatty acids) absorb better.

Now check your elbows for two things. If the skin is dry and flaky, once again you need more essential fatty acids. Do the same as you would for lifeless hair, which we talked about earlier, until the dryness and flakiness are gone. But if you notice silvery scales on red, raised patches of skin, you probably have psoriasis. Look for the same signs on your knees, your scalp, your tailbone, and, for that matter, anyplace else on your body.

If you do have psoriasis, it’s best to eliminate all alcohol, sugar, and refined carbohydrates. (Bet you’ve heard that suggestion before...) The active form of vitamin D3 in a topical form can also be very helpful, although it can be expensive if you need a lot of it (and you’ll need a prescription). Nickel and bromide in small doses can sometimes eliminate or lessen psoriasis. (Try Psorizide Forte, a homeopathic preparation.) Fumaric acid esters (natural metabolites) can be helpful too, but work with a physician with these since they occasionally cause low blood sugar levels. Eliminating food allergies can help from a little to a lot, depending on the person and the severity of the psoriasis.

Have you noticed a persistently tender spot at the side of your elbow where the muscles and tendons of your forearm attach? You’ve probably been suspecting that it’s “tennis elbow,” and you may have been told to take some pain relievers and “just rest it.” But frequently you can help it heal a lot faster by rubbing in a combination of liquid vitamin E (mixed tocopherols) and DMSO (with added minerals) several times daily.

You’re a middle-aged woman and you’ve noticed you have much less hair on your forearms than you once did. You probably have less hair on your legs too. Get your DHEA levels checked because they’re likely low. If they’re especially low, your underarm and pubic hair may be thinning out too. (This doesn’t apply to men since testosterone hides this sign of low DHEA.) Consider using enough DHEA to at least achieve levels common between ages 30 and 40. For women, that’s usually between 10 and 15 milligrams per day. Your immune system will function better, and you’ll lower your risks for several types of cancer.

You’re having pain and numbness from the underside of one or both wrists that travel into the palm of your hand and maybe even into your fingers? Try bending your wrist forward and compressing it firmly from behind. Hold it for two or three minutes. If that brings on or aggravates the pain and/or numbness, you likely have carpal tunnel syndrome. Start taking 100 milligrams of vitamin B6 three times daily. (The “pyridoxal-5-phosphate,” or P5P, form of vitamin B6 works the best.) Try it for several weeks before you decide to schedule surgery. Also before you opt for surgery, try rubbing liquid vitamin B12 mixed with DMSO into the underside of the injured wrist several times daily. To do this, you’ll likely need a prescription for injectable B12.

A helping hand

Time to look at your hands. Let’s start with your fingernails. Your nails look like they bend and break easily. Do they chip, peel, or layer back? It’s almost always caused by a weak stomach (again), not making enough hydrochloric acid, pepsin, or vitamin B12 absorption factor (“intrinsic factor”) to digest a wide variety of nutrients, so that a woman’s fingernails “just can’t grow right.” (Oddly enough, men with weak stomach function rarely have weak fingernails.)

Weak nails can also mean a weak thyroid, insufficient essential fatty acids, or very poor calcium intake. Supplementing with biotin can some-times strengthen nails dramatically.
I see you also have a few scattered white spots on your nails. These usually appear in middle school students, but often in high school students too. Adults can get them but rarely do. Zinc is always the answer to this problem—even if blood, hair, or urine levels are said to be “normal.” Usually 30 to 60 milligrams daily are needed until the white spots are gone.

Adults with white spots on their nails need zinc too, but also should try eliminating grains until your nails completely grow out, as “phytates” in grains can interfere with zinc absorption.

See the little cracks and splits in the skin on the tips and sides of your fingers? Zinc (along with essential fatty acids) will work for this too. Remember those nuts and seeds!

One of your finger joints get “stuck” and won’t move without quite an effort? Then it moves quite suddenly? That’s called “trigger finger.” Years ago, Dr. John Ellis (who also described the role of vitamin B6 in the relief of carpal tunnel syndrome) found that taking the same amount of vitamin B6 (100 milligrams, three times a day) for several months almost always eliminates this condition.

Persistent pain at the base of one or both thumbs? A series of daily vitamin B12 injections will sometimes take it away. But remember, when B12 injections are effective—get that gastric analysis done!

How the smallest details can make a big difference in your health

So far in our nutritionally oriented physical exam, we’ve covered everything from the top of your head down to the tips of your fingers. Now let’s talk about how to deal with the painful condition of arthritis.

