Digestion and Health Flashcards
What are the 3 primary functions of the digestive system?
- Digestion (mechanical and chemical)
- Absorption (mostly in small intestines)
- Excretion
List the 5 parts of the digestive tract
Mouth
Pharynx
Oesophagus
Stomach
Small & Large Intestine
List 4 accessory organs of the digestive system
Salivary glands
Pancreas
Liver
Gall bladder
Why should you chew food up to 20 times per bite? (2)
To ensure food is broken down as much as possible to aid digestion in the stomach.
The more you chew, the more amylase is released allowing better breakdown of carbohydrates.
Should you drink with your meal?
What would you recommend?
No - as this dilutes saliva and gastric juices in turn reducing the digestive potential and nutrients absorbed.
Drink 30 mins before a meal to minimise needing to drink with food. And wait 30-60 mins after eating. Take little sips if needed while eating.
What enzyme is found in saliva? Briefly describe it function.
Salivary amylase starts breaking down long carbohydrate chains (polysaccharides) found in starchy foods, into smaller sugar chains.
NB Saliva also contains IgA antibodies for immune defense.
What pH does saliva enzymes need to be at? What happens in the stomach?
Salivary amylase’s optimal pH is 6.8.
It is therefore denatured by stomach acid which is too acidic.
Describe why the pH of saliva might change and what its impact is.
NB List at least 6 causes.
Excess acidity in body tissues will be excreted via saliva, lowering it’s pH. This impairs the functionality of salivary amylase and therefore can impact digeston of carbohydrates.
Other factors that can lower the pH are:
refined sugars, meat, dairy, processed foods, chewing gum, cigarettes, coffee & alcohol, chronic stress, and being sedentary.
Describe what happens when food enters the stomach.
(Include any hormones and enzymes involved)
Food stretches the stomach, releasing the hormone gastrin, which stimulates the enteric nerves in the stomach wall.
Both stimulate peristalsis of the stomach leading to the formation and release of gastric juices contacting HCI and digestive enzymes - lipase and pepsinogen.
The stomach churns the bolus, mixing it with the gastric juice to break down the food.
Briefly describe 2 enzymes released in the stomach.
Pepsinogen - an inactive enzyme that becomes it’s active form, pepsin, when exposed to HCI. Pepsin breaks down proteins.
Gastric lipase - breaks down lipids (fats)
List 4 substances that the stomach can absorb.
Where do they go once absorbed?
Water
Alcohol
Iodine
Fluoride
They enter the venous circulation and are escorted to the liver by the portal vein.
What is HCI?
Hydrochloric acid is stomach acid.
What nutrients are required for the body to create hydrochloric acid (HCI)?
List 3 food sources of each.
Zinc
- nuts, seeds, eggs, oysters, fish and meat
Vitamin B6
- whole grains, sunflower seeds, legumes, walnuts, green veg, carrots, potatoes, avocado, fish.
What 3 actions does stomach acid perform?
1) Break down proteins (pepsin) and fats (lipase)
2) Triggers pancreatic juice and bile release into the duodenum (via CCK) when acidic chyme enters the small intestine.
3) Eliminates micro-organisms such as bacteria, viruses, and fungi, protecting from infection.
NB therefore H.pylori is often associated with low stomach acid.
List 4 causes of low HCI/stomach acid?
Chronic stress (sympathetic dominance lows down enteric nervous system)
Low vitamin B6 and zinc
Autoimmune gastritis
Medications (such as proton pump inhibitors)
Chronic Helicobacter pylori infection
Aging (gradually declines over 50)
How can you test stomach acid levels in a client?
First thing in the morning, mix 1/2 teaspoon of bicarbonate soda in a glass of water and then swallow.
If audibly belching by 2-3 minutes - sufficient levels.
If no belching after 3 minutes - low levels.
With regards to protein digestion, describe 3 implications of low HCI.
1) Protein putrefaction creates compounds called polyamines that are implicated in colorectal cancer.
2) Undigested food allows bacterial to proliferate in the small intestine causing Small Intestine Bacteria Overgrowth (SIBO)
3) Reduced gastric activity results in less intrinsic factor compromising B12 absorption.
What symptoms can low stomach acid present?
- Bloating, belching, and flatulence within 1-2 hours after meal.
- Abdominal pain and ‘fullness’ after eating with foul-smelling stools.
- Possible floating stools.
