Advance Naturopathic Case taking Flashcards by Kirsty Larcombe

Name the 5 naturopathic princilples

1 The healing pwer of nature
2. Treat the cause not the symptom
3. Treat the whole person
4. Prevention is preferable to cure
5. A naturopath is an educator/teacher

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What are the 5 principles of Herring’s law of cure?

From the inside out- e.g. a boil clears internal toxins away from more vital organs to the skin
2.From more important organs to less (from the lungs asthma to the skin eczema
The mind gets better before the body- anxiety starts improving before PMS does.
Symptoms disappear in reverse order to when they arrived
From above to below. Toxins disappear off the ends of the fingers or toes

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Name 5 common root causes of disease (the roots in the naturopathic tree)

Senedary lifestyle
Genetics
Nutrient deficiencies
Toxic environment
Structural damage
Adverse Childhood events

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What are the bio-chemical inflammatory mediators?

C-reactive protein (CRP)
Erythrosite sedimentaion rate (ESR)
Serum ferratin
Calprotectin

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What lifestyle factors can contribute to symptoms/disease?

Sleep, stress, excercise, nutrition, hydration, relationships

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Name the possible biochemical endochrine mediators

TSH, T4, fT4, fT3, oestrogen metabolism. progesterone, tesosterone, cortisol, DHEA and HbA1C

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Name the 7 core clinical imbalances which need to be considered when deciding which systems are under stress>

Assimilation-Digestion
Strutural integrity-cell and mucous membrane health. Joints and cartilage, bones and teeth
Communication -hormones and endocrine system and neurotransmitters

4 Defence and repair-Inflammation, immunity

Transport and circulation-Lymphatic structures, vascular structures, and mobilisation of blood lipids
Energy and mitochondrial health
Detoxification and elimination

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Name 3 signs/symptoms of an assimilation imbalance

Pallor/shortness of breath
Dysbiosis-gas and bloating
Food allergies and intolerances
Heartburn
Untable weight
Illnesses that will impede absorption (cystic fibrosis or coeliac)

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Name 3 signs/symptoms of an structural integrity imbalance

Oesteoarthritis
Join, ligament or muscle pain
Skin problems- acne, eczema, psoriasis
Leaky gut-autoimmunie conditions
Low essential fatty acids
Low vitamin D
Low bone minerals (Ca, Mg, Zn, B and P)

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Name 3 signs/symptoms of an communication imbalance

1.Reproductive issues
2. Fatigue
3. Stress
4. Low mood
5. Disturbed sleep

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Name 3 signs/symptoms of a defense and repair imbalance

Recurring infections
Fatigue
Poor wound healing
Skin issues
Autoimmune conditions
Intestinal permeability
Low vitamin D
Antioxidents status
High free radical exposure

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Name 3 signs/symptoms of a mitochondrial health imbalance

Weakness
Fatigue
CFS/ME
Parkinsons disease
MS
Poor cognitive function
Intestinal permeability

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Name 3 signs/symptoms of a transport imbalance

Circulatory issues
CVD
Raynauds
Peripheral neuropathy
Lymphatic issues (e.g. odema)

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Name 3 signs/symptoms of a detoxification and elimination imbalance

1.Constipation
2. Bloating
3. Light/dark coloured stools
4. Smelly feet
5. Oestrogen dominance
6. Dry itchy skin
7. Yellow skin
8. Nauseous after fatty foods
9. Excessive cellulite
10. Weight gain
11. Fatigue

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What 3 emotional considerations must we take into account in naturopathic case taking?

Mental health- Cognitive function and perception. Impairment may result in dementia, sensory processing disorders etc.
Emotional Health- Emotional regulation and sense of well-being.
Influenced by- coping strategies, perception of quality of life, self-esteem, having a purpose, adverse childhood experiences
Spritual Health- Does their life mirror their values? Also considers stress, resistance and relationships with friends, family and community.

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What could a red Malar flush (red discolouration of cheeks) indicate?

Yin deficiency
SLE
Rosacea (linked to H pylori)
B3 deficiency

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What could a lined forehead indicate?

Many lines-poor intestinal health
One line-Small intestine issues (decreased absorption)

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What could lines between the eyebrows be an indication of?