Before you rely on supplements to relieve or control the pain, try eliminating all of the nightshade vegetables—tomatoes, potatoes, Bell peppers of all colors, eggplant, and (if you haven’t quit already), tobacco. There’s no test for nightshade sensitivity, so the only way to tell if they’re contributing to your problem is to eliminate all of these foods for several months and observe whether it helps you or not. (If you want more details, go to www.noarthritis.com.)

If eliminating nightshades doesn’t help, there are a few other things you can try. First, there’s glucosamine, which has been found to help repair and regrow degenerating joint cartilage. Try 500 milligrams three times daily. Make sure to give glucosamine at least three to four weeks to start relieving pain, and three to four months before you decide for sure whether or not it’s helpful enough to continue.

In the 1940s, Dr. William Kaufman demonstrated that niacinamide could completely control degenerative arthritis pain and stiffness, and it still works over 60 years later. Try 500 to 1,000 milligrams three times daily. (Dr. Kaufman found it worked much better when spread throughout the day.) As with glucosamine, you won’t notice any difference for three to four weeks, and your improvement will plateau at three or four months. After you’ve been using niacinamide for several months to a year, your joint mobility should be noticeably improved, even in joints that haven’t moved much at all for years.

Unfortunately, if you quit, the pain and stiffness will return again, starting after a few weeks.

Although it’s unusual, some people get nauseated from taking this much niacinamide. If that happens, stop for a few days and resume at half the amount.

Natural ways to tackle pain from the “other” arthritis

But I see that you have another sort of arthritis problem, with noticeable swelling in the joints where the fingers join the palms and some swelling in the wrists too. This is usually a sign of a different sort of arthritis—the rheumatoid kind. If you haven’t had a blood test for it, please get one done. If it’s positive, check for food allergies right away. Food allergies don’t cause rheumatoid arthritis, but they always aggravate it, and eliminating the foods you’re allergic to will help reduce your pain and swelling even though it won’t eliminate it entirely.

You can also help reduce inflammation by taking a tablespoon of omega-3 essential fatty acids twice daily. I’d recommend that old standby, cod liver oil. And work as much ginger into your diet as you can. No one knows how, but it helps reduce swelling and inflammation in rheumatoid arthritis. Unless you’re a championship ginger eater, it’ll help to add ginger capsules, too. They can’t hurt unless you’re allergic to them, so use up to 10 to 12 daily (spread out of course). Most people who try the ginger are pleased with the results.

And here we are again: Get your stomach acid checked! Several European studies demonstrated that just taking replacement stomach acid and pepsin significantly reduced rheumatoid swelling and inflammation.

Remember the “old wives tale” about copper bracelets for rheumatoid arthritis? Well, there’s actually a double-blind, placebo-controlled study done in Australia that found them significantly effective. Copper supplements and zinc also help. 

Some of the people I work with have observed improvement in rheumatoid arthritis with relatively high doses of buffered vitamin C (not the acidic form) and vitamin K3. (Buffered vitamin C combined with vitamin K3 is available as ProsStay through the Tahoma Clinic Dispensary and Life Enhancement Inc. 800-543-3873, www.life-enhancement.com).

I’ve seen cases of both rheumatoid and osteoarthritis (degenerative arthritis) improve with the use of cetylmyristoleic acid (CMO). Osteoarthritis has frequently gone away completely. The rheumatoid type gets better but usually doesn’t disappear altogether. I like the “original” Myrisitin CMO formula put together by its discoverer, Harry Diehl. (If you want the full story, look at the August 1996 issue of Nutrition & Healing.) 

The essential fatty acid found in the green-lipped mussel, eicosatetraenoic acid (ETA), has also been helpful for both types of arthritis. It’s sold under the names “Lyprinol” and “Lyprinex,” which are both available in many natural food stores.

With so many helpful approaches to relieving the swelling and pain of rheumatoid arthritis, I’ll bet you can guess that none of them are absolutely curative. But it’s worth trying to find the combination that’s right for you.

Keep your hands in working order

Ever heard of Dr. John Ellis? He’s the Texas physician who discovered that vitamin B6 can eliminate carpal tunnel syndrome, trigger finger, and other hand conditions.

Look at the backs of your hands. Have you noticed that they’re a bit puffy and swollen and that you can’t see the tendons? Try holding your hands upright, keeping the joints joining your palms and fingers perfectly straight. Now try and bending the middle and end joints so that your fingertips touch your palms. Can’t do it? That’s a positive “Ellis sign,” and it means you need extra vitamin B6. Try 100 milligrams three times daily for up to six months—until all the puffiness is gone, you can see your tendons, the “Ellis sign” is gone, and your hands are much more flexible. If you’re interested, you can try to find an old copy of Dr. Ellis’ book The Doctor Who Looked at Hands at the library or on the Internet.

