What Your Nails Say About Your Health (cont.)

An iron deficiency can cause the nail bed to be thin and concave and have raised ridges.

While most of Fox's patients don't come in to report nail problems, he often checks their nails anyway. "The nails offer many little clues to what's going on inside you. Lupus patients get quirky, angular blood vessels in their nail folds. Psoriasis starts in the nails up to 10% of the time" and causes splitting and pitting of the nail bed.

Heart disease can turn the nail beds red. Obsessive-compulsive disorder can show up in the nails through persistent nail-biting or picking, Fox says.

Even common disorders like thyroid disease can cause abnormities in the nail beds, producing dry, brittle nails that crack and split easily.

He lists the following 10 examples of nail changes that could indicate a serious medical condition.

What Your Nails Say About Your Health:
10 Possible Signs of Serious Conditions
Nail Appearance Associated Condition
White nails Liver diseases, such as hepatitis
Yellowish, thickened, slow-growing nails Lung diseases, such as emphysema
Yellowish nails with a slight blush at the base Diabetes
Half-white, half-pink nails Kidney disease
Red nail beds Heart disease
Pale or white nail beds Anemia
Pitting or rippling of the nail surface Psoriasis or inflammatory arthritis
"Clubbing," a painless increase in tissue around the ends of the fingers, or inversion of the nail Lung diseases
Irregular red lines at the base of the nail fold Lupus or connective tissue disease
Dark lines beneath the nail Melanoma

'Rarely the First Clue'

But can a doctor truly detect undiagnosed heart disease or kidney problems by looking at your nails? American College of Physicians spokeswoman Christine Laine, MD, MPH, says it's not likely. She doesn't dispute the connection between nails and disease, but she cautions, "Nail changes are rarely the first clue of serious illness. In most instances, patients will manifest other signs or symptoms of disease before nail changes become evident. For example, it would be unusual that nail clubbing was the first thing a patient with emphysema noticed. Breathing difficulty probably would have been present already."

In addition, Laine, who is the senior deputy editor of the Annals of Internal Medicine, notes that certain illnesses may cause nail changes in some patients but not in others. "For example, not all people with liver disease develop white nails," Laine tells WebMD. The reverse is true as well - not everyone with white nails has liver disease. "In the absence of other signs or symptoms of disease, I would be reluctant to launch a complex, expensive work-up for systemic disease solely because of nail findings."

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