Nail changes? Pale nails.: Hi, I have Hashimoto's... - Thyroid UK

Thyroid UK

141,251 members166,507 posts

Nail changes? Pale nails.

JackiePotatoes profile image
16 Replies

Hi, I have Hashimoto's and for the last few years, I've slightly overmedicated with levothyroxine though my endo was happy to do so, as I felt better.

I noticed recently that I have what looks like the start of Terry's nails - pale (pale not completely white) nail beds with a dark pink line before the white tip of the nail. I only have half moons on my thumbs.

There's seems to be a lot grim reasons for Terry's nails, but I have sometimes seen Thyroid disorders mentioned but not in much detail.

I wondered if anyone else has noticed this sort of weird change to their nails?

My GP ran a cbc and some other tests, but other than my thyroid, everything seemed okay.

Written by
JackiePotatoes profile image
JackiePotatoes
To view profiles and participate in discussions please or .
Read more about...
16 Replies
SlowDragon profile image
SlowDragonAdministrator

welcome to the forum

Lack of half moons is common with Hashimoto’s/under medicated

What were your most recent thyroid and vitamin rest

TSH, FT4 and FT3

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum, especially with Hashimoto’s

What vitamin supplements do you currently take

Are you on gluten and/or dairy free diet

Recommended that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

If you can’t get everything tested via GP/endo

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 and includes BOTH TPO and TG antibodies -£29 

randoxhealth.com/at-home/Th...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 (Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

Only do private testing early Monday or Tuesday morning. Last dose levothyroxine 24 hours before test

Mijmijkey74 profile image
Mijmijkey74 in reply toSlowDragon

Out of interest - is everyone supposed to have half moons showing on each fingernail? Or only on Thumb nails? I don't have any half moons on any of my nails. Does that mean I have a thyroid problem?

JackiePotatoes profile image
JackiePotatoes in reply toMijmijkey74

For some people, it is nothing to do with your thyroid and they are just hidden behind the skin of your cuticle. Those missing alone, I don't think is any reason for real concern.

helvella profile image
helvellaAdministrator in reply toMijmijkey74

My lunulae (medical name for half moons) are present and correct on all ten of my digits.

But, and this is the point, they did shrink considerably when I was hypothyroid and on insufficient dose. Mind, I think the contrast between the lunulae and the rest of the nail is a little less than it used to be. Though that could be things like ageing - I don't know because I've never previously been this old. :-)

JackiePotatoes profile image
JackiePotatoes in reply toSlowDragon

Hi! Thank you!

Here are my recent results:

TSH - 0.09

Free T4 - 24.5

Free T3 - 4.9 (3.1-6.8)

Levothyroxine dose has since been reduced.

---

B12 was at lower end: 202 (range 197-771) I'm largely vegetarian.

Folate normal: 8.4 (range 3-20)

Vitamin D was was low 46 (range 50-150)

Ferritin wasn't checked oddly, so maybe I'll get that done myself.

---

Also had a dexa scan which was normal.

--

kidneys function normal, cholesterol normal, no diabetes.

-

liver was normal apart from slightly elevated levels of billirubin. My Gp pulled up some previous tests over last decade and said that it was normal for me, and perhaps suggestive of Gilberts syndrome, though no-one has ever mentioned this to me before.

Doc said to get more sunshine and take otc Vitamin b12.

JackiePotatoes profile image
JackiePotatoes in reply toJackiePotatoes

Have tried a gluten free diet but made no real difference to me. I avoid white carbs and pasta due to bloating.

Re: half moons. To be fair, they have been missing from my fingers for years, but the white appearance on my nails is new.

I also have vertical ridges on my nails which have gotten worse over the years. Related to B12/D I imagine.

