The above photos are pictures of my thumb nail and big toe nail. As one can see from the photos, I have severe Vertical Ridges on them, as I do on all my nails. My nails are now very brittle, and they are brittle enough that they are starting to crack and chip at the edges at times. Thankfully, I’ve never lost my nails, as some flox victims have. Since I have an autoimmune thyroid condition, this would probably be considered the most likely cause of my nail problems. However, I don’t think my nails are improving at all despite being on thyroid hormone replacement medication again (combo T4/T3 since Dec 2014), and I do have a concern that they will continue to deteriorate. Remember that I can’t tolerate higher levels of T3 or iodine, and therefore, the natural TH replacements, so perhaps that has something to do with it as well. I can’t help but feel that my nails are an indication of a common underlying mechanism in all this, representing some kind of keratin/epithelial cell damage, and that if they improved, many of my other symptoms would too. Although keratins are most well known for their role in hair, skin, and nails, there are a variety of keratins, and they are located in most tissues, including the thyroid, thymus, pituitary, olfactory, and other glandular and endocrine organs, where their role is to protect epithelial cells from damage or stress.
Supposedly Vertical Ridges are considered completely benign and not an indication of anything important (see video here, and article here,). They are considered another symptom that often occurs simply due to “aging”, but I’m not buying it. I have plenty of friends older than me, and they don’t have these vertical ridges or dry, brittle nails at all. Additionally, a quick search on the internet shows that plenty of younger people (including tweens and teens) report these vertical ridges, so it’s not simply something due to “aging”. Some of the websites do mention things like a thyroid condition, vitamin or mineral deficiency, or autoimmune condition as a potential cause or contributor. I would agree with all these possibilities. However, I would go one step farther and include other possibilities as well.
For me, probably one of the more interesting connections relates to some topics I discussed on the “Phantosmia” page. There, I suggested that the odors people are smelling aren’t “phantom” at all, but instead are representative of a very real phenomenon going on with our metabolism at the time the smell is occurring. The odors are very real, and can be a valuable clue to help elucidate potential mechanisms of biochemical reactions and potential malfunctions of those. In my case, much of my phantosmia consisted of sulfur-based odors. For example, the phantosmia I experienced tended to be similar to “burning hair” or cigarette smoke. It turns out the odor is also very similar to the odor emitted from filing my nails. (You can try this yourself by filing your nails and taking a whiff). It also reminded me of when I owned horses, and their hooves were regularly trimmed; the pungent odor of “horse hooves” permeated the barn.
A major protein making up both hair and nails, as well as skin and the hooves, horns, and claws of animals, is Keratin. Per Wiki: “A distinguishing feature of keratins is the presence of large amounts of the sulfur-containing amino acid cysteine, required for the disulfide bridges that provide additional strength and rigidity for proteins such as hair, nails, hooves, and claws. Extensive disulfide bonding contributes to the insolubility of keratins. The pungent smells of burning hair and skin are due to the volatile sulfur compounds formed.” In several places on this website, I suggested that FQ’s may be damaging or affecting secretory cells in general, which would include endocrine and exocrine epithelial cells, and cells with well developed ER/Golgi apparatus. For some dedicated secretory cells, it has been estimated that as many as 100,000 disulfide bonds can be formed a second, resulting in a staggering amount of oxidative stress. (1).
I wonder if it’s no coincidence that I have Vertical Ridges on my nails, and experience sulfur-based Phantosmia. I wonder if this could be because of a disorder or abnormality of one or more keratins primarily due to a variation in one or more of the numerous genes coding for keratin, or secondarily to a protein folding or endoplasmic reticulum disorder within certain types of epithelial cells, as well as secondarily to a thyroid or “autoimmune” disorder. Again, FQs appear to target cells with high turnover (hair, nails, skin, intestinal mucosa) and secretory functions, which would include both exocrine (sweat, salivary, lacrimal, ceruminous, sebaceous, mucous, mammary) and endocrine (pineal, pituitary, pancreas, ovaries, testes, thyroid, parathyroid, thymus, hypothalamus, adrenal) epithelial cells. The epithelial cells of the sinus cavities, especially right up there by the olfactory bulb area seem to be especially hard hit in some of us with FQT/FQAD, often resulting in decreased mucous secretion (severe dryness and pain in the sinus cavities) with various levels of Phantosmia (and possibly anosmia and hyperosmia in some cases). The FDA drug insert for Cipro says: “Ciprofloxacin is present in active form in the saliva, nasal and bronchial secretions, mucosa of the sinuses, sputum, skin blister fluid, lymph, peritoneal fluid, bile, and prostatic secretions . . . Tissue concentrations often exceed serum concentrations in both men and women.” This seems to further suggest that FQs concentrate in epithelial cells with higher secretory functions. Although hair and nails at first don’t seem to have much in common with nasal sinuses or olfaction, here, I’m suggesting that when it comes to FQT/FQAD, a link might be thiols, cysteine, disulfide bonds, and keratins related, at least for those of us with both nail disorders and “keratin-like” phantosmia odors.
