The thyroid is a small gland in the neck which is responsible for a multitude of bodily functions. These include warming the body, activating the immune system, regulating the metabolism, and controlling the body’s growth.
Some people have an overactive or underactive thyroid gland, which can have various side effects. One vital sign that you’re experiencing problems can be seen in the toenails. Just like the hair and skin, our nails can indicate that there’s an imbalance.
We’re going to explore the effects of thyroid problems on the toenails. We’ll also look at other medical issues that could be responsible for changes to the color and composition of the nails.
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Can Thyroid Problems Cause Nail Changes?
Thyroid problems can affect every element of the body, from your heart rate and temperature to your hair, skin, and nails.
The nails are an indicator of our health. They tell us when something is off balance in the body. This is why it’s so important to monitor the appearance of your nails.
A Brief Overview of Thyroid Issues
The thyroid is a butterfly-shaped gland which is located just in front of your trachea. It has two main functions: to control growth in early life and to control metabolism. To stimulate these functions, it releases two hormones: thyroxine (T4) and triiodothyronine (T3).
T3 is the hormone that regulates the body’s metabolism. T4 is what’s known as a ‘pro-hormone,’ which means it only becomes active when it is converted to T3 by the body.
There are dozens of factors that affect the thyroid’s function, throwing the production of these hormones out of balance. This then has a knock-on effect on the rest of the body’s functions.
Four main issues can affect the thyroid:
- Overactive thyroid – also known as hyperthyroidism. This can cause unexpected weight loss, as well as changing the mood, causing nervousness or hyperactivity.
- Underactive thyroid – also known as hypothyroidism. This has the opposite effect, causing weight gain and making the sufferer feel tired and depressed.
- Goiter – this involves swelling of the thyroid gland, which is usually harmless and fades without further treatment.
- Thyroid cancer – accounts for less than 1% of all cancers diagnosed.
By far the most common problems are overactive and underactive thyroids.
Overactive Thyroid (Hyperthyroidism)
An overactive thyroid produces an excess of thyroid hormones in the body. These additional hormones circulating the body can cause a range of serious problems, with symptoms including:
- Difficulty sleeping
- Nervousness and anxiety
- Mood swings
- Swelling in the neck (from the gland itself)
- Weight loss
- Palpitations
- Heat sensitivity
- Fatigue, tiredness, and weakness
- Twitching and trembling
Anyone can develop an overactive thyroid, but it’s thought to be around ten times more common in women than men.
It’s also most common during the ages of 20 and 40. It can develop in younger and older women, but this is when hyperthyroidism is most likely to start.
Hyperthyroidism and Toenails
Hyperthyroidism can cause a condition called Plummer’s nails. This is when the ends of the nails start to rise away from the nail bed. This condition usually begins on the fourth finger or toe, before spreading to the other nails.
When the nails start to loosen and pull away from the nail bed, it can cause pain and discomfort. If the nails snag on loose objects, they can pull away entirely, which is enormously distressing.
Plummer’s nails also mean that dirt can then get under the nails, making them appear unkempt and increasing the likelihood of infections or fungus developing. Toenail fungus can cause nail discoloration, pain and difficulty walking once the symptoms progress.
One type of hyperthyroidism is caused by Graves’ disease. If you have an overactive thyroid caused by Graves’ disease, you might also notice that your nails become thicker and ridged.
This can be confusing because thicker nails are also associated with fungal nail infections, so you may not know whether you have an overactive thyroid or fungus.
Underactive Thyroids (Hypothyroidism)
An underactive thyroid doesn’t produce enough of the hormones that the body needs to function. This can cause various symptoms as the body attempts to cope with the lack of certain hormones.
These symptoms can include:
- Tiredness
- Weight gain
- Depression
- Dry skin and hair
- Aching muscles
As with overactive thyroids, underactive thyroids are more common in women. Just 1 in 1,000 men develops the condition, compared with 15 in every 1,000 women. Congenital hypothyroidism is also possible, with 1 in 4,000 babies born with this condition.
Hypothyroidism and Toenails
What effect does hypothyroidism have on the toenails? It turns out that having low thyroid function wreaks havoc on your toenails, causing a range of different problems to occur.
1) Jagged Cuticles (Paronychia)
One of the hallmarks of low thyroid function is paronychia (jagged and rough cuticles.) Jagged cuticles are often linked with protein deficiencies and tyrosine deficiencies.
Tyrosine is an amino acid which is responsible for helping thyroid function, and it’s very common to see those with an underactive thyroid present with both protein and tyrosine deficiencies.
2) White Ridges
Have you noticed that you see vertical white ridges along your fingernails and toenails? This can be down to a selenium deficiency, which is also linked with low thyroid function.
Selenium is crucial in the conversion of T4 to T3 – as we learned before, T4 is inactive until it is converted, so if there’s a lack of selenium in the body, it can lead to not enough T4 being activated and turned into T3.
When our bodies don’t convert T4 to T3 very well, we can start to see signs on our exterior. One of the signs is white ridges on the nails. You might also notice white spots on the toenails signaling a selenium deficiency or underactive thyroid.
3) Pale Nail Beds
Regular, healthy nails should have a small crescent-shaped white area at the base. If you have hypothyroidism, you might notice that the crescent shape gets lighter or disappears entirely.
This is because the inadequate protein synthesis caused by hypothyroidism can cause a slowing of the metabolism, which directly affects the nails.
4) Ingrown Toenails
Hypothyroidism can also cause symptoms that are as yet unexplained by medicine. One of these is ingrown toenails. Doctors don’t completely understand why those with low thyroid function are more likely to have ingrown toenails.
Having an ingrown toenail can be very painful, especially if not treated properly. It can cause problems with mobility, and leave the entire are susceptible to bacterial or fungal nail infections.
5) Fungal Infections
A fungus is also a common side effect. The thyroid hormone is responsible for the strength of your cardiac contractions. The stronger the contractions, the more blood will make it to your extremities – the fingers and toes, especially.
Without strong enough contractions, the fingers and toes can become cold, and the low oxygen state caused by lack of blood flow can contribute to fungal overgrowth.
Fungal nail infections can be unpleasant – they smell foul, they can cause pain and discomfort, and they can be difficult to remove.
If you have a fungal infection that you think is the result of hypothyroidism, it’s vital that you see a doctor. You can address the fungal infection effectively with a range of over-the-counter treatments, from tea tree oil to medicated creams.
But without treating the underlying cause – the underactive thyroid – you run the risk of the fungus coming back over and over again.
Toenails Reflect Your Health
The toenails are a great indicator of the state of our internal processes and bodily systems. They can give vital clues as to whether our bodies have deficiencies in certain vitamins or minerals. They can also flag up conditions like hyperthyroidism or hypothyroidism.
Problems with the thyroid can cause many symptoms of health issues. Thyroid hormones are responsible for many processes within the body, and if we have too little or too much, it can throw the delicate endocrine system out of balance.
Pay attention to the state of your toenails. They may be covered up for most of the day, but be sure to inspect them regularly. From raised nail beds to white ridges and fungal toenail infections, there are lots of things to keep watching out for if you’re worried about low or high thyroid function.
