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Are Ridges in Nails a Sign of Hypothyroidism?

Learn what vertical lines or ridges in fingernails tell you about your thyroid health in this article.
Are Ridges in Nails a Sign of Hypothyroidism?
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Just like your skin and hair, your nails can offer insight into your overall health. Changes to your nail thickness, appearance, strength, and color can be a sign of a health condition that may need your attention. But we often ignore these changes because nails are a seemingly uneventful part of the body. Indeed, we usually only pay attention to them when we cause damage to them or need to perform maintenance. But if you have ridges in your nails, it may be time to pay a little closer attention to what your nails are telling you about your thyroid and overall health.

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What are nail ridges?


Nail ridges are lines that can run either vertically or horizontally on your nails. You can see and feel these ridges. Usually, these ridges are elevated, but sometimes they can also leave indentations. 


Nails are made of keratin, a protein in the hair and the skin's epidermis (outer layer). Just like your hair can become brittle and your skin can dry out, your nail health can also change depending on your age and health status.

The difference between vertical and horizontal ridges in nails


Vertical ridges in nails

Vertical ridges on the nails are pretty common and are usually benign, meaning that they do not signal that anything is wrong. Running from your cuticle to the tip of your nail, these ridges in fingernails are generally a sign of aging, and as such, can become more pronounced the older you get. 


Some people are also more likely to have ridges in their nails based on their genes and environmental factors like their diet and how they use their hands.


If you have vertical ridges, you may also notice that the nails undergo other changes, such as:

  • Thickening or thinning
  • Becoming rougher
  • Splitting easily
  • Forming fissures, and
  • Breaking frequently


In some cases, vertical ridges may be a sign of rheumatoid arthritis or peripheral vascular disease


Horizontal ridges in nails

Horizontal ridges are usually a greater cause for concern. Called Beau's lines, these horizontal ridges or indentations typically show up if there has been trauma to the nail or an underlying problem with your health. If there is one horizontal line that looks like an indentation, it usually means there was trauma. Often, these lines only appear on one nail. 


You will need to be more concerned about a horizontal line if it occurs on multiple fingers or multiple ridges appear on one nail without an apparent cause. The appearance of horizontal ridges on numerous fingers may be a sign of chronic disease or systemic illness. 


Illnesses that can cause horizontal or Beau's lines include:

  • Acute kidney failure
  • Syphilis
  • Mumps
  • Thyroid disease like hypothyroidism
  • Subungual melanoma (melanoma of the nails)
  • Diabetes
  • Endocarditis
  • Pneumonia
  • Zinc deficiency
  • Malnutrition


What does the thyroid have to do with nail growth


The thyroid gland produces thyroid hormones that affect every cell in your body. Thus, every organ system can suffer when thyroid hormone levels are out of balance, including the integumentary system, including your skin, hair, and nails.


People with too little thyroid hormone (hypothyroidism) often struggle with symptoms of dry skin, brittle nails, and hair thinning. Perhaps the primary reason this occurs is that every system in your body slows down when there is not enough thyroid hormone. Therefore, the skin does not renew as quickly, the hair growth cycle is suppressed, and nail growth is slowed and compromised. 


In regards to nail growth, ridges can form when cellular turnover slows down, allowing keratin cells to build up before they have a chance to grow out.


Treating ridges in fingernails caused by hypothyroidism


Start by treating your thyroid condition

If there is a reason for the ridges in your fingernails, you need to treat the cause. If you have a thyroid problem like hypothyroidism, you need to optimize your thyroid hormone levels with thyroid hormone replacement medication. 


Thyroid medication is usually the first step in treating hypothyroidism, but there are also other ways you will want to support your nails if they have ridges.


Eat a healthy diet

Malnutrition may be a likely cause of nail ridges in many people, and certain medical conditions can make it hard to absorb the proper nutrients to support your whole body down to your nails. 


It is essential to eat a nutrient-dense diet full of wholesome foods with minimal (or no) processing. Refined sugars, alcohol, caffeine can also interfere with healthy nail growth, so try to limit these items as much as possible. Your nails benefit from natural food sources rich in lipids, peptides, and natural oils that occur in avocados, eggs, and nuts.


Furthermore, antioxidants can give your integumentary system the boost it needs to promote health renewal and regeneration. Additionally, because many diseases like hypothyroidism or Hashimoto's disease (an autoimmune disease that is the leading cause of hypothyroidism) may cause a level of chronic inflammation in the body, it is helpful to incorporate anti-inflammatory foods into your diet.


Try a support supplement

It can sometimes be challenging to get all of the nutrients you need, even if you eat a diverse diet. Sometimes, the food we eat interacts with our ability to absorb specific minerals and vitamins, or the gut has difficulty breaking down particular molecules causing nutritional deficiencies.


Taking a supplement that aims to help support your skin, hair, and nails can be a great way to get plenty of certain nutrients you may generally have difficulty obtaining. 


Keep in mind that if you take a supplement that contains biotin, it can interfere with some thyroid lab results, so check with your lab to ask if you should avoid taking biotin before testing your thyroid.

Note: Paloma Health's lab uses a specialized assay, so there is no need to delay your medications or supplements, including biotin. You may also take the Paloma Health at-home thyroid test with or without regard to food, so no need to fast.


A note from Paloma Health


If you are worried about ridges in your fingernails, it pays to test your thyroid, as nail ridges are common in people struggling with thyroid hormone imbalance. You can check your thyroid with an at-home thyroid test kit


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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