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Clinical Signs And Other Indicators Of Vitamin And Mineral Deficiencies: A Simple Test And Educational Exercise For Your Patients

There are a number of well-established clinical signs and symptoms associated with vitamin and mineral deficiencies that all health practitioners should be aware of. As well, certain nutrition and lifestyle behaviours and the use of certain medications can promote vitamin and mineral deficiencies, usually from lack of intake or accelerated depletion of specific nutrients.

Studies indicate that 91% of North Americans do not ingest the RDA levels for each vitamin and mineral on a daily basis. Further, the RDA levels for many nutrients are considered to be sub-optimal according to many anti-aging and nutrition experts, especially in regard to certain antioxidant vitamins, vitamin D and selenium. Further, many people engage in dietary and lifestyle behaviours that encourage nutrient loss from their body and/or take medications that impair absorption, or promote excretion and accelerated loss of vitamins and minerals from the body.

Considering the important role played by vitamins and minerals in the prevention of cancer, heart disease, dementia, osteoporosis, cataracts, macular degeneration and other health problems, most adult patients (unless there are contra-indications) stand to benefit from taking a high potency multiple vitamin and mineral each day that is antioxidant-enriched, contains 500 mg of elemental calcium, and a B-50 complex.

The following questionnaire is designed to help identify patients who are showing signs of vitamin and mineral deficiencies as well as those who are at increased risk for vitamin and mineral deficiencies.

Part One: Lifestyle Factors and Clinical Indicators of Vitamin and Mineral Deficiency

 

 

Question

Response

Feedback for Yes Answers

  1.  

Do you eat fewer than 5 fruit and vegetable servings per day, on average?

Yes____ No____

Insufficient intake of fruits and vegetables (less than 5 servings per day) deprives the body of many necessary nutrients including antioxidants, B-vitamins and phytonutrients

 

  1.  

Do you often experience a scaly, flaky, seborrheic condition at the outer nose margins above the lips?

Yes____ No____

Flaky seborrheic conditions on the face are associated with deficiencies in Vitamins B2, B6

  1.  

Do you have soft nails or do they chip, crack or peel easily, and/or are they brittle or contain ridges (not smooth)?

Yes____ No____

Soft nails or nails that chip, crack or peel easily, and/or are they brittle or contain ridges (not smooth) are often caused by deficiencies in calcium, and other minerals

  1.  

Are there white spots under your fingernails?

Yes____ No____

White spots under your fingernails is often a sign of zinc deficiency

  1.  

Have you noticed small red spots under your skin?

Yes____ No____

Red spots under the skin are often an indicator of vitamin C deficiency.

  1.  

Do you consume more than three alcoholic beverages per week, on average?

Yes____ No____

Consuming more than three alcoholic beverages per week, on average, is associated with depletion of the following nutrients:

  • Vitamin A
  • Beta-carotene and other carotenoids
  • Vitamin B1
  • Vitamin B2
  • Vitamin B3
  • Vitamin B6
  • Vitamin B12
  • Pantothenic Acid
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Potassium

and produces increased exposure to free radicals

  1.  

Do you drink more than two cups of coffee or caffeinated tea (of any kind) per day, on average?

Yes____ No____

Drinking more than two cups of coffee or caffeinated tea (of any kind) per day, on average depletes the body of vitamin C, many B-Vitamins, and minerals

  1.  

Are you a smoker?

Yes____ No____

Smoking cigarettes increases free radical exposure and depletes the body of antioxidants, B-vitamins and minerals

  1.  

Has your skin been damaged by sunlight and/or do you use a tanning bed more than once per month?

Yes____ No____

Damage to the skin from sunlight and tanning beds results in the production of free radicals and depletion of antioxidants that protect the skin from future ultra-violet light exposure.

  1.  

On a scale of one to five, is the daily stress level in your life three or greater, if one is a low level of stress and five is a high level of stress?

Yes____ No____

 

It appears that your stress level is at a level sufficient to create hormonal imbalances that can lead to the depletion of Vitamin C, many B-Vitamins, and minerals.

  1.  

Do you often experience cracks at the margins of your lips

Yes____ No____

Cracks at the margins of the lips is often associated with Vitamin B2 Deficiency

  1.  

Do you often experience a sore or burning tongue?

Yes____ No____

A sore or burning tongue is often caused by deficiencies in Vitamins B2, B6, B12 Deficiency

  1.  

Have you experienced a reduced ability to taste food?

