Nail abnormalities

[ALybella]

I am a 27 year old healthy female.
While pregnant 2 years ago, I was not getting sufficient food intake and not taking my vitamins. At around 5 months into the pregnancy, my nails began to grow out a complete opaque white from the root, (they did not turn white, and they grew out white). I began taking my vitamins, and the nails slowly grew back normally. At the time no renal or liver abnormalities on blood work, Dr. said it was nothing to worry about. Problem resolved. About six months later after chronic severe stress, I began to have some white lines grow again, not uniformed on several nails. Some nails just had minor spots other had lines that were not even and did not follow the lunula, 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 enlargement, he said the liver felt very good., no organ enlargement   My LFT are as follows

total protein:7.3
Albumin: 3.8
Globulin: 3.5
ALT: 15
AST: 20
Ratio: 1.3
Alk Phosp: 45
Bill total: 0.5
All CBC within normal range, Platelets 285, WBC 8.0
All within limits.
PT: normal
PTT: normal
No loss of appetite
Normal stools
Normal abdominal  CT Scan
Only slight pressure on right side of flank by belly botton, Dr. said it’s too low to be liver associates

Doctors don't seem to care about these nail changes. I do suffer from Seborrhea Dermatitis, but no other skin disease, also some diagnosed eczema on back. I'm real concerned about this being a liver problem, even though all panels for the last 2 years (almost 6) have shown up completely normal at an optimal 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, usually like a crescent shape. Not all fingers, almost always ring and pointer on left hand involvement.  I read that Terry’s nails and Muerckes lines are associated with liver disease, can these abnormalities be liver disease aswell, despite normal LFT’s, CT Scan and physical examination.

[Kevin Pho, MD]

Nail changes can be indicative of liver problems.  However, with normal LFTs, this would be less likely.  Imaging the liver with an ultrasound can provide further evaluation, but I probably won't go much further than that.

If the nail changes continue, a referral to a dermatologist can be considered for further evaluation.  Sending part of the nail off for culture can be considered to evaluate for fungus.  

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[ALybella]

By the way, I look at Mee's, Terry's nails and Muerchkes lines, my lines do not resemble any of those.  My actual nails is a pinkish color.

[ALybella]

Is it true that you can have cirrhosis and perfectly normal liver enzymes??? If you had cirrhosis would your liver feel enlarged upon physical examination?  Or via abdominal CT scan

[kmz123]

No your liver shrinks when you have cirrosis and that would
come up on a Ct scan.

[ALybella]

Anyone, any comments on nail changes

[yoshi]

Some diseases that can affect the shape, integrity and colour of the nail include:
Lung disease
Heart disease
Kidney disease
Liver disease
Thyroid disease.

[diamond79]

I have the same problem with my nails. Ever since I was pregnant with my son (he is now almost 2 years old). They are in horrible shape--esp. my thumb nails. They have craters and lines going horizontal across them. Some of them curl down at the tips as well. And they are extremely brittle (peel all the time). I asked my dr. about them and he didn't have a clue. He asked if I closed them in a door or something--which I ahve not. He then figured some sort of dificiency...but didn't bother testing. I have had my liver checked just before I had my GB removed and it was fine so it can't be that. I admit, my diet isn't the greatest in the world but alot of other people are worse then me and don't have nail problems like I do. If you find the answer to your nail problem please post as I am curious to know what is the cause!

[ALybella]

DO you get white lines on them too.  Mine are not really lines but like white spots that go like halfway throught the nail.  Are yours like that too

[diamond79]

Yes, I got what look like bubbles in my nails. That is how they started out. From there they turned into the craters and the lines..which is where they are at now. They will start growing in normal and then start all over with the above. It's not really a BIG problem although it is embarrassing when someone notices and asks what happened to my nails. LOL.

[PAJ]

I have this ,dont remember where it came from
COMPLETE LOSS OF NAIL Trauma
NAIL PLATE LOOSE Injury; nail psoriasis; fungal or bacterial infections; medicines; chemotherapy; thyroid disease; Raynaud’s phenomenon; lupus
WASTING AWAY OF NAILS; NAIL LOSES LUSTER AND BECOMES SMALLER Injury or disease
THICKENED NAIL PLATE Poor circulation; fungal infection; heredity; mild, persistent trauma to the nail
PITTED NAILS SOMETIMES WITH YELLOW-TO-BROWN “OIL” SPOTS Eczema or psoriasis; hair loss condition
VERY SOFT NAILS Contact with strong alkali; malnutrition; endocrine problems; chronic arthritis
SPOON-SHAPED NAILS Iron deficiency; thyroid disease
CLUBLIKE NAILS GROWING AROUND SWOLLEN FINGER ENDS Chronic respiratory or heart problems; cirrhosis of the liver
HORIZONTAL RIDGES Injury; infection; nutrition
LONGITUDINAL RIDGES Aging, poor absorption of vitamins and minerals; thyroid disease; kidney failure
BRITTLE, SPLIT NAILS Nail dryness; nails in contact with irritating substances (detergents, chemicals, polish remover); silica deficiency
INFECTED NAILS: RED, TENDER, SWOLLEN, PUS Bacterial or yeast infection
OVERLARGE MOONS Overactive thyroid; genetics; self-induced trauma (habit tick)
NO MOONS Underactive thyroid; genetics
DISCOLORED FINGERNAILS Colorless: May indicate anemia
Red or deep pink: Can indicate a tendency to poor peripheral circulation
Blue: Blood may not be receiving adequate oxygen due to respiratory disorders, cardiovascular problems, or lupus erythermatosus.
Yellow: Could indicate fungus, diabetes, psoriasis, use of tetracycline, or heredity.
White, crumbly, soft: May be a result of a fungus infection
Half white/half pink: May indicate fungal infection or, more seriously, kidney disease
Small white patches: Usually a sign of injury to the nail matrix
Purple or black: Usually due to trauma, or may also be a sign of vitamin B12 deficiency. A brown or black streak that begins at the base of the nail and extends to its tip could be a diagnostic clue to a potentially dangerous melanoma. See your healthcare provider.

[Linda J]

I would suggest you see a dermatologist. Psoriasis(which i've had all my life), eczema and seborrhea can affect nails. I've had some white spots on my nails for the last 40 years and my dermatologist has always told me it was due to psoriasis. It is sometimes worse than others and sometimes they revert back to being "normal". I doubt you have liver disease based on the symptoms you describe.

Linda J

[LisaU]

If vertical ridges mean poor absorption, how do I fix this?