Many of us dismiss the little physical annoyances we live with daily — dark under-eye circles, peeling fingernails, perpetual bloating. We think of them as mere idiosyncrasies (“Oh, that’s just me . . . ”) or as the inevitable signs of aging. But what if these signs are the body’s way of letting us know something is amiss?
Although irregularities like brittle fingernails and skin discoloration aren’t necessarily harbingers of serious disease, they can clue you in to underlying imbalances that may eventually contribute to chronic conditions like type 2 diabetes, heart disease, Alzheimer’s, and cancer.
“If people self-monitor and pay attention to their symptoms, it can open them up to subtle underlying health shifts,” says Portland, Ore.–based naturopath Mary Fry, ND, who teaches integrative nutrition at the Maryland University of Integrative Health.
If you tend to ignore your body’s signals, you’re not alone. Today, time-pressed doctors are more likely to send us off for a screening — perhaps a mammogram, colonoscopy, MRI, or CT scan — than perform a simple, routine physical exam of our skin, eyes, mouth, hands, and feet. And if medical professionals don’t show much interest in the signs and signals coming from our physical bodies, then why should we?
“I joke, but I only half joke, that if you come to one of our hospitals missing a limb, no one will believe you till they get a CAT scan, MRI, or orthopedic consult,” Stanford School of Medicine professor Abraham Verghese, MD, said a few years ago in his popular TED talk. “When we shortcut the physical exam . . . we overlook simple diagnoses that can be diagnosed at a treatable, early stage.”
Meanwhile, technological wizardry is significantly more costly — in money, time, and emotional stress — than simply studying your own fingernails. And even an MRI can’t observe symptoms in context.
“I think the power of the physical exam is that you begin to see the patterns and the points of connection,” explains P. Michael Stone, MD, MS, a family physician who practices functional medicine in Ashland, Ore., and is a faculty member at the Institute for Functional Medicine.
And a doctor is not always required. All of us are well equipped to examine our own bodies’ signs, especially once we start taking the time to study them more carefully.
To learn how to start reading the signs of imbalance, we asked several progressive health providers to describe eight common telltale physical symptoms they look for during an exam, as well as what these might indicate about underlying health.
The symptoms profiled on the following pages will help you observe your body’s signals with more insight. While each one can indicate a variety of underlying conditions, they all serve as useful starting points for checking in on baseline health. Use them to decide if it’s time to make a change in your diet or lifestyle — or time to make an appointment with your healthcare provider for further support.
Symptom: Smooth Tongue
Possible causes: B-vitamin deficiency and possible gastrointestinal (GI) issues
While a smooth red tongue might seem normal, it can indicate an inflammatory condition called glossitis. When the tongue is so smooth that you can’t see your taste buds, Stone says, “that’s classically associated with a B12 deficiency. But other nutrients, including some of the other B vitamins, as well as zinc, can play a role, too.”
What you can do: In addition to adding a good multivitamin to your diet (which is essential for every condition mentioned here), eat more whole foods rich in B vitamins and zinc, like grassfed beef, oysters, and organ meats, and look for high-quality B and zinc supplements. Know that B12 deficiency can contribute to a host of health issues, including depression. (For more on this, see “All About B Vitamins“.)
Also be on the lookout for GI issues related to nutrient absorption like low stomach acid, says Fry. Bloating, belching, or burning sensations immediately after meals are signs of low stomach acid, which can also lead to protein deficiency.
“Often there are absorption issues at play with GI issues, and some nutrient deficiencies might be showing up on the tongue,” Fry explains. She routinely examines the tongues of patients she treats for GI complaints, because symptoms like glossitis often clear up as people start to absorb more nutrients.
Symptom: Decreased Sense of Taste
Possible cause: Zinc deficiency
A slight decline in the sense of taste (known as hypogeusia) is common in people over 60 and can be associated with a variety of conditions, but one of the most prevalent is a zinc deficiency, says Bette Bischoff, MD, RD, a functional-medicine doctor in Tulsa, Okla.
A decreased sense of taste might not seem like a big deal, but many experts say it can lead to diminished appetite, poor nutrition — some people might pile on the sugar and salt to make their food taste better — and even depression. (For more on zinc deficiency, see “The Many Faces of Zinc”.)
