Fatigue, Dry Cough, Toenail Ridges

For the past 9-10 months, I've been constantly feeling tired. It's not so much muscle fatigue as it is more like my brain is "foggy" and I sort of feel a bit sleepy all the time. I can't concentrate because of it. It's extremely frustrating and it affects everything I do.

I've also had a dry cough for about 6 months now. It's usually just 1 or 2 short coughs at a time (though this happens a lot throughout the day). It's not painful or anything, just annoying.

And I'm not sure if this is related, but I also have horizontal ridges on both my big toenails. It's like it's indented. I don't know the exact time this started, but probably around 6-7 months ago. And recently, a new ridge seems to be forming at the base of the nail. So that'll make it two horizontal ridges on each nail. I saw a foot doctor about this, but he really didn't have much to say. He said all my other nails were fine, so maybe it was because of my shoes, but I'm not quite sure about that.

I saw my doctor about my symptoms recently, and I got some tests done (blood work and chest x-rays). Both turned up nothing.

My doctor thought it might be valley fever (I live in Arizona by the way, and have been living here for over 10 years), but the blood test was inconclusive for coccidioidomycosis. They said they'll need to do another test next week.

I'm not sure what else it could be or what kind of specialists I should consider seeing. Could this really just be allergies? For this long? And for it to hit me this hard all of a sudden? I really don't know.

I don't even know if all these symptoms are related. Though one thing I found interesting is that I went on vacation for about a month back in April (out of the country to East Asia), and during that time I felt pretty good. Maybe not 100%, but there was definitely an improvement. I didn't have my cough either.

I'm considering going to an allergist next and see what they have to say. But does anybody have any other ideas? I researched this online, but I couldn't pinpoint anything (Iron deficiency? Thyroid problem? Some sort of autoimmune disorder? I don't know).

If anybody has any ideas, I'd appreciate it. Thanks. :)

[Red_Star]

The horizontal ridges are called beau's lines. They usually develop when nail plate growth is temporarily disrupted. This can occur with direct injury to the nail matrix; an inflammatory condition such as psoriasis; infection around the nail plate; repetitive picking at the nails or cuticles; manicure. Systemic causes include nutritional deficiencies; illnesses accompanied by high fever; metabolic conditions; certain drugs (eg: chemotherapy); diminished blood flow to the fingers (eg: raynaud's phenomenon).

One nutrient deficiency that is found to be a cause of unexplained dry cough is vitamin B12. Low vitamin B12 symptoms also include fatigue and brain fog. Optimal B12 serum is above 800pg/mL or 600pmol/L.  

Excerpt from  "Vitamin B12 aids persistent dry cough"

"This study focused on 42 individuals with chronic, unexplained cough.  Of  these, 27 were found to be deficient in vitamin B12.  The remaining 15 people were not B12 deficient. The investigators found “laryngeal hyper-responsiveness” to histamine was significantly more common in individuals with B12 deficiency than those without."

[vrage]

Thanks for the response, Red_Star.

Well, I do have very poor circulation (and it seems to have gotten worse lately). I wonder if there could be a connection there. Though the nail problem might not be related to my other symptoms.

The nutrient deficiency sounds like something to look into. My body is definitely trying to tell me something, I just don't know what yet.

After I see an allergist, I'm thinking about seeing an endocrinologist. Hopefully I can find some sort of answer soon. The inability to concentrate is really taking its toll on me.

[Mire111]

A related discussion, y was started.

[Mire111]

Hi Vrage,

I hope your keeping well. I am suffering from the exact same symptoms as you are. It started around 5-6 month ago, I feel constantly tired, no matter how much I sleep (7- 9 hours/night) I am always tired. Furthermore, I cannot concentrate at work or anything else. Everything seems like a big effort. I am no longer sharp or alert at work and approach tasks with indifference.

About 4-5 weeks ago I noticed horizontal ridges on my big toes. Then all the other toes started to form horizontal ridges. I immediately thought I must be deficient in some vitamin. I have no doubt in my mind that the symptoms are all related after reading your post.

I live in Ireland so I don't think this is a regional / weather related illness. I am going for blood tests tommorow so my question is how have you got on since and did you find the root of the problem?