Yes____ No____

A reduce ability to taste food is often caused by a zinc deficiency

  1.  

Do your gums bleed easily?

Yes____ No____

 Gums that bleed easily is often a sign of Vitamin C deficiency

  1.  

Do you bruise easily?

Yes____ No____

 Skin that bruises easily is often associated with a deficiency in Vitamin C, Calcium, and/or Vitamin K

  1.  

Are you a slow healer from bruises and cuts?

Yes____ No____

 Slow healing capabilities is often an indication of sub-optimal nutrient status of Vitamin C,

  1.  

Do you feel chronically tired?

Yes____ No____

Feeling chronically fatigued in the absence of disease is often associated with multiple vitamin and mineral deficiencies

  1.  

Do you have irregular eating patterns?

Yes____ No____

Irregular eating patterns tend to contribute to an inadequate intake of essential vitamins and minerals and often leads to at least marginal deficiencies in many vitamins and minerals.

  1.  

Are you on a weight loss or calorie restricted diet?

Yes____ No____

 Calorie restricted diets cannot provide optimal intake levels of all vitamins and minerals and thereby, contribute to marginal deficiency states of many vitamins and minerals. Individuals on calorie-restricted diets (under 2,000-25000 calories per day) are advised to derive the missing nutrients from a multiple vitamin and mineral

  1.  

Do you feel run down and/or are you experiencing a weakened state of immunity?

Yes____ No____

 Feeling run down and/or in a weakened state of immunity suggests that multiple nutrient deficiencies may be a factor. Studies reveal that supplementation with certain antioxidant vitamins, as well zinc and selenium can bolster immune function in older subjects and in those with certain types of compromised immune function

 

 

  1.  

Does your hair fall out easily, and/or is it dry and brittle and/or does it lack optimal lustre and sheen?

Yes____ No____

 Hair falling out easily, and/or dry and brittle hair and/or lacklustre hair that is dull in appearance are all associated with multiple vitamin and mineral deficiencies

 

Part Two: Drugs Causing Nutrient Depletion

Do you regularly use any of the following medications or agents? Indicate Yes or No beside each item.

 

  1.  

Laxatives

Yes

No  

Your regular use of laxatives is associated with depletion of the following nutrients :

  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Calcium
  1.  

Long term antibiotic therapy

Yes

No

Your regular use of antibiotics is associated with depletion of the following nutrients : 

  • Vitamin B1
  • Vitamin B2
  • Biotin
  • Pantothenic Acid
  • Vitamin C
  • Vitamin E
  • Vitamin K
  • Potassium
  • Magnesium
  • Zinc
  1.  

Cholesterol - lowering drugs? (any of the following)

  • Cholestyramine
  • Colestripol
  • Questran
  • Colestid
  • Atromid-S

Yes

No

Your regular use of cholesterol-lowering drugs is associated with depletion of the following nutrients : 

  • Vitamin A
  • Vitamin B12
  • Beta-carotene
  • Folic Acid
  • Vitamin D
  • Vitamin E
  • Vitamin K
  • Iron
  1.  

Anti-gout drug called Colchicine

Yes

No

Your regular use of colchicine to treat gout is associated with depletion of the following nutrients : 

  • Vitamin A
  • Vitamin D
  • Vitamin B12
  • Folic Acid
  • Iron
  1.  

Steroid hormones?

i.e., Cortisone, Prednisone

Yes

No

Your regular use of certain steroid drugs is associated with depletion of the following nutrients : 

  • Folic Acid
  • Vitamin D
  • Zinc
  • Magnesium
  • Vitamin C
  • Calcium
  1.  

Aspirins for arthritis or any other reason (or other non-steroidal anti-inflammatory drugs – i.e., Ibuprofen, Naproxen

Yes

No

Your regular use of nonsteroid anti-inflammatory drugs is associated with depletion of the following nutrients : 

  • Folic Acid
  • Vitamin C
  • Vitamin K
  •  Iron
  1.  

Antacids (i.e. Maalox, Tums, Mylanta, Rolaids, Diovol)

Yes

No

Your regular use of antacid drugs is associated with depletion of the following nutrients : 

  • Vitamin A
  • Vitamin B1
  • Folic Acid
  • Vitamin B12
  • Chromium
  • Iron
  1.  

