Nail Changes

[ALybella]

I am a 29 year old healthy female.
While pregnant 2 years ago, I was not getting sufficient food intake.  AT around 5 months, my nails began to grow out a complete opaque white from the root.  I began taking my vitanims, and the nails slowly grew back normally.  AT the time no renal or liver abnormalities on bloodwork.  Problem resolved.  About six months later after chronic severe stress, I began to have some white lines grow again, not uniformed on several nails.  The lines were not even and did not follow the lanula.  Had renal and liver panel all normal.  This happens now about twice a year, always following a traumatic experience for some reason, for example my moms near overdose.  My concern is, that I always read online that this could be a liver problem.  My Doc just performed a physical, said no liver enlargment, AST (23) ALT (24), normal Bill, normal ALK Phos, Albuimn 3.8 (in range), normal renal levels.  Doctors don't seem to care about these nail changes.  I do suffer from Seborehhic DErmatitis, but no other skin disease, also some diagnosed eczema on back.  I'm real concerned about this being a liver probles, eventhough all panels for the last 2 years (almost 6) have shown up completely normal at an optinmal level.  COuld this be caused by stress or something less serious?

Ex: The lines grow out, they are not identical, some follow the proximal fold but not all the length around. Not all fingers, almost always ring and pointer on left hand.

[Alan Rockoff, MD]

If your liver tests are normal, I see no reason for you to think you have a liver problem.  Liver problems are are causes of nail abnormalities, but nail changes like the ones you describe are common even without liver problems.  Most nail changes are not possible to explain (or to treat).  It's enough that internal issue are looked for.  They have been, and you're OK.  Therefore, I recommend you pay no attention to the nail color changes--cover them with polish if you want.

Best.

Dr. Rockoff

[ALybella]

Thse are my labs

total protein:7.3
ALbumin: 3.8
Globulin: 3.5
ALY: 15
AST: 20
Ratio: 1.3
Alk Phosp: 45
Bill total: 0.5
All CBC withing normal range
All within limits.

I am just scared about reading in all these websites about it correlating to liver disease.  I asked the Doc about AUto Hep, Wilsons and Hemachromatosis, and he just laughed and said I didn';t have any of the diseases.  But how about Cirrhosis, does that not effect your nails??? I looked up Mee's Limes and Muerchkes lines, and they do not resemble any.  They move with the nail growth and are very uneven and go about half way through the width of the nail.  It happens about once to twice a year.  Can this just be normal???

[Alan Rockoff, MD]

Cirrhosis would show itself with liver tests that are way out of whack.  You really have nothing to worry about.  Please turn your investigative energies elsewhere--you'll be much better off.

Dr. Rockoff