Describe 4 naturopathic ways you can support your client in increasing stomach acid.
- Unfiltered and unpasteurised apple cider vinegar in a little water before meals to support HCI and bile production.
- Bitter herbs/foods 15-20 mins before a meal to stimulate stomach acid release.
E.g. gentian, barberry bark, dandelion, goldenseal.
Foods - rocket, chicory, artichoke, watercress. - Zinc and B6 rich roods
- Eat mindfully - relaxed, chew properly, avoid over-eating.
- Diet rich in fruit and veg.
- Fermented vegetables such as sauerkraut.
What is the role of CCK? (2)
Cholecystokinin is a hormone released from the duodenal wall, triggering the release of pancreatic juice and bile.
CCK also induces a sense of satiety.
What triggers CCK?
How might low stomach acid affect this process?
The initial presence of the acidic chyme in the duodenum is a key factor in CCK release, meaning that low stomach acid can significantly impair digestion if CCK is not adequately triggered.
What happens to the chyme’s pH in the duodenum?
Chyme enters at a pH of 2. This is acted upon quickly by bicarbonate, which is released by the pancreas and liver. This neutralises chyme and creates a pH of about 6.5 in the duodenum.
How much nutrient absorption takes place in the small intestine?
90%
Briefly describe the 3 regions of the small intestine.
- Duodenum - 30cm long where most digestion takes place.
- Jejunum - 2.5m long where most absorption takes place.
- Ileum - 3.5m long where vitamin B12 is absorbed.
Describe the surface area of the small intestine.
The overall surface area is actually the size of a tennis court!
The large surface is created mostly by folds in the small intestine forming finger-like projections known as villi that contain blood and lymphatic capillaries.
The small intestine cell membranes also fold to create microvilli. This is also known as the brush border.
What are brush border enzymes?
Enzymes that are attached to the small intestine lining and are imperative for absorption.
List 4 brush border enzymes and their function.
Maltase
Sucrase
Lactase
- all break down sugars into glucose, fructose etc.
Dipeptidase
- breaks down protein into amino acids.
How does the function of digestion earlier in the digestive tract impact absorption in the small intestine.
Carbohydrates, proteins and fats are only absorbed once they have been digested into the simplest forms. This emphasises the importance of optimal function in areas such as the mouth, stomach, pancreas and gallbladder especially.
E.g. protein needs to be chemically digested in the stomach and then in the small intestines into amino acids.
How are carbohydrates, amino acids, and fatty acids absorbed?
Carbs (single sugars) and amino acids enter the blood capillaries of the small intestine to be sent to the liver via the portal vein.
Fatty acids including fat-soluble vitamins (A, D, E, K) are digested in the small intestine and enter lymphatic capillaries.
Describe the role of the pancreas.
It is an accessory digestive organ with both endocrine and exocrine functions.
Key exocrine function is to produce enzymes that digest carbohydrates, proteins, and fats. These are secreted into the small intestine.
Pancreatic enzymes are part of ‘pancreatic juice’, of which we produce 1.2-1.5 L/day.
Describe 3 pancreatic enzymes.
Pancreatic amylase - carbohydrate into smaller chains
Pancreatic lipase - fat into fatty acids
Proteases - protein into smaller peptide chains
Describe the anatomical position and structure of the pancreas.
Sits in the posterior abdomen, behind the stomach. It is connected to the duodenum via the pancreatic duct which is used to secrete pancreatic juice into the duodenum.
What happens in pancreatic enzyme production is poor.
Food ferments in the intestines, resulting in symptoms such as bloating, flatulence, and abdominal pain about 1 hour after eating.
The lack of adequate digestion can also lead to weight loss, and B12 deficiency.
Describe the impact of over-eating on the digestive system. (3)
When eating often and too much, digestive enzymes are used up. Not all food can be digested, resulting in malnutrition and bodily dysfunction.
By over-eating, organs such as the stomach and pancreas are placed under stress. They are constantly under demand to produce digestive juices, potentially depleting the capacity.
Furthermore, energy is directed away from healing and repair, increasing the risk of disease.
List 3 ways (eating habits) that support the digestive system health.
Do not eat more than 3 meals a day.
Avoid over-eating and snacking between meals.
Don’t drink with meals.
What did Bernard Jensen find in relation to undigested food.
Undigested materials are stored in the mucous-secreting lining of the intestines, impairing absorption and delivery of nutrients to body tissues.
