For over a decade - and certainly longer - I was unknowingly suffering from a severe B12 deficiency with symptoms written off as due to perimenopause and then menopause. During this time and starting at the age of around 38-40 (now 54) I recall my nails had exceedingly pronounced vertical nail ridges. While I still have them they are becoming less noticeable as I've been self injecting. Has anyone else had this as an early symptom?
Curious...nail ridges and PA - Pernicious Anaemi...
Curious...nail ridges and PA
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mountmuir27
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Hi,
I remember having slight ridges but these disappeared after some months of treatment.
One nail symptom I had was that the moons (lunulae) on my nails almost disappeared and gradually returned with treatment.
I also noticed that my nails grew really slowly before I got treatment and they were brittle.
I was also plagued with fungal infections that affected my fingernails and toenails which I think was due to B12 deficiency affecting my immune system.
When I searched online for "B12 deficiency signs fingernails" I found articles that said that people with B12 deficiency can sometimes develop hyperpigmentation of their nails which can give a bluish colour to nails.
Thank you so much for sharing! I only have moons on my thumbs after several months of treatment. One is starting to appear on my right hand index finger. Very brittle nails and a coated tongue. I suspect my deficiency was present much longer than realized and likely the first severe symptom was vertigo at age 29-30 which I seem to recall resolved with a multi-vitamin. At the time I didn't realize I had a B12 deficiency, of course, although clearly I was still absorbing enough B12 from the multi to "help" a bit. Cervical spondy was my own "trigger event" that led me down the path of researching, learning PA is a known cause of cervical spondylitis that is otherwise unexplained, and thankfully recollecting my Oma (grandmother) had bi-weekly B12 injections. That and severe gastritis that lasted for weeks on end ultimately had me begging for B12 injections.
I had - and still have - no moons on any nails except thumbnails.
I still get vertical ridges, and sometimes cobbled nails, most usually on thumbnails.
At first, I often got thin black vertical lines too - these I first thought might be splinters rising up (I'd been a woodworker for many years) but soon realised that they were blood-streaks. Later I would get painfully strong pressure on nail beds (thumbs again), that would later slowly grow out as horizontal grooves and ridges.
A haematologist once inspected my nails -and asked me if my GP had ever looked at them.
I have read that delaminating/ ridged nails and disappearance of moons are symptoms of B12 deficiency. I once Googled it for images - some photos of dreadfully damaged nails, yet this does not seem to be either well-known or looked for.
This might be a very minor symptom but useful as an indicator - visible damage able to be seen without even having to take off your coat .
Surely a plus in an 8-minute appointment !
My thumbnails remain the most ridged (cobbled?). I have also had periods of horizontal dips in my nails which I've read happen during times of severe anemia so low iron in addition to and/or as a direct result of PA. As it turns out there are older posts in this very topic on this site. Thank you for sharing as well!
Cobbles: rounded like cobblestones or bubbles, as if your nail has blistered.
Ridges: can be horizontal or vertical.
Blood-streaks: vertical and think this is when vertical ridges split, maybe (?)
Plus, in case that isn't sufficient, turn your hands over to show vertical lines in skin of fingers, palms, delamination of fingernails, splits in skin at upper corners of nails.
That's just hands.
I can go through symptoms from top down regarding hair, scalp, brain, sight, sinuses, sense of smell, saliva gland/duct issues, teeth, tongue, gums ..... none of which, taken independently, would cause particular alarm. But I'm not past the neck yet !
Hello I have them I keep asking the dr about my serum iron as it’s only 11 she just says your iron is fine, so I don’t know why I have them , hope you find someone who can help
That’s interesting, it’s not a connection I’ve ever made but I have deep vertical ridges on some of my finger nails. I also have only the smallest half moons on my thumbs but none on my finger nails.
Truly. The smoothing of nail ridges only happened once I started self injecting 2 times per week.
Mine have been like that since I was in my teens and haven't really gotten much better. I went grey in my early twenties and started self injecting in my 30's. My current mean cell volume is 99.8 fL and even with injecting every other day never goes below reference levels (78-98). If I miss injections for more than a week they go even higher.
Like you the ridges on my nails haven’t improved and my MCV is always just above the reference range. I si twice a week.
On the plus side, I’m in my 60s but my hair isn’t particularly grey and I feel fit and well.