While some practitioners use a zinc taste test to diagnose deficiency (if you can’t taste the bitterness in a zinc-water solution, you are deficient), Fry notes this is not as accurate as a blood test. Initially, she prefers to look directly at the body for signs of insufficient zinc: Peeling fingernails, white spots on fingernails, and hair loss are all symptomatic of inadequate zinc intake or absorption.
What you can do: Eat zinc-rich foods like oysters, grassfed beef, nuts, and lentils (add lemon or lime to increase absorption), and take a high-quality zinc supplement — ideally no more than 40 mg a day of a complex that contains zinc gluconate, zinc amino acid chelate, and zinc citrate.
It’s also a good idea to consult a functional-medicine nutritionist because your zinc levels must be in balance with your copper levels, says Bischoff.
“Zinc and copper actually compete with each other for absorption,” she says. “So, you might have someone who has decreased zinc levels because they have such high copper levels.”
Symptom: Bad Breath
Possible cause: Gut dysbiosis
Most people try to combat bad breath by zealously brushing their teeth and gargling with mouthwash, but these tactics tend to mask an underlying problem. Chronic bad breath is often a sign of gut dysbiosis, a microbial imbalance in the digestive tract that is frequently the result of food intolerances. “This kind of bad breath doesn’t go away if you chew gum because it’s coming from an -internal place — not something you just ate,” Fry says.
The mouth has a robust micro-biome with a host of enzymes that aid digestion, adds Robynne Chutkan, MD, a gastroenterologist who practices functional medicine and is the author of the recent book The Microbiome Solution: A Radical New Way to Heal Your Body from the Inside Out. When people take too many antibiotics or consume too much sugar, it throws off the bacteria in the mouth, as well as the gut, leading to bad breath and cavities.
What you can do: The first step is to adopt a healthier diet that favors good digestion and gut function. (For more on addressing dysbiosis, go to “How to Heal a Leaky Gut“.)
If you have chronically bad breath, it’s wise to visit a functional-medicine practitioner who can get to the root of your condition, whether it’s dysbiosis or another internal issue, like sinusitis.
At the same time, show respect for your mouth’s ecosystem, says Chutkan. Stay away from antibacterial and alcohol-based mouthwashes that destroy your mouth’s good flora and can throw off your body’s overall microbial balance.
Symptom: Dark Under-Eye Circles
Possible cause: Food allergies
Fatigue is the most obvious culprit for dark circles, but if you’re well rested and don’t have a cold or sinus infection, they could indicate a range of other issues, including food allergies. Sometimes called “allergic shiners,” dark under-eye circles may appear when nasal and sinus congestion causes blood to pool under the eyes, where the skin is the thinnest.
What you can do: If you suspect food sensitivities, you can try an elimination diet or allergy testing to smoke out the culprits, says Fry. (For details on elimination diets, see “The Institute for Functional Medicine’s Elimination Diet Comprehensive Guide and Food Plan“.)
Fry adds that it’s important to read any symptom, including dark under-eye circles, within the context of your overall health and other symptoms.
“If, for example, someone reported that she had symptoms of irritable bowel, and then had a period of stress, and then she started getting dark circles under her eyes, I would be thinking food allergy,” Fry explains.
Alternately, if the patient had no history of GI symptoms, Fry might look to other causes, like an allergy to something in her environment.
Symptom: Thinning Hair (primarily in women)
Possible cause: Inadequate protein or protein absorption
Heredity is the most common cause for hair loss in people of both genders, usually with a receding hairline for men and overall thinning for women. But if your hair starts to fall out at an alarming rate and it doesn’t correspond to a family pattern, most functional-medicine providers will check your protein levels.
“Protein is emphasized pretty heavily in a Western diet, but some people exist on carbohydrates all day long,” says Bischoff.
Protein absorption is also key, she adds, noting that 40 percent of people over 60 do not have enough hydrochloric acid (HCl) in their stomachs to properly digest protein. She also points out that the millions of people who are on proton-pump inhibitors (PPIs), a class of drugs used to treat gastroesophageal reflux disease (GERD), will have trouble digesting protein because PPIs decrease gastric-acid production. (For more on this, see “Digestive Enzymes“.)
Thinning hair can also be associated with thyroid dysfunction and hormonal imbalance, say Bischoff and Stone, as well as deficiencies in vitamins and minerals such as zinc.
