Hypothyroid - problem with nails?

[queridalady]

Hello lovely thyroid warriors. It's been a while since I posted but am having a problem with my nails and wondered if anyone had experienced similar. My latest test results are as below. These are after an increase in T4 from 125 to 150 per day at my request as I was struggling with tiredness and leg cramps etc. Its a battle to get a higher dose as my TSH is suppressed but as you can see, even with the increased dose I am at the bottom of the range with FT3. So since the increased dose I have had some accidents with my nails, crushed two in a drawer (awful) and rammed my plastic brush bristle up 2 of my nails. I was keeping them too long really. so long story short, took the gel polish off and some of my nails are lifting off the nail bed (Onycholysis?) its bad on the nails I had the trauma but I can see it a little on two other nails. My GP frightened me to death by asking me to send off clippings to test for fungal infection which I have done and since then, 2 weeks ago, I have been using teatree every day etc. But I have read that thyroid disease can cause this too? It has happened since my increased dose and wondered if my body thinks I am over medicated due to my TSH and this is causing the nail problem? I have worn gel polish for many years without issue.

Has anyone else had this problem as a result of thyroid disease maybe?

Thanks as always

Serum free triiodothyronine level 3.96 pmol/L [3.1 - 6.8]

Serum free T4 level 14.4 pmol/L [11.0 - 23.0]

Serum TSH level 0.06 mU/L [0.27 - 4.5]

[SeasideSusie Remembering]

queridalady

Actually, your FT4 and FT3 aren't badly balanced. FT4 is 28% through range, FT3 is 23% through range. So even though your TSH is below range, your FT4 and FT3 should be higher in range.

What are your nutrient levels like? They need to be optimal for thyroid hormone to work. Do you have results for

Vit D

B12

Folate

Ferritin

If not, ask for them to be tested, or do them privately.

I can't answer your question about nails I'm afraid, but I stopped using nail polish many, many years ago (before gel products). I didn't think it was healthy to have nails continually covered with a chemical product that didn't allow my nails to ever be "natural" and "breathe". Apparently gel manicures can eventually cause thinning of nails and weaken the nail bed so maybe not a good idea to use them continually without a break.

[queridalady in reply to SeasideSusie]

thank you for your advice Susie. I'm usually anaemic. I was before becoming hypo and I have low B12 too. So I supplement Iron, B12 and Vit D3 and have done for a while. I eat a good diet, Gluten free, lots of veg etc. I wouldn't rule out gel polish but I'm not convinced as this has been sudden and I take my polish off regularly and never saw anything. nails were is good condition. I am on low dose PPI 10mg a day so I know absorption can be an issue. I sued to be fit and well before my thyroid packed up 6 years ago! gee whizz. I appreciate your help x

[mgh4090]

It is most likely Onycholysis from overmedication. I was probably an extreme case but I had the same thing (and other worse issues) from overmedication. Most Doctors will not attribute it to the medication and it is hard to find a lot if info on the internet but it is out there if you really dig. Here is a link to a short article I found -

ncbi.nlm.nih.gov/pubmed/967...

My story is that I was put on 125 Mcg of levo as my initial dose by my general MD, my TSH was about 6.4. I was on it for about 2.5 months before I started getting really bad side effects. I was told to stop all medication - by them my TSH was .045. First it was a lot of nausea - and I started to lose weight from not eating. Then my hair started falling out in clumps - next my nails started separating from my nail beds. Eventually I lost about thirty pounds, lost about 90% of all my hair including all other body hair, lost all my fingernails and toenails.

This did not happen quickly or all at once and I went to so many doctors it is ridiculous. I stopped all medication on 8/21/18 and as of today my hair is growing back - I now have about 2 inches (although completely gray), my nails are growing back - about 2/3 back and my nausea is somewhat manageable. My problem was I was put on a high dose right from the start and it sent my body into some kind of shock. If you are getting the nail symptoms now the medication has already done some damage to your system. You really need to talk to specialist if you are not already and keep an eye out for hair loss or nausea and also your toenails (they took longer than my fingernails to react.

Good Luck,

Mary

[queridalady in reply to mgh4090]

thank you for your reply and I'm so sorry to hear about your suffering. I am glad you are starting to get on the mend. I have been on thyroxine for 5 years and more or less at the same level. I have had a lower TSH before but not very often. I'm not sure what I can do if it is my TSH level causing this...I wont be able to function on any less thyroxine.

[MaisieGray in reply to mgh4090]

"It is most likely Onycholysis from overmedication. ..... If you are getting the nail symptoms now the medication has already done some damage to your system."

I don't think you can accurately assert either. There's no indication from what the OP has written that like you, she was started on too high a dose of Levothyroxine, and her dose was recently increased by a perfectly reasonable 25 mcg. Rather than showing over-medication, her FT3 and FT4 blood test results are both well below even midway in range. There are a number of causes of onycholysis, if that is the problem, amongst which, both hypothyroidism and hyperthroidism are numbered. If the cause was indeed thyroid-related, the OP's numbers and dosing history seem to indicate the former rather than the latter.

[Framboise]

I had a similar problem with my nails. Three of them started to lift and go white and look really strange. I had injured each of the three during the previous year in various ways, usually knocking them against something hard so that the nail turned back momentarily. At the time I always wore nail varnish and I wore rubber gloves to wash anything in the kitchen, neither of which helped. It turned out to be a fungal infection which gets under a nail injury like that and seems to settle in. It could well be that low thyroid causes a general low resistance in the body to allow that to happen, but it was noticeable to me that it began after damaging my nails and then wearing varnish all the time, rather than corresponding with starting thyroid hormones, altering levels or a change of brand etc..