This would create an optimal environment for parasites and candida to flourish, as well as under nourishing body tissue and organs.
Describe the function of the gallbladder.
The gallbladder sits under the liver - storing bile that is produced by hepatocytes in the liver.
Bile consists mostly of water as well as bile salts, cholesterol, and bilirubin.
Predominantly after digesting fats, the gallbladder contracts and ejects bile down the common bile duct into the duodenum.
Describe 4 functions of the gallbladder.
- Fat emulsification - bile breaks lipids into smaller molecules, increasing the surface areas ready for pancreatic lipase.
- Carries detoxified products from the liver - detoxified harmful materials for excretion.
- Stimulates peristalsis in the intestines.
- Excretes excess cholesterol.
Considering the gallbladder, what could the impact be on someone who is avoiding eating fats?
As the gallbladder is largely stimulated by the presence of fats:
- less excretion of detoxified substances from the liver
- less excretion of excess cholesterol
- less peristalsis and therefore possible constipation
What is the biliary tree?
The biliary tree refers to a network of ducts collecting bile and juices from the liver, gallbladder, and pancreas before exiting at the sphincter of Oddi into the duodenum.
Briefly describe the passage of the portal vein
Transports nutrients and toxins from the GIT (mouth oesophagus, stomach, small and large intestine, and anus) to the liver.
How much blood does the liver filter per minute?
1.4 litres
What nutrients does the liver store and why?
Carbohydrates
Fates
Minerals such as iron
Vitamins such as A, D, E, K and B12
These can be released into the blood to be made available to cells as required.
What’s the liver’s role with hormones?
The liver produces hormones, including insulin-like growth factor 1 (IGF-1) and angiotensinogen.
It also deactivates hormones that are no longer needed.
List 4 things that can impair liver detoxification.
Lack of nutrients
Exposure to lots of trans fats
Alcohol
Heavy metals
Caffeine
Pesticides
Briefly describe phase 1 of liver detoxification.
Phase 1 = Biotransformation
Detoxification occurs within hepatocytes. The convert volatile toxins into smaller substances that are more water-soluble
CYP450 enzymes create an active binding site on the toxin or hormone so it can be conjugated.
Toxins are oxidised creating free radicals. These must be nutrialised by anti-oxidants such as vitamins A, C, and E.
Briefly describe phase 2 of liver detoxification.
Phase 2 = Conjugation.
Chemical reactions modify reactive toxins to make them safe and excretable.
What nutrients are required for phase II detoxification? (3)
Sulphur
Magnesium
B vitamins
Name 3 herbs that can support liver detoxification.
Dandelion
Milk thistle
Licorice root
Name the key antioxidant required for neutralising free radicals in the liver.
Glutathione
(formed from cysteine, glycine, and glutamine)
What 4 ways does the body eliminate waste?
Bowels
Urine
Sweat
Exhalation
Briefly describe what occurs in the large intestine.
Any remaining materials enter the large intestine (pH 5-7) through the ileocaecal valve.
This is the final stage of digestion and absorptions. Digestion is assisted by the microflora.
Water and some minerals and vitamins are absorbed.
Mucus is produced by goblet cells and lubricates the lining. No digestive enzymes are released here.
What are the 4 regions of the large intestine?
- Caecum - where the appendix is attached
- Colon - ascending, transverse and descending
- Rectum
- Anal canal
Describe the location and purpose of the appendix
Attached to the caecum of the large intestine.
It’s almost entirely formed of immune tissues.
It also acts as a reservoir for beneficial gut bacteria.
What is GALT?
Gut Associated Lymphoid Tissue which is responsible for about 70% of the immune system.
It’s found in the GIT wall and houses leukocytes - macrophages and lymphocytes.
How does GALT build its immune response?
Leukocytes are in close proximity with trillions of microbes attached to the intestinal epithelium. They learn to identify microbes through this close interaction with bacterial surface antigens located in their cell membranes.
Where will you find clusters of GALT?
Tonsils
Oesophagus
Stomach
Intestines
What gases can be produced in the large intestine by the microflora?
Methane
Hydrogen
Describe 4 functions of the microflora.
- Final stage of nutrient extraction through microbial fermentation.
- Synthesis of vitamins such as biotin & K2
- Support intestinal barrier by producing short-chain fatty acids from fibre.
- Pathogen protection by outcompeting for attachment in the epithelium.
