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Lesions That Shouldn't Be There Are Signifricant As Are Things That Should Be There

Written by Adele Huls

Lesions That Shouldn't Be There Are Significant As Are Things That Are Missing Part 3

During the examination you are looking for and noting things that shouldn't be there as well as for things that are there. For example, a Goiter.(can be caused by iodine deficiency but may be caused by thyroiditis or other non-nutritional conditions).

A person may present with multiple ecchymoses (can be caused by Vitamin K or C deficiencies or PEM) or corneal and scleral vascularization (often a riboflavin or multiple B vitamin deficiency).

Or, there may be lesions that shouldn't be there that may affect food intakes. Unfortunately an example I often see is poor oral hygiene that has led to inflammed gums and soreness affecting one’s ability to chew. I have observed Mandibularis Tori, bony growths behind the mandible on the lower jaw. that affect ability to eat with ease. The same client has Torus (singular of tori) on her upper hard palate (Palatinus Torus). Tori make eating difficult. The mouth is basically “full” of these bony growths leaving little room for food in the mouth. The client has had them removed but they regrew. It is a hereditary condition. Her granddaughter, who is in her mid twenties also has Tori..

Also observe for things that are missing that should be there: a 15 y.o. male once presented with "gobs" of hair that were missing and what was there was very easily pluckable. Otherwise, he was a picture of health. Hair loss took place rather quickly and before the school year was over he was completely bald and is to this day. Tests were run as he was losing hair and his alopecia was not nutrition related. Sometimes it can be due to a zinc or biotin deficiency, due to hyper or hypothyroidism, due to the parathyroid gland not working properly, or due to B12 deficiency. I checked them all. Drs. never did find an answer other than that it was an autoimmune response.

As mentioned earlier, pale nails that are not blanchable are common in people with a microcytic anemia (low Hgb & Hct with a high RDW and low MCV) identified as Fe++ deficiency but also can be seen in cases of macrocytic anemia (low Hgb & Hct with a high RDW and high MCV) with either a folate or Vitamin B12 deficiency.
The high RDW coupled with low Hgb & Hct is a clue that the anemia is most likely nutrition related. When the anemia is macrocytic is is very important to determine if it is a folate or Vitamin B12 deficiency or both so it can be properly treated. (There are other possibilities but they are not as common.) Treating with folate if the deficiency is, in fact, a Vitamin B12 deficiency can cause neurological damage. Wrongful folate treatment of a Vitamin B12 deficiency can cause the B12 deficiency to be masked and therefore unlikely to be treated. Left untreated the neurological damage could then progress.

Clients may present with little affect and pallor. Always further check to see what symptoms the person has. A similar situation once led me to discover the person had unintentionally lost a significant amount of weight due in part to hypogeusia (for past 8 years) and poor intakes. The client was found to have a zinc deficiency which caused the hypogeusia. She could not “taste” food and had lost interest in eating, thus her poor intakes and weight loss. The Zinc deficiency was treated.

Bottom Line: What's there and what is missing, should it be there? To help you in this determination and hone your skills our web site will help. If you would like to speed up your skills acquisition in this area do consider hosting a workshop in your area or attending one sponsored by another group. Our Guidebook and DVDs once completed will also help. There are other good resources out there also like a good medical dictionary with pictures of lesions. To get started, Just Do It! Start inspecting for lesions and studying the details of a nutrition-focused physical exam.