Reader says, “I am embarrassed to admit how my nails look, even though I take MSM and other supplements that I buy from another company. I read that MSM helps produce collagen and keratin that are necessary to produce healthy hair and nails. However, a couple nails have little dips or curves while others are cracked where they are weakest near the tips. Can you tell me what’s causing this condition and what I can do about this?”
While I am not trained or qualified to offer a professional diagnosis or advice, it would appear from your brief description that you are afflicted with a common nail disease called koilonychia (“spoon nails”) that is often linked to an iron deficiency. As a point of reference, please review the following description of koilonychia written by Melissa Conrad Stöppler MD, that was published on Medicine Net:
Spoon-shaped or spooning fingernails refers to a concavity in the fingernail itself, resulting in a depression in the nail that gives an appearance of a spoon shape to the entire nail. This growth disturbance in the nail is medically known as koilonychia. The spooning is typically such that a water droplet may be placed and held in the depression within the nail.
In an article entitled, “How A Diagnosis Of Koilonychia May Indicate Systemic Disease,” Kristine Hoffman DPM provided this supplemental commentary about the characteristics of koilonychia that was published on Podiatry Today:
In adults, koilonychia is associated with several acquired disorders including lichen planus, psoriasis, Plummer-Vinson syndrome, Darier’s disease, Raynaud’s disease and lupus erythematosus… The most common cause of koilonychia is chronic iron deficiency anemia.
Source: Fawcett RS, Linford S. Nail abnormalities: clues to systemic disease. Am Fam Physician. 2004; 69(6):1417-24.
Below are excerpts from two sources (the National Heart, Lung, and Blood Institute and the American Society of Hematology) that describes some characteristics of iron deficiency anemia:
Iron-deficiency anemia is a common, easily treated condition that occurs if you don’t have enough iron in your body. Low iron levels usually are due to blood loss, poor diet, or an inability to absorb enough iron from food… Treatments may include dietary changes, medicines, and surgery.
Source: What Is Iron-Deficiency Anemia? National Heart, Lung, and Blood Institute
Iron is very important in maintaining many body functions, including the production of hemoglobin, the molecule in your blood that carries oxygen. Iron is also necessary to maintain healthy cells, skin, hair, and nails.
Iron-deficiency anemia is diagnosed by blood tests that should include a complete blood count (CBC). Additional tests may be ordered to evaluate the levels of serum ferritin, iron, total iron-binding capacity, and/or transferrin.
Source: Iron-Deficiency Anemia, The American Society of Hematology
Heme Iron vs. Non-Heme Iron in Food
Heme iron is derived from hemoglobin and is found only in meat, poultry, fish, and other types of seafood. In comparison, non-heme iron is present in plant-based foods such as fruits, nuts, and grains as well as eggs and dairy. Animal meat is unique in that it actually contains both heme and non-heme iron. Our bodies are able to absorb heme iron more readily than non-heme, which is an important consideration if you are a vegetarian, or have been diagnosed with a malady called hemochromatosis where your body stores excess iron in cells, tissues, and organs at dangerously high levels.
As noted on the Iron Disorders Institute website, several food groups and substances can interfere with the absorption of iron, including:
• Medications such as antacids that reduce the amount of acid in the stomach.
• While daily consumption of 50 milligrams or less of calcium has little effect on iron absorption, a much larger amount (300-600 milligrams) can inhibit the absorption of heme and non-heme iron. Calcium supplements should be taken along with vitamin D and in a citrate rather than a carbonate form.
• Eggs contain a iron-inhibiting protein called phosvitin. One boiled egg can reduce absorption of iron in a meal by as much as 28%.
• Oxalates (compounds derived from oxalic acid) naturally present in common foods such as spinach, kale, strawberries, beets, nuts, and chocolate can interfere with the absorption of non-heme iron.
• Polyphenols found in coffee, cocoa, apples, and some herbal teas can adversely affect iron absorption.
If you strongly suspect that your unnatural nail appearance is due to an iron deficiency, seek professional advice from your dermatologist, nutritionist, or medical practitioner. In addition, take some time to review your diet. Become acquainted with the two types of dietary iron — heme and non-heme. Consume foods that improve your absorption of iron, and avoid those items that impair your ability to use this vital mineral.
Koilonychia Symptoms & Signs
Medical Author: Melissa Conrad Stöppler, MD
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National Heart, Lung, and Blood Institute
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Egg yolk protein and egg yolk phosvitin inhibit calcium, magnesium, and iron absorptions in rats.
Ishikawa SI1, Tamaki S, Arihara K, Itoh M.
J Food Sci. 2007 Aug;72(6):S412-9 | PubMed
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