Your nails say a lot about your health and doctors have actually looked to patients’ nails for clues about their health for centuries. It may seem like a strange connection, but changes in the visual appearance of your nails can be a sign of iron deficiency. The reason for this is that iron helps to carry oxygen throughout the body, including to your tissues. When you’re iron deficient, your tissues and muscles get less oxygen and this can show in your nails.

Koilonychia (Spoon-Shaped Nails)

The medical term, Koilonychia refers to concavities of the nail resulting in a spoon-shape (soft nails that appear to be scooped out). This is the most common nail change for people with Iron Deficiency, often presented in the later stages (Iron Deficiency Anemia).

A water drop test is used to diagnose Koilonychia – this test is performed by placing a droplet of water onto the nail; if the drop is held in the depression (does not slide off), then the nail has become concave from “spooning.”

Koilonychia can be found in infants as a normal variation, but this typically corrects itself with age (within the first few years of life). Koilonychia can be associated with various systemic diseases such as Raynaud’s disease (where some areas of the body feel numb and cold in response to cold temperatures or stress) and Lupus Erythematosus (an autoimmune disease). Interestingly enough, Koilonychia can also be associated with Haemochromatosis (too much iron in the body).

Other Nail Changes

• Ridges – Ridges in the nail are common as we age, but when they occur in our younger years, or are particularly pronounced in the center of the nail, it’s often because of iron deficiency. The ridges go up and down the nail and there may be a thicker/more noticeable line up the center of the nail;
• Brittle Nails – This is another sign of aging that is also a very common symptom of iron deficiency;
• Pale or White Nailbeds – Anemia is often the cause of nail beds that appear pale or white.

What You Can Do About It

Aside from being diligent about nail care, the first thing you’ll want to do is see your doctor to rule out any other symptoms that may be causing changes in your nails. If iron deficiency is indeed the culprit; increasing the amount of iron-rich foods in your diet and/or adding an oral iron supplement will help treat the deficiency which should help your nails as well.

Often times changes in the appearance of your nails due to iron deficiency/iron deficiency anemia occur in more advanced stages, but they may also represent other diseases rather than iron deficiency, or simply be a normal variant. Because of this, it is important to also look out for other common signs and symptoms of iron deficiency and speak with your doctor to recognize iron deficiency early or rule it out altogether.

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Content and advice provided on The Iron Maiden is for information purposes only and should not serve as a substitute for a licensed health care provider, who is knowledgeable about an individual’s unique health care needs