I got rid of it with something from my GP which I had to paint on my nails for a few weeks after having filed the top of the nail to make it absorb better. For a while after it cleared up, if I wore nail varnish again it started to come back, so I just stopped the varnish for about a year and now it's all fine again and I can wear varnish again. I hope you can sort it out as easily!

[queridalady in reply to Framboise]

Thank you for the information Framboise. I’m glad you were able to sort it! My nails are all white where it has lifted and pink and healthy looking elsewhere. I’m using tea tree and have sent clippings off for testing. It’s making me very paranoid! Think I might try dropping my Levo back to the previous level just to see if that helps.

[Framboise in reply to queridalady]

Yes that's what mine looked like. Hopefully the testing will show exactly what it is and then you can treat it. I tried tea-tree on mine, and also Vicks, as I read that was good, but it was only the paint on liquid from my GP which got rid of it. No need to feel paranoid though, these things happen, I hated friends seeing my nails when they looked like that because normally they'd always been highly polished and beautiful, but whatever has caused yours, it will get better!

[queridalady in reply to Framboise]

Thank you Franboise for your kind and positive response. I’ve just noticed 2 more nails showing signs but this is 3 weeks after first discovering the problem and I have been very careful not to cross contaminate nails since then. Just don’t understand xx

[queridalady in reply to Framboise]

Just got my test results. Negative for fungal infection which is good. Just don’t know what it is! X

[Framboise in reply to queridalady]

Ah that's interesting, especially if more nails are being affected! I would have thought that if it was to do with your thyroid med change then more of us would experience similar problems, but possibly it's a very individual thing.

I wonder in this case if could be to do with the gel varnish. Have you searched to see if that's possible? The varnish I use is the normal gloss type not gel, so I'm not sure how different it would be.

[queridalady in reply to Framboise]

I know, it’s strange. I have used the same gel years really but it has been off for 3 weeks now so would be surprised if that was the cause of the recent nail problem. So vain to be upset about nails I know but it’s like the tip of the iceberg with everything else we put up with lol! Xx

[dtate2016]

May I also suggest goldenseal for a fungal infection? Teatree oil is a wonderful topical application and for that matter you can use goldenseal in a topical way. ( I have used it successfully taking it internally for both fungal infections and viral infections - even gets rid of warts which are caused by viruses !)

As for causes. rather than jump right straight to the medication being the issue and/or over medication, There’s more and more science that talks about what causes Hashimoto’s in the first place or thyroid disorders - and it’s more and more leaning towards a gut root cause. I would look for a remedy there. Yes we can be gluten-free, dairy free, soy free, etc. - but adding biodiversity will fight fungal infections. Sauerkraut, kimchi, Kiefer, Kambucha, probiotics, pre-biotics. Fluconazole is a medication that one can start first if it’s available to you. Here in the states I have a functional doctor that recommends at least a 10 day course and then to follow up with the above. But most people with thyroid disorders probably have got disorders as well.

I have begun to make my own sauerkraut and I’m gonna learn how to make kimchi I’ve made my own Kiefer is well - it’s a hassle and my busy lifestyle really doesn’t have room for it but when I do make the time for it I lose weight I have energy my nails and yes I have had a nail problem - they get better. And as an added bonus I usually need less medication less NDT. I’m convinced that we’re going to find the cure one day and it’s going to be in the gut, our diet - A diverse gut biome.

Lastly, I would look to a balance of magnesium and potassium. We hear so much about calcium and biotin for a strong nails and silica - even glucosamine. But most of us are magnesium deficient . Without the magnesium we can have all the nutrients in the world and still have weak and brittle nails.

I also agree with going Gel free and Polish free - it’s OK for special occasions but healthy nails do you need to breath. The very first nail fungal infection I ever had was when a friend gave me a gift of a pedicure.

My two cents - what’s worked for me. But again I would look at the medicine last As a cause.

[queridalady in reply to dtate2016]

This is really interesting and helpful, thank you. Just today I have had my results that it is not fungal which is good news. However just yesterday I have new signs of nail lifting on 2 more nails 😔. So the Onycholysis is being caused by something. I’m guessing the increased dose of thyroxine as that is the only thing that had changed. I am in total agreement with you about the gut. I take good probiotics and supplement with sublingual iron, B12 and vitD. I had magnesium tested and it was ok. I think I have some goldenseal somewhere. I might try taking some! Thank you again for your advice. I wish I knew what was going on with my nails! X

[mgh4090 in reply to queridalady]

I seem to have stepped on toes with my comments about overmedication - so just to clarify - that was my experience and may not apply to all. However since you now know it is not fungal it is time to look elsewhere for causes.

I went to two different endocrinologists as well as dermatologists and they were in agreement that the most probable cause was the medication - and I never polished my nails with gel or anything else. I seemed to have gotten all of the bad side effects so my case is very unique I know. But I would hate to see someone else suffer as much as I did so I can't help but add my experience.

[queridalady in reply to mgh4090]

Don’t worry! Everyone’s experience is different and I appreciate you taking the time to write. It’s been so nice that people have been kind enough to reply to me xxx