One line-Stomach insufficiency (e.g. HCL, pepsin)
Two lines- Liver imbalances (alcohol, suppressed anger)

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What could brown shadows under the eyes indicate?

Liver stagnation

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What could blue/black shadows under the eyes be a sign of?

Adrenal exhaustion. Kidney issues

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What could white nails be an indication of?

aneamia, odema or vascular conditons

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What could white spots on the nails indicate?

Calcium, Zinc or silica deficiency

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What may be implicated if the lanula (moon shape on the nail) is absent on the thumbs?

Malabsorbtion

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What could a pale blue lanula indicate?

Diabetes Mellitus, anaemia or peripheral neuropathy

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What could a red lanula indicate?

CV disease Connective tissue disorder Malignancy

Name 3 nutritional imbalances that could be implicated in dry brittle nails

1. Biotin 2. B12 3. Vitamin A

What pathologies are associated with dry/brittle nails

1. Oesteopenis 2. Thyroid disorders 3. Severe malnutrition

What nutritional deficiencies can cause wicks (hangnails)

Protein B vitamins Vitamin C

Name 3 possible causes of Beau's lines (a furrow in the nail caused by interrupted growth at the nail matrix)

1. Severe infection 2. Myocardial infarction 3. Severe Zinc deficiency 4. Surgery or chemotherapy

What is the cause of Mee's lines (white bands across the full nail width)

Heavy metal toxicity or chemotherapy

Name 5 possible causes of longitudinal ridges on the nails

1. Ageing 2. B vitamin deficiencies 3. Rheumatoid arthritis 4. Peripheral vascular disease 5. Lichen Planus

What could cause central ridges on the nail?

Repetitive trauma Iron, folate or protein deficiency

What could cause nail clubbing?

Pulmonary and CV disease (80%) Gastrointestinal (5%) Hyperthyroidism

Name 3 possible causes of nail spooning (Koilonychia)

1. Iron deficiency 2. Protein deficiency 3. Haemochromatosis 4. Raynaud's disease 5. Diabetes Mellitus

What are the possible causes of nail pitting?

Psorisis (random pits) Alopecia (ribbed) Eczema Lichen Planus

What are the possible causes of nail thickening?

Fungal infection Chronic eczema and psorisis periperal vascular disease Old age

What are the possible causes of nail beading?

Endochrine conditions - Diabetes mellitus Thyroid disorders Addisons B vitamin def

What causes pncholysis (the splitting of the nail from the nail bed)

Hypethyroidism Posiris and eczema trauma contact dermartis Acetone

Which organs are the back of the tongue affiliated with?

Kidneys Bladder Intestines Reproductive organs

Which organs are the centre of the tongue affiliated with?

Stomach Spleen

Which organs are the sides of the tongue affiliated with?

Gall bladder Liver

Which organs are the tip and front of the tongue affiliated with?

Heart Lungs

What could a pale tongue indicate?

Qi or Yang deficiency Excess cold Iron deficiency anaemia

What could a red tongue indicate?

Inflammation and infection A red tip (heart area) indicates underlying anxiety

What could a purple tongue indicate?

Blood stagnation Reduced Qi Poor circulation Cyanosis (low oxygen)

What could prominent red papillae indicate?

Excess heat

What could excess papillae indicate?

Often follow anti-biotic treatent. Require pro and prebiotics

What could a dry and cracked tongue be indicative of?

Dehydration

What could impaired taste signify?

Zinc deficiency

What could scalloped marks on the edges of the tongue indicate?

Weak digestion Pancreatic insufficiency

What could be implicated when a tongue is raised/upturned at the edges?

High stress

What could a tongue tremor indicate?

Spleen/Qi deficiency Excess Vata (ayurveda)-nervous energy and anxiety Magnesium deficiency

In Ayurveda, what does the mid-line of the tongue represent?

The spine

What could a medial fissue (crack down the midline) of the tongue be indicative of?

Deficiency of digestion. An under secretion of digestive juices

What could a midline fissure at the tip of the tongue indicate?

Heart problems (constitutional tendancy) Thyroid issues

What could a geographical (mapped tongue) indicate?

Yin deficiencey B vitamin depletion psorisis

What does a brown coating on the tongue indicate?

Chronic excess heat-leading to degenerative changes

What does a greasy yellow coating on the tongue indicate?