That thickening right along one of the tendons in the palm of your hand is likely a condition called Dupuytren’s contracture. If you treat it early, it won’t get bad enough that it pulls the finger over and requires surgery to make it functional again. Lots of vitamin E (mixed tocopherols, of course, maybe 800 IU daily) can help, but squeezing the liquid out of the vitamin E capsules and rubbing it directly into the thickened tissue at least twice a day with a little DMSO is much more helpful. At a different time of day, rub in potassium iodide, along with DMSO again. Twice a day is even better. No, there’s not an iodine deficiency here, but it works because it’s an “anti-fibrotic.” 

PABA is another “anti-fibrotic” that works against Dupuytren’s contracture and other fibrotic conditions, but you usually need to take 2 grams, three times daily, for up to a year. If you use much more, you could possibly get a fever, rash, and a temporarily lowered white blood cell count.

What’s this? A few small, raised patches of skin on the back of your hands? They’re dry, rough, and look like they have small yellowish-brownish scales. Have a dermatologist check them out, but they’re likely actinic keratosis. They’ll usually go away if you use the topical eggplant extract called BEC5. (For details, see the article starting on page 1 of the December 2005 issue of Nutrition & Healing.)

Alleviate breast tenderness

Have you had your annual breast check? Your mammogram was OK, and you’ve been told that the small bumps scattered through both breasts are “just” fibrocystic breast disease? Then you need to get rid of anything containing caffeine. Yes, I know that some women can drink all the coffee they want and not have fibrocystic breast problems, but unfortunately that’s not the case for you. Women with fibrocystic breast problems are always caffeine-sensitive.

More importantly, you need a lot more iodine than others do. In 1976, I learned from Dr. John Myers that fibrocystic breast disease can always be eliminated—yes, I did say always—by applications of iodine. If you have a bad, painful case, you’ll need the original Myers treatment, described in the January 2005 issue of Nutrition & Healing. If it’s not so bad, use two drops of Lugol’s iodine daily—you’ll need a prescription for that—or two daily drops of Tri-odide by Scientific Botanicals, or take one Iodoral tablet daily. The last two are available at natural food stores, compounding pharmacies, and the Tahoma Clinic Dispensary. Let’s make sure to monitor your thyroid function while you do this. Fortunately, I’ve rarely seen a problem with these quantities.

You’ll likely notice a difference starting within a month. Continue whichever iodine preparation you’re using until the fibrocystic breast disease is gone. But remember, the worse the fibrocystic problem, the more likely you need Dr. Myers’ original method. Oh, and if you continue the iodine, you’ll likely lower your breast cancer risk too. You might want to read the May 2005 issue of Nutrition & Healing for details about that.

You say there’s a sore spot next to your breast right where your rib joins your breastbone? Is it also sore above and below that, too? This is called “costochondritis.” Sometimes vitamin B6 helps, especially for women, but more often it’s caused by a strain on this joint stemming from a misalignment in your back.

Let’s check for that. Remember how we checked the neck? Let’s check the back the same way. Just use a finger to press firmly on each of the vertebral spines, that row of bony bumps down the middle of your back. If one or more hurt when pressed, it’s time for a visit to the chiropractor to correct the misalignment. If you have back pain, it’ll likely take care of that, and it can also eliminate the misalignment that’s bringing on the strain causing your costochondritis.

Advice that will give you a leg up in taking control of your health

In the final part of your nutritionally oriented physical exam, let’s start by checking out your stomach. I’m going to gently tap on your abdomen. Listen carefully, and you’ll hear that sometimes the taps sound hollow, and sometimes they sound like dull thuds. The hollow sounds indicate gas trapped in the stomach or intestines. Yes, it’s true that you could have gas because of what you ate last night, but the location and quantity of the gas can be clues to more serious problems.

For example, if most of the gas is located in your upper abdomen in the “V” between your lower ribs, it’s in your stomach. Empty stomachs aren’t supposed to have gas in them: Gas in the gastrointestinal tract is almost always the result of microbial fermentation, which means there are germs lingering there. Since normal stomach acid kills all micro-organisms (except for Helicobacter pylori, the ulcer-causing bacteria), stomachs should be sterile. As one of my med school professors said, a sterile empty stomach is a “collapsed bag” containing no food—and no gas, either.

So, if you didn’t eat and there’s gas in your stomach, you very likely don’t have enough acid even to kill germs, much less to digest all your food properly. You guessed it: Time for that stomach acid test!