Would appreciate any feedback you may have? Hopefully you will check this again soon

[panda2526]

Ok, posted on another thread you had asked on, and told you about iron overload, and now I see you live in Ireland!!!!!!!!

THis is a major issue in people of Irish descent, 1 in 4 Irish will be carriers of HFE Hereditary Hemochromatosis. They have a HHC Society in Ireland as well you can look up. THis is amazing...I can almost 100 percent guarantee your symptoms are iron related...

My husband was just diagnosed, we live in Canada, but his father was Irish, and died of congestive heart failure, which is a direct cause of iron overload. My husband has the two mutated genes C282Y and H63D. Please check into this immediately!

If you live in Ireland there should be much greater awareness of this disease. 1 in 4 carriers, and 1 in 20 marriages or relationships end up with two carriers, which means the children involved are also at risk.

My husband has ALL the same symptoms, and my recent blood tests show high iron storage as well, and I have those symptoms.

Ask your doc for iron overload screening. Let us know what happens.

[Mire111]

Thank you for posting, makes interesting reading. I have never heard of this disease. Just to be clear, I have never posted on any other thread before but perhaps it was 'vrage' (see above original posting) who I believe lives in Arizona.

I guess your husband had a series of horizontal ridges growing on all or some of his toe nails and he suffered fatigue also?. This 'dry cough' has only started the past few days . I have a small rash on my inner thigh also. Did your husband get a rash or anything like that?

Did your husband go to a specialist? What treatment did he receive? I find the doctors over here have a snobby attitude to internet suggestions etc. I thought I was low in iron or B12.

I'll wait on the blood tests anyhow and hopefully it will pick up on high iron levels and I can get treatment then. I'm in my mid twenties so its not uncommon to happen to someone my age

[panda2526]

Ya, sorry, realized after I posted about the other post thing, but you do live in Ireland...I think I got that part right...lol

Anyway, hopefully your doc has ordered these tests. Not on routine blood work, unfortunately. We found out by accident due to another condition he has. And if you have thought that you iron is low, then it is interesting that low iron and high iron can have the same effects. But a person can be anemic and iron load at the same time, so docs are confused...

if your tests some back and they do not include ferritin, transferrin saturation, TIBC or serum iron then they have not screened for overload.

As far as rashes, my husband has had several different types of skin manefestations through his life, excema is common, and he has lesions on his face as well. THere are so many things I can hardly keep track. But iron overload manifests on skin, in eyes, he also has a rare eye condition in which the blood vessels in his eye are hemmorhaging leading to vision loss.

His joints ache and can hardly move sometimes, the body pain is very severe at times. Fatigue for many years. Knees very sore, and painful to the touch in spots. Heart palpitations, shortness of breath, grey skin, sweating profusely...the list is endless and in everyone it is different too based on how long you`ve been storing iron and the type of iron overload you have and the reason you are storing iron. Some are not genetic.

My husband sees a internist.

The toenail ridges are in me, and my nails, which is related to psoriasis. For many years I have had strange symptoms the docs wont or cant recognize and refuse to treat or take seriously due to some tests coming back normal, or high normal...I just came back from my doc who also is treating my husband, family doc, and he treats me like I am crazy even though I have high and abnormal test results for iron, he will not listen to my requests for genetic screening, like the only reason I am asking is because my husband has it. I was furious. Read the stories of people who have finally found out they have HHC and you`ll see the same thing over and over, average 10 years to diagnosis, and three docs.

Any other questions, or about your tests...let me know. Get copies of all your blood work and results. You are entitled to get them. THen let us know. I started a group on this site about HHC, so you can tag it and become a member and share your story if this comes out.

No matter what the reason for your illness, my hope is you find out. Answers are such a relief. At least you know what to do about it

[Mire111]

I have just received the results of my blood tests today. My iron levels were normal as was everything else - except for my cholesterol. It measured 6.5 which puts me in the very high risk category for heart disease. This is quiet shocking as I generally eat healthy and am not overweight. However I believe the ridge formation on my toe nails was definetley tring to tell me something.