I've had a single streak of grey in my hair since my mid-late 30's if not earlier although did not notice until I stopped bleaching my hair blonde and went natural. This is called poliosis and yet another symptom of B12 deficiency undetected by doctors. Apparently it's normal to have poliosis, nail ridges, hearing loss/tinnitus, brain fog, urinary incontinence, repeated chronic diarrhea, high fasting blood sugar despite running/cycling/not eating, and so forth, at a younger age. Yes. That was sarcasm.
NHS link about nail health, mentions iron deficiency but sadly not B12 deficiency.
nhs.uk/conditions/nail-prob...
I found interesting case reports/articles when I searched for
"nail pigmentation B12 deficiency"
"lunulae b12 deficiency research"
Medical/research articles may have upsetting details.
Older forum thread that mentions nail moons (lunulae)
healthunlocked.com/pasoc/po...
"with symptoms written off as due to perimenopause and then menopause"
I'm sure there will be many on this forum who will empathise.
I was left undiagnosed for many years and by my late 30s had dementia and spinal symptoms. I had various rubbish diagnoses eg hypochondria, psychosomatic symptoms, MUPS (Medically Unexplained Symptoms), functional neurological symptoms.
Diagnosed with ME/CFS (seen as a mental health condition in my area) and fibromyalgia. I think the fatigue and pain were typical symptoms of B12 deficiency. I experienced gaslighting by some doctors.
This link about Patient Safety has links to help those having difficult health experiences with B12 deficiency in UK.
healthunlocked.com/pasoc/po...
Thanks for posting this. I'm now feeling strong enough to reply to my surgery in response to their reply to my complaint about my treatment, so this could be my next port or call.
Good luck, I can't remember if you've started a thread about complaint. Forum members may be able to provide support if you do. Click on Posts tab (top left of screen on computer) and search with term "complaint" to find relevant threads.
It's important to protect privacy so I understand if you don't post about it.
No, I haven't written a specific post about my complaint. I didn't want to clog up the forum when people on here need support so urgently. The gaslighting was shocking but also sending me away after 6 loading doses telling me I was only going to be given B12 pills now, despite no investigation into why I had become B12 deficient and my high B12 intake from my diet. And the good old "you don't have PA because you were negative for intrinsic factor..." statement that they would not listen to the facts about. I have concerns about the integrity of one practitioner who conveniently didn't make any notes on my record but then essentially accused me of being uncooperative, obsessed with getting a PA diagnosis and who claimed in her reply to my complaint that she was concerned I might have ME or spinal cord problem. Even recalling the incident makes me irate!
I will so as you suggest and look for posts on complaints!
For years my GP denied that I had a B12 deficiency problem, despite mean cell volume results of 101 to 104 and rising. I've only had moons on my thumbs for a long time, vertical nail ridges for a decade I'd guess, plus a host of other symptoms.
I've been si twice a week since seeing Dr Klein in August. Moons are just beginning to appear on 2 fingers on each hand now, but the ridges are still the same. Early days....👍
My daughter had vertigo and infected throat and nasal passages.
Her nails looked thick ridged and brittle
Also stroke lije sympyons down one side after a walk.
She was 19.
Another symptom on Hindsight missed.
A brain scan dine before a B12 test !!
My nails used to be strong and good and grew quickly .
This changed . Looked flat ridged and almost sitting on top.
Most of my symptoms were dismissed as menopause or anxiety !
It wax a strange collapse. A force pulling me to the right resulting in my first ever vertigo attack that g.ps started to listen..
The menopause definitely my trigger .
Step hormonal changes .
Often think we both coujd have been 'saved ' from a simple b12 test s few yesrs earlier !!!
My GP has always put my nail condition and the ridges down to my psoriasis (had since 16, now 43), even a dermatologist said the same. My nails have only been affected in the past 7 years... this is a revelation!! Thanks for highlighting this as a low B12 symptom, mine was untraceable on a blood test back in 2020. I'll be keeping an eye on how they change before and after injections. Thanks again!
Hi TracyT24,
Psoriasis is often found with PA (Pernicious Anaemia).
Were you ever checked for PA?
PAS (Pernicious Anaemia Society) has lots of useful info on website.
PAS membership is separate to membership of this forum.
pernicious-anaemia-society....
I think psoriasis is mentioned in their article on "PA and other conditions".
pernicious-anaemia-society....