SlowDragon profile image
SlowDragonAdministrator in reply toJackiePotatoes

Only add one supplement at a time, then wait at least 2 weeks to assess before adding another

Probably…..Starting with B12

Low vitamin D

Vitamin D 46 (range 50-150)

GP should prescribe 1600iu everyday for 6 months. But likely better to supplement at least 2000iu daily yourself

Retest after 2-3 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Come back with new post once you get iron and ferritin results

There are thousands of posts on here discussing low iron and ferritin

Suggest you read many posts and replies by humanbean on iron and ferritin

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

SlowDragon profile image
SlowDragonAdministrator in reply toJackiePotatoes

What’s the range on Ft4

Was test done early morning and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

On levothyroxine for good conversion of Ft4 to Ft3 we need OPTIMAL vitamin levels

Vitamin D at least over 80nmol

Serum B12 at least over 500

Active B12 at least over 70

Ferritin at least over half way through range

as vegetarian it’s frequently (almost always) necessary to supplement B12 daily and a daily vitamin B complex…….especially if also hypothyroid

Similarly low ferritin highly likely on vegetarian diet

If you get bloating…..that strongly suggests gluten intolerance. Zero point being almost gluten free. It needs to be absolutely strictly gluten free to be effective

SlowDragon profile image
SlowDragonAdministrator in reply toJackiePotatoes

B12 was at lower end: 202 (range 197-771)

Folate normal: 8.4 (range 3-20)

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week or two

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

B12 drops 

natureprovides.com/products...

Or

B12 sublingual lozenges 

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

Vitamin B complex for low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until over 500

Note that improving folate when B12 is very low is not a good idea. Taking folate before B12 is good enough can lead to severe neurological problems.

en.wikipedia.org/wiki/Subac...

It is vital if you intend to supplement both B12 and folate that B12 is started a week before the folate.

Batty1 profile image
Batty1

Great now Im looking at my nails and I have no moons and they are whiteish pink … is this normal?

Wilky21 profile image
Wilky21

Hi

Jackie

I have experienced nail changes. At first it was just in my thumb. I thought at first it was fungal mail not nothing worked to get rid of it. Then it started in my fourth finger on a different hand exactly the same.

My GP referred me to a dermatologist but they couldn’t cure it either and weren’t sure what it was

I then had an appointment with my endo who confirmed it was to do with thyroid disease and there was nothing they could do to prevent it.

I just now keep them very short and they do seem to be improving

Sharoosz profile image
Sharoosz in reply toWilky21

I have ridged, splitting nails too. They sometimes split vertically down to the quick, which is horrible. I generally keep them short anyways for playing piano and gardening, but would love to see the splitting improve!

JackiePotatoes profile image
JackiePotatoes

Hi Wilky, was it the whites of your nails getting bigger, by any chance?

Wilky21 profile image
Wilky21 in reply toJackiePotatoes

hi Jackie

Yes it was. It was at the end of the nail and it just got bigger. It looks awful

JackiePotatoes profile image
JackiePotatoes in reply toWilky21

Yes, I've had that before. it's the nail lifting away from the bed, I believe and common with thyroid problems.

Wilky21 profile image
Wilky21 in reply toJackiePotatoes

Thankyou for confirming that. I didn’t know what it was. It went on for years. Neither did the GP. Glad it’s all sorted now. Hope you get sorted

Not what you're looking for?

You may also like...

Problem with nails

My nails are so awful, the usual hypo ridges some even look like they might crack. I also have...
daisymoo profile image

Nails

Hi guys, just wondering if you might be able to help, I was diagnosed hypothyroid June of last year...
Nikki69 profile image

Finger nails going white

Hello - I wonder if anyone has had an issue with their nails? My finger nails have started going...
jostafford0 profile image

Poor nail quality

Does anyone else have extremely poor nail quality? My nails are in a terrible condition..if they...

Thick toe nails - fungus?

Toenails. I have thick big toe and pinky toe nails. Under one big toe is a white lump in the middle...
foxyfouro profile image

Moderation team

See all
PurpleNails profile image
PurpleNailsAdministrator
helvella profile image
helvellaAdministrator
SlowDragon profile image
SlowDragonAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.