Physical Examination: Certain risk factors and signs of nutrient deficiency or excess can be identified during the physical examination. Any one sign is rarely diagnostic; the more signs present the more likely they reflect a malnourished individual.

Hair: dull, dry, sparse, shedding

Eyes: cloudy, pale, dry, red, dull

Lips: swollen, red, cracks at sides

Gums: bleeding, abnormally red, swollen

Teeth: dental enamel erosion in bulimia due to induced vomiting

Tongue: swollen, red, fissured, glossitis, atrophic lingual papillae due to deficiency of riboflavin, niacin, folate, vitamin B-12, protein or iron

Skin: dry, flaky, hyperpigmented, decubiti present, decreased skin turgor, poor wound healing due to deficiency of protein, vitamin C, zinc; xanthomas due to increased serum lipids

Nails: spoon-shaped, brittle, and ridged

Face: dark skin, scaling skin, pallor

Hands: smooth areas on backs of fingers and nails in bulimia from inducing vomiting

Lower extremities: edematous

Muscular: wasted, weak, tender, xanthomas (tendon, planar, palmar) in hyperlipidemia

Neurologic: apathy, lethargy, disoriented, memory loss, and paresthesia

Laboratory Tests: Many lab tests can provide useful information on patients’ nutritional status along with information on their medical status.

• Red Blood Cell Parameters: hematocrit and hemoglobin (low values indicate anemia), low mean corpuscular volume (MCV) or microcytosis-- iron, copper, pyridoxine deficiency, high MCV or macrocytosis - folate, vitamin B₁₂ deficiency.
• White Blood Cell Count: neutropenia is often seen in deficiency states.
• Serum Lipid Levels: total cholesterol >200 mg/dl, HDL <35 mg/dl, LDL >130 mg/dl.
• Vitamin levels: folate and vitamin B₁₂ can be helpful.
• Creatinine-height index (estimate skeletal muscle mass).
• Visceral proteins: serum albumin, serum transferrin etc.
• Blood Urea Nitrogen (BUN).
• Urinary Urea Nitrogen (UNN).