- Production of appetite-regulating proteins
- Mood regulation through synthesis of neurotransmitters.
Describe 2 consequences of damage to the intestinal lining.
When damaged, the tight junctions become ‘leaky’ allowing large molecules including undigested proteins to enter circulation before being broken down into their simplest forms.
Cell membranes of some gut bacteria can also enter the blood, leading to excessive immune responses and potentially allergies and autoimmunity.
List 6 possible causes of intestinal permeability.
- Poor nutrition (trans fats, refined sugar, processed food)
- Heavy metals
- Pesticides
- Drugs
- Excessive stress
- Dysbiosis
- Alcohol and smoking
- Radiation and chemotherapy
- Early weaning (<6 months)
How can we support microflora diversity?
Through a healthy and varied diet.
Typical Western diet can allow strains to become pathogenic.
As well as poor nutrition, what other factors can negatively impact colonies of bacteria?
- Chronic stress
- Diabetes
- Medication such as antibiotics
- Lack of digestive enzymes (affecting acidity)
What is dysbiosis?
Describes an imbalance in the colonies of bowel flora, leading to a disruption in health.
List 4 health implications/conditions associated with dysbiosis.
- Vitamin, mineral, amino acid insufficiencies.
- Malabsorption of carbohydrates and fats
- Inflammatory bowel diseases (eg Crohns)
- Colorectal cancer
- Alzheimer’s and Parkinson’s
- Autoimmunity, allergies, intollerances
- Obesity
- Mood disorders
List 4 health implications/conditions associated with eating junk food.
- Gut dysbiosis leading to inflammation, reduced immunity and leaky gut.
- Spikes in blood glucose resulting in excess insulin production.
- Increased risks of Type 2 diabetes, obesity, PCOS, and acne
- Increased BP and cardiovascular disease
- Deficiencies in vital vitamins and minerals
- Addictive eating behaviour
- Mood swings
Briefly outline Germ Theory v. Terrain Theory
Louise Pasteur developed Germ Theory of desease which hold microbes such as bacteria responsible for disease.
Antoine Bechamp developed Terrain Theory which holds that germs were opportunistic in nature and lived with us symbiotically.
What is the MMC?
The Migrating Motor Complex is a pattern of electromechanical activity in the smooth muscle between the stomach and distal ileum during periods between meals.
It is thought to serve a housekeeping role and sweep residual undigested material through the digestive tract.
This cleansing of the tract helps prevent SIBO.
List 4 ways we can support the MMC?
- Avoid over-eating
- Minimise heavier proteins
- Leave longer gaps between meals
- Consider intermittent fasting
- Optimise sleep
- Pro-kinetics (e.e. ginger, artichoke)
- Bitters before meals
- Stimulate the parasympathetic nervous system by using diaphragmatic breathing exercises.
What 2 key components are needed for the elimination of waste via the bowels?
Water & fibre
List 3 ways we can support the elimination of waste through the bowels
- Aloe
- Psyllium husk
- Linseeds
- Magnesium
- Reduce refined sugars
(as well as increase water intake and fibre)
What is the ‘brain of the gut’?
Describe its key components.
The enteric nervous system which extends from mouth to anus.
Key components = 2 nerve plexus which are embedded in the wall of the digestive tract:
Myenteric plexus (motility / peristalsis)
Submucosal plexus (secretion of juices)
Describe the impact of the parasympathetic and sympathetic nervous system on the enteric nervous system.
The enteric nervous system functions independently but is regulated by the autonomic nervous system.
Parasympathetic = rest & digest
Increased motility and secretions
Sympathetic = fight or flight
Decreased motility and secretions
Describe the role of the vagus nerve in digestion.
Extends from the head, and travels through the thorax and diaphragm, where it innervates the digestive organs. It connects the brain and the gut.
Vagus nerve activity directly stimulates both myenteric and submucosal plexus - increasing motility and digestive secretions.
What can stimulate and suppress the vagus nerve?
Suppressed by stress.
Enhanced by diaphragmatic breathing.
Describe the role and implications of serotonin levels.
Serotonin plays a role in peristalisis, secretion, and sensation with over 95% of it produced in the GIT.
Due to it’s association with mood, this explains a possible link between poor gut health and depression.
List 5 key factors that can compromise overall digestion.
- Inadequate chewing
- Poor nutrition through junk food, refined sugars, and excessive protein.
- Drinking whilst eating.
- Caffeine.