I suspect that people who tend to develop Vertical Ridges on their nails have an inborn genetic or epigenetic predisposition to do so. On the other hand, it seems pretty clear that environmental insults – such as the FQs – could trigger, “unmask”, or cause a variety of nail issues, as many FQ victims can attest. Although Vertical Ridges for the most part are considered an annoying, but benign condition, I think they can be an additional clue as to underlying mechanisms or conditions. As I included on the “I Believe I Had A Predisposition” page, in my case, for example, these ridges actually started in my thirties. I wonder if this is one of the few visibly obvious symptoms I developed pre-flox that might connect to my predisposition to thyroid problems and FQ susceptibility in the future (another symptom is that I started getting gray hair early in my twenties). I would notice maybe one ridge on one nail, and then over the years, it slowly increased to another ridge on another nail, and eventually, multiple ridges on nails. This suggests to me my underlying predisposition for something other than aging, including future thyroid problems or future FQ reaction. Post flox, this progression increased significantly, and my nails are now severely dry and brittle, with numerous multiple ridges on all nails. So far, I haven’t lost my nails, as some flox victims have, but I have to be careful as they crack and chip so easily now. Many of the nails on my smaller toes are extremely brittle and “curling into” the skin around the toe, giving me ingrown toenail symptoms for the first time in my life.
I don’t know how many flox victims have vertical ridges on their nails. However, I’ve seen reports on the internet from many flox victims talking about nail disorders, even losing entire nails. There are many types of nail disorders, and Vertical Ridges is only one of them (which, as we’ve seen, is not even considered a disorder most of the time). For some good pictures and descriptions of nail disorders, search the title “Fingernail and Toenail Abnormalities: Nail the Diagnosis” (sorry, it wouldn’t let me link) or see a research publication here or Mayo Clinic site here). Be forewarned; looking at some of these pictures, perhaps I should be thankful for what I’ve got, despite the dry brittleness and vertical ridges.
There really isn’t anything to be done now for my nails. There’s nothing that’s going to actually get rid of or clear up these ridges for me now. I’ve been on a variety of thyroid hormones, lots of vitamin and mineral supplementation, and omega oils and coconut oil supplementation when I could tolerate it, and my nails continue to get worse. Although these vertical ridges are supposed to be a sign of “aging”, like I said, I don’t buy it. In some cases, the problem may be nutritional. It’s easy to suspect it might be hormones in general as well, although as I’ve mentioned, I know other older post-menopausal women who don’t have these vertical ridges or any other nail problems. However, in some cases, such as my own, I think they’re an indication of a fundamental genetic or epigenetic variation, possibly with keratin production, enzymes involved with disulfide bond formation, or other proteins involved in nail and hair formation. And they may also be an indication of underlying propensity for future disease conditions or states, including, perhaps, susceptibility to FQs. As with Phantosmia, it would be great if researchers (and physicians) would say: “How curious, that all these people of all ages have these vertical ridges on their nails, and others don’t. How interesting that many people with autoimmune conditions have vertical ridges on their nails. What else could all these people have in common, other than the vertical ridges? I wonder what we can learn from this?”
Vertical ridges on nails is something that has simply been thrown into the basket of “aging”, despite all the evidence to the contrary. Simple association studies of the “vertical ridges on nails” populations, both FQ-related and not, might bring up some surprising associations, if only someone would take the time to consider and look for them.