Excessive gas elsewhere in the abdomen could have several causes. It could be that your digestive enzymes are low, and you aren’t properly digesting and absorbing a variety of nutrients. (A digestive analysis test will tell us that.) If that’s the case, you should take digestive enzymes after meals. Another possibility is that you have a food allergy. You could also have lactose intolerance or gluten-gliadin sensitivity, which is similar to allergies, but not exactly the same. Or maybe it’s Candida (yeast) overgrowth or other “unfriendly” microorganisms. Nearly all of these conditions will interfere with normal digestion and assimilation to one degree or another, so it’s important to find out which condition (or combination of conditions) may be causing all of this gas.

What your legs can tell you about your diabetes risk

I noticed that you have “skin tags” just where your abdomen and legs come together. They indicate the same thing as skin tags on the neck or under the arms: a greater possibility of insulin resistance, which leads to Type II diabetes. They can even indicate that you already have a mild case of Type II diabetes. To find out for sure, you should have a glucose tolerance-insulin resistance test (GT-IRT) done.

The results can help you determine if you’re at risk for diabetes even if you’re still years away from actually “coming down” with it. And that gives you plenty of time to make sure you don’t. You might want to refer back to the July 2001 issue of Nutrition & Healing for more information on the glucose tolerance-insulin resistance test.

Moving down your leg, you may have noticed a “grating” feeling inside your knee that happens when you repeatedly flex and extend your lower leg while your kneecap is compressed. You say it even swells up occasionally? Looks like you’re beginning to develop osteoarthritis. Younger individuals with osteoarthritis have a higher incidence of Type II diabetes. To be on the safe side, you should ask your doctor more questions about other symptoms that could indicate blood sugar regulation abnormalities (such as low blood sugar levels), and get a test done if necessary.

In the meantime, there are some things you can do to alleviate the pain and even reverse the damage to your joints. Conventional doctors will tell you to just take aspirin or another pain reliever and that someday you’ll probably need knee joint replacement. 

But you can take 500 milligrams of glucosamine and 1 gram of niacinamide three times daily, plus 1 tablespoon of cod liver oil daily. That’ll stop the joint from deteriorating and will often even build new cartilage in the joint. If the joint is really bad, try inhaling Pentosan. (You can get more details about that in the April 2005 issue of Nutrition & Healing.) Pentosan can also help any other joint with degenerative arthritis.

It’s a different story when knee pain occurs in children between the ages of 10 and 15, though. Usually, it’s a condition called Osgood Schlatter’s disease, and it’s characterized by a tender swelling an inch or two below the kneecap, right over the front and top of the tibial bone. Most pediatricians will tell you that there’s nothing to do except take aspirin and wait for it to go away. But that can take a year or more, and in the meantime, the child has to sit on the sidelines and watch his classmates play at recess.

But there’s a better solution: 250 micrograms of selenium and 400 IU of vitamin E as mixed tocopherols will usually get rid of the pain in just four to six weeks. No kidding! I’m not sure why most pediatricians haven’t heard of this simple technique, but I’ve been writing about it since 1979. 

Keep your legs looking smooth

Your shins might not be discolored, but do they have excessive dry skin? I’m not surprised. Shins are among the most common locations for it. But remember: When you notice dry skin, it doesn’t mean you have a deficiency in a high-priced skin cream—it means you have an essential fatty acid deficiency! As I mentioned before, flaxseed oil can help with this. 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.)

You may have also noticed that you have lost most of the hair on your lower legs and on other places on your body. For women, this is most likely caused by low DHEA and testosterone levels. You should get tested soon: DHEA is important to normal immune function, and it reduces your risk of getting cancer.

For men with little or no leg hair, check your testosterone levels first, as it’s a more powerful hair grower than DHEA. But let’s check DHEA, too, as long as we’re checking hormones.

I see two or three bruises on your legs and more elsewhere. You bruise more easily than anyone you know? You’re likely low on vitamin K, flavonoids, or both. You can boost your vitamin K levels by eating deep green vegetables. You may even want to take probiotics since more vitamin K is made by “friendly” intestinal bacteria. Boost your flavonoid levels by eating blue, red, and purple foods. But until the easy bruising goes away completely, you should also take 5 to 10 milligrams of vitamin K daily and use a supplement high in flavonoids, such as bilberry, hawthorne, or ginkgo.

Looks like you’re starting to get varicose veins on both legs. You say your mother had a really bad case? Like anything else, they do run in families, but you can get them to slow down, or sometimes even stop, with vein-strengthening, flavonoid-rich foods and flavonoid supplements —the same ones that reduce easy bruising. Also make sure you have enough fiber in your diet. Without it, too much pressure can build up in your abdomen, which may slow blood return from your legs and worsen those varicose veins.

