Dr. Dawn Harper January 10, 2018

From facial expressions to mishapen nails and sweaty palms - you’d be amazed by some of the tell-tale clues to illness your doctor is on the lookout for, says Dr Dawn Harper

As students at medical school we were sometimes asked to look at a part of someone’s body and make a ‘spot’ diagnosis without asking any questions or performing a more extensive examination. Even these days, as a GP of many years, I still find myself searching for unexpected clues in my patients’ bodies to help me reach a diagnosis.


Just shaking someone’s hand when they first come into the surgery can reveal a lot. Warm, sweaty palms can be a sign of an overactive thyroid, for example, while cold, wet hands may suggest anxiety. Nicotine-stained fingers are a sure sign someone is or has been a heavy smoker - regardless of what they tell you. A fibrous (rubbery) band across the palm of the hand causing the little finger to bend in is called a Dupuytren’s contracture, and, although the exact cause is unknown, diabetes, smoking and certain medications (for instance, for epilepsy) may trigger it.


If you place your thumbnails together back-to-back, you should see a diamond-shaped space caused by the angle between the nail and the nail bed. If you don’t, you could have ‘clubbing’, a potential sign of an underlying illness such as heart, lung or liver disease. Spoon-shaped nails, also called koilonychia, may be linked with low iron levels. Nails that lift off the nail bed and flake (onycholysis), meanwhile, can be the result of an overactive thyroid or psoriasis. Normal, healthy nails grow around 0.1mm a day but stop growing during a serious illness. When they start to regrow a horizontal ridge forms. Measuring between the cuticle and the ridge can hold the clue to the date of the illness.


An expressionless, serious or severe-looking face, even when you’re not in a bad mood, can be a clue to Parkinson’s disease – it’s called ‘masking’. A round moon-shaped face on the other hand could be a sign of Cushing’s disease, a rare hormonal problem caused by overproduction of the stress hormone cortisol. If you’ve lost the outer third of your eyebrows your doctor might send you for a test for an underactive thyroid. If you notice yellowish fatty deposits (xanthelasma) around your eyes, meanwhile, it could be a sign of high cholesterol levels.

Did you know?

A white streak in the hair similar to a badger can sometimes be associated with a rare cause of congenital deafness.


If you notice a white or greyish ring around the coloured part of the eyes, an ‘arcus senilis’, you could have circulatory problems. Startled, staring eyes showing the whites, meanwhile, are another symptom of overactive thyroid. Most of us know that yellow eyes are a sign of jaundice and very pale eyes a symptom of anaemia, but did you know that a burst blood vessel in the eye could mean high blood pressure? And a droopy eyelid (ptosis) could be a sign of muscle weakness caused by, for example, the chronic autoimmune neuromuscular disease, myasthenia gravis.


You may be surprised at how much your mouth can give away without you talking. A shiny red tongue, for example, indicates anaemia, while one that resembles a strawberry could be a sign of scarlet fever. Recurrent mouth ulcers may be a sign of inflammatory bowel disease (IBD) or even non-specific urethritis (NSU). Ever noticed small purple spots on your lips? They’re a feature of a rare genetic condition called Peutz–Jeghers syndrome, which is linked with polyps in the gut.


Even your ears can have hidden clues to disease. If you have diagonal creases in your earlobes you could be more at risk of developing heart disease. Lumps in the earlobe (tophi) can be a sign of chronic gout, a type of arthritis that can cause severe pain, inflammation and swelling - often in the toes, ankles, knees and fingers.


Our skin, the largest organ in the body, often reflects problems elsewhere. Tiny broken blood vessels, which turn white on pressure, aka ‘spider naevi’ are common in pregnancy but can also be a sign of liver disease. People who seem to have a constant tan, without sun exposure, could have Addison’s disease, a rare disorder of the adrenal glands. Alternatively, this could be a sign of ‘haemochromatosis’; a condition where the body accumulates too much iron. If you came to the surgery complaining of an intensely itchy blistering rash on your trunk and limbs, meanwhile, I’d suspect dermatitis herpetiformis, a condition usually linked with coeliac disease.


Legs shaped like inverted champagne bottles can be a sign of a rare inherited condition of muscular weakness called Charcot-Marie-Tooth disease (CMT). Purple lumps on the shins, like raised bruises, can indicate anything from being on the pill to sarcoidosis, a chronic inflammatory condition.

So if you ever visit your GP with one complaint and leave needing tests for another, go with it. They might be on to something!


While some of these findings may simply be quirky associations, remember there are some symptoms that must never be ignored:

  • Any new lump
  • A changing mole
  • Blood in your stool
  • Blood in your urine
  • Unexplained weight loss

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.



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