Problem with toenails

[BURKEB3]

Has anyone experienced a problem with their toenails. one of mine is falling off and another is cracking near the bottom so will probably fall off as well. I changed from Armour to WP Thyroid about 5 months ago and I don't feel as well on it and I seem to be putting on some weight, I mostly do the gluten free but sometimes fail. I am on 90mg but I have raised it a bit this week as temps low . not due back to doctor for another few months. please advise

[bluebug]

Toe nails grow slower than finger nails. Apparently it takes on average 6 months for finger nails to grow from the start to the tip of your finger. This means that any nutrient deficiencies or metabolic disturbances will take months to appear in your nails.

It would be a good idea in 6 weeks to have your thyroid hormone tests as normal then to post the results in a new thread. In addition you can have your ferritin, folate, vitamin D and vitamin B12 levels checked to confirm the levels are optimal.

[BURKEB3 in reply to bluebug]

Thank you for your quick response. I will do as you suggest and get the test results. I am already getting B12 injections but they have been reduced as levels had gone up to 2000.

[bluebug in reply to BURKEB3]

Ahh that explains it.

In regards to the vitamin B12 testing is your GP aware that NICE guidelines state that they should not bother with vitamin B12 testing once you are supplementing/injecting?

Instead you should be monitored first with a full blood count and reticulocyte count then with just full blood counts.

The reason for this is blood/serum B12 tests just check the total B12 in your system not what is active in the cells and whether it is actually working. The full blood count will determine whether your blood cells are within range in size and count, while the reticulocyte count just checks the whether your are producing the right amount of immature red blood cells.

Also if you have neurological symptoms between your injections you need to be referred to a haematologist.

[BURKEB3 in reply to bluebug]

Yes, I only recently became aware of this and no, neither my doctor nor the doctor on haematologists team I am attending mentioned this so need to talk to both about this at my next visit. I am just getting one injection every 6 months so maybe I should increase the number.

[bluebug in reply to BURKEB3]

They will give you the minimum they can get away with. To get anymore you need to give them clear symptoms of vitamin B12 deficiency.

If that doesn't work then groups like B12d.org are worth joining to sort out your own.

[BURKEB3 in reply to bluebug]

Thanks, It's hard to understand why or how they didn't know about the NICE so I am going to check out some of the organisations as you advise as you have been very helpful.

[bluebug in reply to BURKEB3]

NICE are guidelines but there is nothing which enforced doctors to legally comply with them.

Most of the time they get away with saying NHS England/Scotland/Wales/NI didn't provide funding for that even though the test you are asking for maybe cheaper.

I remember someone took a complaint up as far as possible in this case he was complaining about not providing genetic tests for his family in NHS England and he hit a brick wall.

[BURKEB3 in reply to bluebug]

My doctor is fairly reasonable so hopefully she will see the benefit of doing this and some other issues I am experiencing may make her more receptive.

[bluebug]

I have used micropore tape in the past to cover my toe nails when they fall off until the nail bed goes suitably hard. The tape is more paper based so the nail bed under it doesn't go soggy like it would if you used a plaster or more plastic based tape.

[BURKEB3]

I didn't know what to use so that's very helpful. Thanks again for advice