A swell solution

Chronic swelling in your lower legs? Let’s do tests to make sure it’s not something serious, such as a weak heart, liver, or kidneys. Other less-serious possibilities include food allergies, insulin resistance, and Type II diabetes. If there doesn’t seem to be any logical cause for your swelling, you can usually reduce it with horse chestnut supplements. Try two to three capsules or tablets daily, standardized to contain 40 to 50 milligrams of escin each.

Pregnant women who have swelling in their lower legs and ankles along with high blood pressure should have a urinalysis done: It’ll probably show protein in the urine. This is a condition called preeclampsia (or pretoxemia), which can get very serious. Most doctors and obstetricians will tell you there’s no known cause or sure cure. But that’s not true: In the 1960s and 70s, Dr. Tom Brewer identified the cause as poor nutrition, especially insufficient dietary protein. He demonstrated a reduction in the toxemia from between 30 and 50 percent down to zero in the public health clinics where he practiced.

The problem can be reversed every time by switching to a high protein diet and by taking supplemental magnesium, vitamin B6, and betaine hydrochloride with pepsin (often necessary to help normalize protein digestion). If the situation is urgent, you can get a faster result by taking intravenous amino acids along with magnesium and vitamin B6.

Heel healing

I see there are thick, tough calluses on the inner sides of your heels. They’re a definite sign of insufficient vitamin A. Take 50,000 to 60,000 IU of vitamin A daily. (Betacarotene won’t do.) Yes, it’s safe for adults even in such a large amount. In two to three months the calluses should be a little smaller, and in eight to nine months, they’ll be gone. At that point, cut back to 25,000 IU daily. It’s unlikely that the calluses will come back, but if they do, raise the amount again.

If your heels dry out and crack easily, or even bleed, you need more essential fatty acids (for the dryness) and zinc (for the cracking). Take 1 tablespoon of organic flaxseed oil and 30 milligrams of zinc (picolinate is best) twice daily until the cracking and dryness are both gone. Then you can reduce the quantity of each by at least half.

You should also check the pulses on the backs of your feet. If you can’t find a pulse there, then try near and behind the inner anklebone protrusion. If you find that the pulses aren’t equal, there might be a limitation of blood flow which could need further investigation.

Put the spring back in your step

You say the bottoms of your feet are tender and that sometimes it even hurts to walk? Sounds like plantar fasciitis, which is the technical term for inflammation of a certain type of connective tissue on the bottom of the foot.

Even though it’s not caused by a deficiency of vitamin E or minerals, rubbing in vitamin E (as mixed tocopherols) with some DMSO containing multiple trace minerals at least twice daily will usually help lessen or eliminate the pain. Make sure your feet are clean when you do this, since DMSO will “carry in” any surface dirt too.

(DMSO with trace minerals rubbed in with mixed tocopherols will help lessen many other inflammations too, such as “tennis elbow” and other forms of tendonitis. DMSO with trace minerals is available at the Tahoma Clinic Dispensary. See “Resources,” page 8.)

Soreness on the ball of your foot can be an indication of gout. You should have your serum uric acid levels checked. Before trying the regular prescriptions, drink a quart or more of cherry juice concentrate. It’ll often relieve gout pain completely.

Toenail fungus relief that’s worth the wait

Your toenails are getting thick and discolored? It’s likely toenail fungus. Yes, there are over-the-counter drugs as well as prescriptions that can clear up the problem, but they can adversely affect liver function. Instead, try rubbing in oregano oil, geranium oil, or tea tree oil, all over and around the toenail. Then immediately rub in DMSO, which will “carry” the oil right through the nail and start inhibiting the fungus. It does take a while to clear up toenail fungus with this method—sometimes eight or nine months or more. It’ll even take three to four months before you start seeing any results. But most of the drugs take that long too, and this is a much safer alternative.

Oregano oil is too strong for some people, especially blonds and redheads. If you start getting persistently red and irritated, quit until the reaction goes away and then switch to one of the other oils.

I’m glad you stuck in there for the entire physical exam. Like I said earlier—it may seem lengthy, but this is the kind of attention you deserve and that you should be getting from your own doctor.

The best way to stay healthy is to stay informed. Recognizing these signs and symptoms right away will keep you in charge of your own health and well being. But of course, if you think you see an indication of a more serious problem, contact your physician immediately.

Healthier News L.L.C. Copyright 2006. All rights reserved.

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The products mentioned in this article are available through compounding pharmacies, natural food stores, and the Tahoma Clinic Dispensary.

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