Advanced Naturopathic Case Taking: Naturopathic Evaluation Tools: Nails Flashcards
Nail structure:
Nails can reflect the systemic and local medical history, as well as general lifestyle over the previous four–six months. Young children have a fast growth rate of about three months.
* Nail function is formed of three main structures:
1. The nail plate —a keratinised structure which continues to grow throughout life.
2. The nail bed —this is the vascular bed that is responsible for nail growth and support.
3. The cuticle —the epidermal layer between the proximal nail fold and the nail plate.
Tissue Salts
Tissue salts (TS): Homeopathic remedies based on minerals.
* Organs and parts of the body are made of specific minerals or ratios of different minerals.
* These minerals play a vital role in the physical integrity and proper functioning of the organism.
Tissue Salts: Schuessler
- Schuessler, a German homeopath, developed 12 minerals in a homeopathic form and called them tissue salts. Each tissue salt acts on specific tissues, stimulating them to heal.
Tissue Salts: Dosage
- Dosage: Adult: 1-2
- Children: ½ -1
- Infant: 1/4-1/2.
- Chew, dissolve, crush accordingly.
- Acute: every 15-30 minutes until symptoms subside.
- Chronic or maintenance dose: 4-6 times per day.
- Take as long as they work. Stop taking them when the symptom disappears. Also stop after two weeks if no improvement at all
White nails:
- Can be caused by anaemia, oedema, or vascular conditions.
- Apply gentle pressure to the nail bed and release. If it takes more than two seconds for the redness to reappear, it suggests anaemia
- Consider the following possibilities if it fits with the client’s history:
o Anaemia
o Liver cirrhosis
o Renal Failure
o Chemotherapy treatment - White spots like paint are linked to calcium, zinc or silica deficiency / insufficiency.
- TS: Calc phos.
Lunula:
- If the lunula is absent on the thumbs, anaemia or malabsorption should be investigated.
- A pyramidal lunula might indicate an excessive manicure or trauma
- Apyramidal lunula might indicate an excessive manicure or trauma
- A red lunula may suggest cardiovascular disease, a connective tissue disorder or possible malignancy
Lunula= half-moon at the base of the fingernail.
Terry’s Nails:
Nails that are white, with a pink or brown band at the end.
* Can be caused by:
o Ageing.
o Liver cirrhosis.
o Chronic kidney disease.
o Congestive heart failure (also produces ear lobe crease).
o Type II diabetes.
* TS: Calc sulph. And / or Nat sulph.
Brown-grey nails:
Brown-grey nails may suggest:
* Cardiovascular disease.
* Diabetes mellitus,
* Vitamin B12 deficiency,
* Melanoma.
* Lichen planus (an immune-mediated disease affecting skin & mucous membranes)
* Topical agents (e.g. hair dyes).
Thin, brittle nails:
- These are correlated with osteopenia, thyroid disorders, severe mal-nutrition and common mineral deficiencies.
- Hand cream, manicures, nail varnish / varnish remover (acetone) can also increase nail dryness and brittleness.
- TS: Silica and/or kali sulph.
- Potential nutritional imbalances:
o Biotin: 300 mcg x five daily can improve thin brittle nails.
o Vitamin B12: Chlorella, wild salmon, grass-fed organic meat, organic eggs; supporting digestive health (e.g. stomach acid).
o Vitamin A: Eggshell nails: Delicate and curved.
Paronychia:
- Infection of the tissues adjacent to a nail —with redness / tenderness.
- Paronychia may be due to trauma, poor nutrition (e.g. low vitamin C), low immunity and poor hygiene.
- Supplement vitamin C / increase; vitamin C rich foods.
- TS: Silica.
Greek: para = around + onyx =nail.
Wicks (or hangnails):
- Can be due to too little protein, a lack of B vitamins and vitamin C.
- Dryness may indicate lowered EFA status, vitamin A and D, or hypothyroidism. It can also be caused by chemical irritants
- May indicate a need for nervous system / adrenal support
- TS: Kali phos.
Clubbing:
- A loss of the normal angle between the nail bed and fold.
- Thought that clubbing can begin before the effects of pathology are noticed.
- To assess for clubbing: Place both forefinger nails together and look between them. A small diamond space is normal (‘Schamroth’s window’); a lack of a diamond indicates clubbing (‘Schamroth’s sign)
- Causes:
- Pulmonary and cardiovascular causes (80%).
- Gastrointestinal causes (about 5%)
- Hyperthyroidism
- Idiopathic
Koilonychia:
- Spooning (i.e. concavity) of the nails.
- To assess: Place a drop of water on the nail. If the drop does not slide off = spooning.
- Causes include:
o Iron deficiency
o Raynaud’s disease
o Diabetes mellitus
o Systemic lupus erythematosus
o Protein deficiency, especially (cysteine or methionine)
o Haemochromatosis (Iron overload) - TS: Calc phos., ferphos, calc sulph. or nat sulph.
koilo-= Greek for hollow, onych-= Greek for nail.
Beau’s Lines:
- Interrupted growth at the nail matrix produces a furrow in the nail.
- Location may indicate the timing of the illness, whilst the depth may indicate the severity.
- Causes:
o Severe infection.
o Myocardial infarction.
o Severe zinc deficiency.
o Surgery and chemotherapy. - TS: Calc phos. And / or silica.
Mee’s Lines:
- White bands traversing full nail width - indicates an acute illness / trigger.
- Like Beau’s, the line location might indicate the timing.
- Causes:
o Heavy metal toxicity (i.e. arsenic)
o Chemotherapy
