The Collison Newsletter November 2009

  

              NAILS as SIGNS of HEALTH PROBLEMS*  

 

 

Introduction

 

Fingernail condition has been used for thousands of years to give an accurate diagnosis of ailments and maladies in the body.

 

Fingernail changes may signify a number of disorders elsewhere in the body. Often, nail changes will occur before other symptoms start. These changes may indicate illness even before the rest of the body shows any signs. Thus nails can be very useful in diagnosing illness and evaluating health.

 

Nail problems affect people of all ages.

Structure of the Nail 

Fingernails and toenails are made of a tough protein called keratin and have many different parts:

·       Nail plate. This is the visible part of the nail. It is hard and translucent and is composed of layers of the protein keratin.

·       Nail bed. The nail plate sits on top of the nail bed which is responsible for the ‘pinkish’ colour of the nail plate. It also determines the shape the nail will grow.

·       Nail folds. The nail plate rests inside folds of hard skin which overlap the sides of the nail plate.

·       Cuticle. This is a thin flap of tissue that lies over the base of the nail

·       Lanula. This tends to be only visible in the larger nails. It is the whitish crescent shape around the base of the nail plate and is the shadow of the matrix.

·       Free edge. This is the part of the nail that extends past the finger, beyond the nail plate.

·       Nail matrix. This is the only living part of the nail. It is the site of nail growth. It is situated behind and underneath the nail fold, and produces the keratin that makes up the nail plate.

 

In common usage, the word nail often refers to the nail plate only.

Purpose of the Nail 

Nails serve the same purpose as animals’ hooves and horns. Along with hair and teeth, they are appendages of the skin. The only living part of these ‘appendages’ is situated inside or underneath the epidermis.

 

Nails act as a counterforce when the end of the finger touches an object, thereby enhancing the sensitivity of the finger tip, even though there are no nerve endings in the nail itself.

Growth of Nails 

Nails grow at an average rate of 3mm per month. Fingernails require 3 to 6 months to grow completely, and toe nails take longer. The actual growth rate is dependent on age, gender, exercise level, diet and hereditary factors. Nails grow fastest in summer. Contrary to popular belief, nails do not continue to grow after death: the skin dehydrates and tightens, making the nails (and hair) appear to grow.

Healthy Nails 

Healthy nails are pink, which indicates a good blood supply.

 

A balanced, healthy diet is essential for overall good health, as well as healthy nails (see my September 2005 newsletter Acid/Alkali Balance- The Ideal Diet).

 

Nutrients (and supplements that may be necessary) for healthy, strong nails include:

·       Vitamins A, C, D and B complex (B1, 2, 3, 5, 6)

·       Carotenoids (work with Vitamin A)

·       Bioflavonoids (work with vitamin C)

·       Calcium

·       Zinc

·       Essential fatty acids.

Common Nail Conditions 

Common causes of nail problems include trauma, infection and various skin conditions such as eczema and psoriasis. Diet alone, unless there is severe malnutrition, is generally not responsible for abnormal nail changes. Some nail conditions need professional treatment from either a doctor or a dermatologist, while others respond to simple self-help techniques and lifestyle changes.

 

·       Trauma

A blow to a nail or compulsive nail biting can cause a range of problems, including   bruising of the nail bed, lifting of the nail plate, loss of the nail plate and nail ridges. There may be subsequent deformed growth of the nail plate, if the matrix is injured.

 

·       Thickened nails

This condition commonly affects the toenails. Thickening can be due to fungal infection or psoriasis. It may result from poor circulation to the nail matrix.

 

·       Brittle nails

This may indicate a possible iron deficiency or hyperthyroidism (overactive thyroid). Nails that chip, peel, crack or easily break suggest a nutritional deficiency (see supplements above).

 

·       Vertical ridges on the nails

These occur in poor general health and in kidney disorders.

 

·       Horizontal ridges on the nails

These are also known as ‘Beau’s lines’, and can indicate severe stress (physical and/or psychological). The ridge relates to the time of the stress when an interference to nail growth takes place.

 

·       Nail pitting

Small depressions in the nails are common in people with psoriasis. They may also result from nail injury.

 

·       Nail clubbing

Clubbing occurs when the tips of the fingers enlarge and the nails curve around the fingertips. This condition results from low oxygen levels in the blood. This can result from lung disease and congenital heart disease (‘blue babies‘). It may also be associated with inflammatory bowel disease or liver disease. There is a blue colour under the nail (cyanosis, or lack of oxygen).

 

·       Spoon nails

Here the nails are soft and look scooped out. This may be a sign of iron deficiency anaemia.

 

·       Wide, square nails

These suggest a hormonal disorder or imbalance.

 

·       Nail discolouration

The healthy nail plate is pink, and the nail looks white as it grows off the nail bed (the ‘free edge’). Nails can be discoloured by various factors (other than the obvious one of nail polish!) including some medications (including antibiotics, anti-malarial drugs and some drugs used in chemotherapy) and nicotine from cigarette smoking.  Nails can also become discoloured in Vitamin B12 deficiency, kidney and liver disease.

 

·       White nails

These indicate possible liver disease or kidney disease.

 

·       White lines on the nails

These may result from liver disease, and are seen in arsenic poisoning.

 

·       White spots on the nails

Zinc deficiency typically results in white spots. They may also be seen in under-active thyroid states.

 

·       Yellow nails

This is also called ‘Yellow Nail Syndrome’. The nails thicken and new growth slows, resulting in discolouration. Yellow nails can result from any condition that causes nail growth to slow down. It may result from a respiratory condition, such as chronic bronchitis, from swelling of the hands (lymphoedema), or in diabetes.

 

·       Green nails

These may reflect the presence of a bacterial or fungal infection.

 

·       Brown nails

These may occur in kidney failure (uraemia).

 

·       Pale nails

Pallor of the nail bed is seen typically in anaemia, but is also seen with poor circulation and liver failure.

 

·       Nail separates from the nail bed

This is a condition called onycholysis where the fingernails become loose and can separate from the nail bed. This may be associated with injury or infection, thyroid disease, drug reactions or psoriasis.

 

·       Fungal infection

Fungal infections, such as tinea, readily spread from one person to another and can involve the fingernails or toenails. Those with diabetes or with compromised immune systems are at greater risk of fungal infection. The characteristics of a fungal nail infection depend on the infecting agent, but may include lifting of the nail plate off the nail bed, thickening of the nail plate, crumbling of the nail plate, discolouration (usually in streaks) and pitting of the nail plate surface.

 

·       Age changes in the nails

As the body ages, the growth rate of both fingernails and toenails tends to slow. The change of protein in the nail plate makes the nail brittle and prone to splitting, Discolouration is also common.

Conclusion and Things to Remember 

The nails are easy to examine and can reveal much useful information. Changes in the nails are, of course, only pointers as to what may be happening to the nails themselves or elsewhere in the body.

 

Some conditions are more problematic than others and will need professional treatment, possibly with appropriate investigations to clarify an underlying disease or disorder suggested by the changes in the nails. Nail clippings and scraping from beneath the nail may be taken for laboratory analysis when the cause of the nail problem is not immediately apparent.

 

People with diabetes and those with compromised immune systems are more at risk of developing fungal nail infections.

 

The above list of nail conditions is presented for information. They are NOT intended to serve as a diagnostic tool. If in doubt, seek the help of a professional.

 

*Copyright 2009: The Huntly Centre.

  

Disclaimer: All material in the Huntlycentre.com.au website is provided for informational or educational purposes only. Consult a health professional regarding the applicability of any opinions or recommendations expressed herein, with respect to your symptoms or medical condition.

  

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