If you start your own thread there's lots of info forum members can pass on.
Mine have been weak and brittle for a long time, with no moons except on my thumbs.
My mum’s are the same and she is always trying some nail treatment.
I can actually see a horizontal line/bump where new nail is growing in and it seems thicker/healthier/stronger than existing nail. Maybe from B12 injections?
I’ve also had a little wart disappear after starting injections. I’d had it for years on a finger and it just started shrinking and disappeared about a month into SI EOD.
I think B12 injections after a period of B12 deficiency can boost the immune system.
Yes. I have wondered about the link and occasionally googled the relevance. My nails have been severely ridged for many years and I only have moons on my thumbs. I also get the occasional horizontal groove. I did have one nail start to 'spoon' last year, but that has corrected and grown out now. My nails also were extremely brittle just recently ( they were never very strong), and I think that would have been the result of my 'crash' at the end of last year. I have been watching for some improvement in the ridges, but ony the brittleness has eased. My B12 D diagnosis was less than 2 years ago, 9 months into SI now.Curiously, my grandmother had very ridged nails, too, but noone seems to think she had any significant illness. She was almost 103 when she passed away, so maybe she had undiagnosed B12D due to her age.
"I did have one nail start to 'spoon' last year,"
I think nails that spoon are often associated with iron deficiency.
Found loads of info when I searched for "nails iron deficiency".
Medical term for spoon nails is "koilonychia".
Koilonychia can also be associated with B12 deficiency.
That's quite interesting, Sleepybunny. Maybe my iron dropped out for a bit. I know it is quite robust now! 😁
I too have the ridges and only tiny moons on my thumbs. I've been on injections for years now and this hasn't changed. But I've still been iron deficient until half a year ago, so...I can't remember whether my nails ever had moons to be honest.
I've been trying to find out if folate deficiency can also cause loss of nail moons and other nail changes.
Found some interesting articles when i searched for
"lunula folate deficiency"
"folate deficiency nails"
Many on here have folate, iron and vitamin D deficiencies as well as B12 deficiency.
Also common to have thyroid problems so may be worth posting on thyroid UK forum on HU about nail issues.
Yes, I've had them for a long time too. On starting to take tablets, they began to improve. I was taking more and more tablets to cope with my other symptoms as they got worse. As with everyone else, no luck with my GP.
I plucked up the courage and started injections. I am still going in and out of symptoms. I find my nails are a guide as to how well I am doing. Last week, they had heavier lines and I had A. Fib. returning. This week, they are flatter and my heart symptoms are abating.
How they go up and down intrigues me. I would have thought that the nails would need to grow out to change but it seems not.
Yes, I experienced the same as others. I remember when at the Dr office they were "feeling /rubbing"my nails as they talked to me. It was never mentioned but it made me feel good that they were checking for other symptoms, not just going by test results. They increased my injections at that appointment. My nail health has improved but I still struggle with it. Slight lines, only moons on thumbs. Spooning is gone. I lightly buff the lines & ridges down with a file for a smoother look & feel.
Hi mountmuir
Yes corrugated fingernails stated about 20 years ago for me - just after I had my children. In the last 18 months they are less pronounced but still there. They show up more in the rare event I attempted to paint my nails!
I only have obvious moons in my thumbs. On the other finger they are now only just beginning to show.
My nails used to be slow growing and brittle and delaminate - now they grow quickly and are strong.
Very interesting post.
🤗🤗🤗
Might be worth people with nail issues also searching posts on Thyroid UK forum on HU.
About 25 years ago I noticed that my fingernails had vertical lines, and also pitting. I dug around in medical texts and journals, looking for "nail pathology" and similar search words. I found that both the lines and pitting were associated with psoriasis: pits result from proximal (toward the body) involvement of the nail matrix, and vertical lines were associated with distal (away from the body) involvement of the nail matrix.
At the time I was diagnosed with B12 deficiency (2021), my fingernails were thin, papery. After a few months of insufficient B12 dose frequency, I began injecting daily. Also, I started paying a bit more attention to nutrition and began supplementing protein. I also began taking several other supplements, most mentioned by Technoid, because they were associated with neural health. Subsequently my nails have thickened considerably; they still feel oddly stiff when I scratch my head. I have no way of knowing what it was that caused the nails to become more healthy.
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