Oral contraceptives

Yes

No

Your regular use of oral contraceptive drugs is associated with depletion of the following nutrients : 

  • Beta-carotene
  • Vitamin B1
  • Vitamin B6
  • Folic Acid
  • Vitamin B12
  • Biotin
  • Pantothenic Acid
  • Vitamin C
  • Magnesium
  • Zinc
  1.  

Sedatives / Barbiturates (i.e. phenobarbital, fiorinal, phenaphen, atropine)

Yes

No

Your regular use of sedative and/or barbiturate drugs is associated with depletion of the following nutrients : 

  • Vitamin B2
  • Vitamin C
  • Vitamin D
  • Folic Acid
  • Vitamin B12
  • Pantothenic Acid
  1.  

Estrogen Replacement

Yes

No

Your regular use of estrogen replacement therapy is associated with depletion of the following nutrients : 

  • Vitamin B1
  • Vitamin B2
  • Folic Acid
  • Vitamin B12
  • Biotin
  • Pantothenic Acid
  • Vitamin C
  • Magnesium
  • Zinc
  1.  

Caffeine (caffeinated coffee, tea, espresso etc)

Yes

No

Your regular intake of caffeine is associated with depletion of the following nutrients: 

  • Vitamin B1
  • Potassium
  • Zinc
  1.  

Smoking

Yes

No

Your regular habit of smoking is associated with depletion of the following nutrients : 

  • Vitamin B1
  • Folic Acid
  • Vitamin B12
  1.  

Antidepressants ( i.e. prozac, paxil, zoloft, celexa, amitryptyline etc)

Yes

No

Your regular use of antidepressant drugs is associated with depletion of the following nutrients : 

  • Vitamin B2
  • Vitamin B6
  • Calcium
  • Magnesium
  • Coenzyme Q10
  1.  

Amphetamines (i.e. adderall, cylert, ritalin, benedrine, dexedrine)

Yes

No

Your regular use of amphetamines is associated with depletion of the following nutrients : 

  • Vitamin B1
  1.  

Levodopa

Yes

No

Your regular use of levodopa is associated with depletion of the following nutrients : 

  • Vitamin B6
  1.  

Anti-convulsants (i.e. dilantin, celontin, zorontin, carbamazepine, phenobarbital)

Yes

No

Your regular use of anticonvulsant drugs is associated with depletion of the following nutrients : 

  • Folic Acid
  • Biotin
  • Vitamin D
  • Vitamin E
  • Zinc
  1.  

Digoxin or Digitalis

Yes

No

Your regular use of digoxin is associated with depletion of the following nutrients : 

  • Vitamin B1
  1.  

Indomethacin

Yes

No

Your regular use of indomethacin is associated with depletion of the following nutrients : 

  • Vitamin B1
  1.  

Diuretics (i.e. thiazide drugs, hydrochlorothiazide, moderet, apo-trizide, midamor)

Yes

No

Your regular use of diuretic drugs is associated with depletion of the following nutrients : 

  • Vitamin B1
  • Calcium
  • Potassium (thiazide)
  • Magnesium
  • Zinc
  1.  

High Blood Pressure, ACE-Inhibitor drugs (captopril, capoten, lotensin, vasotec, ramipril, altace, prinivil)

Yes

No

Your regular use of ACE-Inhibitor drugs for high blood pressure  is associated with depletion of the following nutrients: 

  • Zinc
  1.  

High Blood Pressure, Beta-blockers (atenolol, metoprolol, propranolol, acebutolol)

Yes

No

Your regular use of beta-blocker high blood pressure drugs is associated with depletion of Coenzyme Q10

  1.  

High Cholesterol, Statin drugs (lipitor, crestor, mevacor, zocor, lescol, pravachol)

Yes

No

Your regular use of statin drugs for high cholesterol is associated with depletion of Coenzyme Q10

I believe this questionnaire is a very useful exercise to help patients understand the adverse effects that faulty dietary patterns and lifestyle practices have on vitamin and mineral status, as well as the nutrient depletion produced by the use of many drugs.

If you are seeking a more complete Nutrition/Lifestyle/Anti-aging Assessment, then send your patients to www.naturalhealthtest.com (Natural Health Test.com), where they will find a complimentary comprehensive assessment designed by Dr. James Meschino D.C., M.S. The feedback report generated from the 173-questions that comprise the questionnaire provides patients and their healthcare practitioners with an expert opinion regarding dietary modifications, exercise parameters and nutritional supplement combinations that best suit the patient’s needs. Many practitioners now use this on-line assessment as a resource to save them time with this important aspect of patient management and patient education.

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