What you can do: The preferred marker for protein status is the amount of prealbumin protein in your blood, which can be measured easily by a doctor, says Bischoff. Meanwhile, if you know your diet relies heavily on carbohydrates, work to incorporate protein at every meal. If you’re concerned about absorption, take a tablespoon of raw apple-cider vinegar about 20 minutes before meals; it can temporarily elevate stomach acid. HCl supplements are another option; they’re available at most natural grocery stores.
To support thyroid health, Bischoff suggests having your levels of iodine, vitamin A, and selenium checked by a doctor.
Again, both Bischoff and Stone stress that any symptom must be read in context. For example, says Stone, if you have thinning hair along with an unhealthy waist-to-hip ratio and skin tags on the neck and armpits, it might signal insulin resistance.
And if you have acne along with cracks in the corners of your mouth, thinning hair might be associated with low levels of zinc, one of the most common minerals associated with hair loss and thinning.
These are all fairly serious health issues, so if you notice significant hair loss, it’s a good idea to visit your healthcare provider for an assessment.
Possible cause: Yeast overgrowth on the scalp
Scrubbing your way out of a head full of dandruff may make matters worse. Those pesky white flakes often signal a form of microbial imbalance right on the scalp, says Chutkan. When you use a harsh shampoo or cleanser, it can strip away a lot of the healthy oils and lead to the colonization of unhealthy bacteria.
“Certain healthy bacteria are lipid-loving — they love fats — so when you remove the sebum and strip away a lot of the fat, those bacteria disappear and a lot of yeast species are allowed to grow,” Chutkan explains. This might not seem serious, but any colonization of pathogenic bacteria in the body is a sign of a weakened immune system, our baseline defense against all disease.
What you can do: Start by ditching the toxic antidandruff hair products and allow your scalp to regain its natural oil balance.
“You probably have a bottle of shampoo with 18 ingredients that you can’t pronounce,” says Chutkan. When Chutkan’s own scalp feels dry, she applies a little diluted apple-cider vinegar, which is an effective natural fungicide.
If you find your dandruff persists unabated, speak to a health professional about being tested for systemic yeast overgrowth, also known as candida. (Learn more about this condition at “Kicking Candida“.)
Symptom: White Spots on Fingernails
Possible cause: Zinc or selenium deficiency
If you have white spots on only one fingernail, you may have injured the base of the nail weeks earlier. But a scattering of white dots on the nail beds (leukonychia) is another classic sign of zinc deficiency, says Stone, as well as low levels of selenium. “So, again, you have to put the symptom in the company it keeps,” he notes.
Zinc deficiency has been connected to poor wound healing, depression, and weak immunity, among other things. Selenium deficiency can make us more vulnerable to oxidative stress.
What you can do: If you have several spots on your fingernails or toenails and suspect a deficiency, Stone suggests eating more zinc-rich foods (like eggs, grassfed beef, and oysters) and taking supplements.
Lentils are a good plant-based source of zinc, he notes, but be sure to add lemon or lime to increase the absorption of the mineral. “Without this, the zinc in lentils is only about 8 percent bioavailable,” he says.
Foods rich in selenium include Brazil nuts and oysters.
Symptom: Brittle, Peeling Nails
Possible cause: General nutrient deficiency, including insufficient fatty acids
Thin, flaking nails are relatively common, according to Bischoff, and might indicate a deficiency of any number of nutrients — iron, protein, essential fatty acids, zinc, calcium, iodine, and vitamins A, C, B6, and B7.
“A lot of times, thin, peeling nails are just a sign that someone needs to have better nutritional support overall,” she says.
What you can do: Eat a wide variety of whole foods and take a high-quality multivitamin and mineral supplement, along with a quality fish-oil capsule for omega-3 fatty acids. While it would be ideal to get all our nutrients from food, says Bischoff, soil depletion means that crops today often have fewer vitamins and minerals than crops grown decades ago. A good supplement helps close that gap.
Peeling nails, a little dandruff, or dark under-eye circles might not seem like a big deal, but taken together, these indicators can tell us a lot. A key point to remember, says Bischoff, is that the mere absence of disease doesn’t mean we’re in the best possible state of health.
“We don’t really address insufficiency in our culture,” says Bischoff. “So we’re not really focused on how to maintain optimal health.” Still, when we pay attention to what our bodies are trying to tell us, we can prevent small imbalances from becoming bigger ones. “Every body has a story,” says Stone.
And yours will reward you for listening.