- Chronic stress
- Nutritional deficiencies
List 4 implications of poor digestion
- Less nutrients absorbed
- Fermentation of undigested food
- Increased toxaemia
- Retention of undigested materials and waste in the intestinal mucosal secretions
Outline the 5 steps of vitamin B12 absorption
- B12 is bound to protein in food when ingested.
- Stomach acid and pepsin split the food protein + B12 apart
- R-protein produced in saliva binds to B12 whilst in the stomach.
- In the small intestine, pancreatic protease splits the R-protein + B12 apart. B12 can then bind to intrinsic factor (released in the stomach)
- B12-intrinsic factor complex is absorbed in the terminal ileum into the blood.
Describe the process of obtaining vitamin D from sunlight.
- Skin cells convert provitamin D in response to the sunlight into cholecalciferol.
- The liver converts cholecalciferol into 25(OH)D
- The kidneys convert 25(OH)D into Calcitriol (the active form of vitamin D3)
List 2 key components needed for the production of vitamin D in the body
Cholesterol is needed for the synthesis.
Magnesium is a key co-factor.
How might we advise a client to increase their vitamin D?
10-20 mins of daily sun exposure.
Eat D3-rich foods such as oily fish.
Eat D2-rich foods such as shitake mushrooms.
Avoid alcohol, drugs, coffee, and refined sugars.
What is the role of vitamin D3 in the digestive system
Increases intestinal absorption of calcium and phosphorus.
Maintains calcium balance in the body, in conjunction with K2 which controls the utilisation of calcium (depositing in bones)
Where is most ingested calcium absorbed?
70-80% in the ileum
What does dietary vitamin D need to help with its absorption?
Fats - so ensuring a good intake of healthy fats in the diet is important.
What other functions does vitamin D have in the body?
Along with calcium absorption, vit D helps regulate bacteria species in the intestines.
A deficiency is linked to an imbalance of intestinal flora and increases the likelihood of inflammatory bowel diseases.
Name 4 anti-oxidants absorbed from foods that can protect cells against free radicals / oxidative damage.
Beta-carotene
Vitamin C
Vitamin E
Quercetin
Which organ in particular requires good levels of anti-oxidants?
Liver - to neutralise a large number of free radicals formed through the process of detoxification.
What 4 minerals from our foods are required for bone health?
Calcium
Phosphorus
Magnesium
Potassium
What is required from our food to build collagen in the bones?
Amino acids
Vitamin C
Thinking about bone health, what condition can dysbiosis in the gut cause and why?
Osteoporosis
Microflora produce vitamin K2 which causes calcium deposition in bones.
What exercises are recommended for bone health?
Weight-bearing exercises
What 6 nutrients from our food is needed to support muscle activity and for what purpose?
Calcium - contractions
Magnesium - relaxation
Iron - delivery oxygen
Sodium - nerve stimulation
Potassium - nerve stimulation
Amino acids - growth and maintenance
How might poor digestive health impact muscles?
Poor digestive health = poor absorption and/or delivery of nutrients.
Result in muscle weakness, aching, cramping, fatigue, pain
How is muscle health also crucial in supporting digestive health?
Diaphragmatic movement provides a visceral massage on the abdominal digestive organs and stimulates the release of serotonin, promoting digestion and nutrient absorption.
What-rich foods can be used as “blood-builders” to nourish the blood?
Chlorophyll-rich foods such as green leafy vegetables, chlorella, spirulina, etc.
(And iron)
What two aspects of digestive health should be considered in ensuring optimal absorption of iron?
Stomach acid levels/acidity
Presence of vitamin C
What 3 minerals does the heart need in order to function optimally?
Calcium
Magnesium
Potassium
List 5 things that could challenge the pH levels of blood.
Excess acidity
Toxins
Poor nutrition
Chronic stress
Limited movement
Name 3 hormones released from GIT epithelial cells and explain their purpose.
CCK - stimulates pancreatic juice and bile flow, and satiety.
Gastrin - stimulates gastric activity
Ghrelin - stimulates hunger
What is released by the endocrine system in response to the ingestion of carbohydrates?
Insulin
What 4 nutrients are needed to produce thyroid hormones?
Iodine
Tyrosine
Selenium
Zinc
What 4 nutrients are needed for electrical activity in the nervous system?
Sodium
Potassium
Chloride
Calcium
Name the crucial vitamin in the nervous system needed for the myelination of neurons?