Damp heat- Inflammation and infection

What does a greasy white coating of the tongue indicate?

Damp cold-excess phlegm and mucous

What does an uncoated tongue indicate?

Yin deficiency

What coating indicates a healthy tongue

Thin, white coating

What vitamin deficiencies can dry/cracked lips indicate? What else can cause this?

B2, B3 and folate dehydration, excess heat associated with too much spicy food, sugar or alcohol

Name 3 possible causes of angular stomatitis

1. Deficiencies- Iron, B vits 2. Infections- fungal or bacterial 3. Bite issues- Causing excess drooling

What nutritional deficiencies can bleeding gums indicate?

Vitamin C Zinc CoQ10

What are the main causes of peridontal disease?

High sugar, meat and dairy Love biofalvanoids, zinc and CoQ10

What is the dominant neurotransmitter when a pupil is a. Contracted b. Dilated

a. Acetylcholine b. Adrenalin

What is indicated when a pupil is a. Contracted B. Dilated

a. Parasympathetic Dominance Inward tension, internalised, cautious,reserved, slow responses. b. Sympathetic nervous system dominance Possible adrenal exhaustion Fast responses

What nutrient deficiency can dry eyes indicate?

Vitamin A, EFAs

What nutrient deficiency can night blindness indicate?

Vitamin A and Zinc

What nutrient deficiency can pale conjunctiva indicate?

Iron

What 2 eye symptoms can be an indication of low iron?

Pale conjunctiva and blue sclerela

What nutritional deficiencies can photophobia indicate?

Vitamin B2, B3, beta carotene, vitamin A, Zinc

What nutrient deficiency can be implicated in lack of eyelashes and eyebrows

Copper

What vitamin deficiency can be implicated in dermatitis on the face?

What nutritional deficiency can be implicated in hyperpigmentation of the mouth, cheek and eye areas?

Protein

What deficiencies can inelasticity of the skin be indicative of?

Vitamin C EFAs Copper

What can hair loss indicate?

Nutrient deficiencies- Iron, protein, biotin Hypothyroidism

What nutritional deficiencies are implicated when hair is dry and brittle?

Iron, protein, EFAs

When is the best time to take a PH saliva reading?

1st test-One hour after brushing teeth 2cnd test- 30 mins before lunch 3rd test- 30 mins before evening meal

What should healthy urine look like?

Straw yellow colour

What could smelly urine indicate?

UTI, dehydration

What would pathology could be implicated if urine was very dark yellow, orange or brown

Jaundice

What is the idea hip-waist measurement in a. males b. females

a 0.95 or below b. 0.80 or below

How do you calculate waist-to-hip ratio and what can it tell you?

Waist divided by hip measurement It can indicate risk level or a heart attack, stroke, diabetes or premature death.

Describe the characteristics of an 'ideal stool'

Neither sinks or floats (but is mostly submerged) Medium brown colour No obvious undigested food remnants (with the exception of corn and seeds)

What can floating stools indicate

insufficient bile excessive intake of fats

What can sinking stools indicate?

decaying matter or unused minerals

What can thin stools be a sign of?

Tension, colon spasm as seen in IBS

What can dry stools be a sign of?

Dehydration, slow transit time, lack of fibre, hypothyroid, stress.

How would you define constipation?

Passing stools less than 3 x per week, needing to strain or passing pellet-like stools on more than 1/4 of occassions.

State 3 causes of constipation

1. A low fibre diet 2. Digestive insufficiency -mechanical- reduced peristalsis -chemical, low HCL, Bile and pancreatic enzymes 3. Dehydration 4. Sedentary lifestyle 5. Stress

What does a pale stool indicate?

Insufficient bile production

What could green stools be a sign of?

Release of toxic matter in bile

What could white mucous in the stool indicate?

Disturbance of intestinal flora Microbial infection Immune response to gluten or lactose Ulcers

What could very dark brown stools indicate?

Slow transit time in colon. Hypothyroidism.

What could an orange stool indicate?

Insufficient bile

Name 2 red flag stool signs and state what each could indicate

1. Black tarry stools- oesophageal/gastric bleed 2. Blood in stools. Darker blood is a sign of a more serious pathology. Bright red blood could be haemorrhoids