B12
What symptoms might develop in the nervous system if poor digestion is impacting mineral and vitamin absorption?
Tingling
Numbness
Loss of balance
Pain
How do Chinese Medicine, Indian traditions, and Western/Euopean naturopathic traditions refer to Vital Force?
TCM = Qi
Indian = Prana
Western = Healing Power of Nature
In western energetics, how is the digestive system seen?
Hot / fire
Name 5 energetically hot foods/herbs
Ginger
Garlic
Rosemary
Thyme
Cayenne
Energetically, how are the following conditions seen:
- Inflammation
- Constipation
- Diarrhoea
- Inflammation = Excess heat
- Constipation = dry
- Diarrhoea = moist
How is the ‘digestive fire’ seen in ayurvedic terms?
It’s called Agni.
Highest in the morning so it is important to eat a nutritious first meal of the day,
The constitution of a person will determine the amount of digestive fire and provides a guide for food intake.
What is the term for undigested foods and toxins in Ayurveda?
Ama
List 5 ways to reduce Ama
- Spices/powdered herbs (corrianger, fennel, cumin, cardamon, fenugeek) to increase digestive fire.
- Fresh ginger root tea
- Three hours between meal and bed
- Eating slowly and chewing well
- 4-6 hours between meals
- Not eating if not hungry
- Adequate exercise
- Avoiding cold water and ice - drink room temp water or hotter
- Not reading or working whilst eating.
What is the spleen in TCM terms?
It does not refer to the organ. The Spleen is a functional organ that encompasses all aspects of the digestion and absorption of foods.
Therefore the action of digestive enzymes in the mouth, stomach, small intestine and pancreas are all functions of the Spleen.
List some symptoms of ‘Spleen Qi deficiency’
Diarrhoea
Bloating after eating
Food intolerances
Indigestion
Describe the function of the stomach in TCM terms.
It is to ‘rot and ripen’
(rotting meals and ripening fruit, veg and grains as nature would).
Key to this is the concept of Stomach Fire - without sufficient stomach fire, foods are digested properly.
List 5 Spleen-friendly food/eating habits
Warm and well-cooked meals like soups and stews.
Warm, wet breakfast like porridge.
Avoid drinking with meals
Avoid energetically cold foods
Avoid dampening foods (gluten, sugar, dairy)
Well-cooked whole grains
Naturally sweet vegetables cooked or steamed
Warming herbs and spices
Would you still recommend herbal bitters for a client with Spleen Qi deficiency?
No as some of the herbs are too cold.
Consider warming Spleen Qi tonics such as ginger, cardamom, fennel, and citrus peel.
In TCM, what are sugar cravings a sign of?
Spleen Qi deficiency.
Giving in to them will further compromise the digestive system and lead to Damp and Heat over time.
What western medical conditions are associated with Damp and Heat?
Candida
Weight gain
Diabetes mellitus
Hypertension
Cardiovascular disease
Considering the Chinese Medicine Clock, at what time should we eat breakfast and why?
7am-9am
Time of the stomach
Eat something warming and hydrating.
Avoid cold smoothies or dry toast.
When considering pulse diagnosis, list 3 pulse qualities and what they indicate.
Rapid = Heat
Slow = Cold
Weak = Qi deficiency
Wiry = Qi stagnation
For tongue diagnosis, name 4 tongue shapes and what they can indicate.
Swollen = Qi/Yang deficiency
Thin = Blood deficiency
Teeth marks = Weak digestion or malabsorption of nutrients
Raised/upturned edges = high stress
For tongue diagnosis, name 3 tongue colours and what they can indicate.
Red = Heat / inflammation / B9 or B12 deficiency
Pale = Qi/Yang deficiency
Blue/Purple = Cold / poor circulation
For tongue diagnosis, name 4 tongue coatings and what they can indicate.
Brown = Chronic excess heat
Yellow = Damp heat
Thick White = Damp cold
No coat = Yin deficiency
(normal = think white coat)
What does a crack in the centre of the tongue indicate?
Small transverse cracks = damage to stomach lining.
Deep centre crack = stomach heat.
Describe 4 nail presentations and what they indicate.
Spoon shaped = severe iron or sinc deficiency
Pale = anaemia
Brittle = mineral def., low stomach acid
White spots = zinc or vit A def.
Vertical lines = nutrient malabsorption
Horizontal lines = strong illness or infection
