Ever heard that your nails hold clues to your health or that hormones and nail growth are linked? It’s 100% true that changes in your nails can be an indicator that something’s happening in your body that needs attention.
What are healthy nails supposed to look like and how fast do they grow?
You can tell when you’re fingernails aren’t at their healthiest just by the way they look. They may be discolored, dry, or break really easily. On the other hand, healthy nails are a pinkish color without really noticeable ridges (some texture is normal). There are no dark spots. The nail bed, or the base of your nail, shouldn’t be puffy and you should see cuticles.
Nails are mostly made of a protein called keratin. Just like everyone’s hair grows at a slightly different rate due to genetics, lifestyle factors, and more, nails do too. Hormones, health conditions, and your micronutrient status can all affect how quickly someone’s hair grows. On average, most people can expect about 3.5 millimeters of fingernail growth every month. Toenails grow at about half that rate.
What conditions and hormones affect my nail growth and health?
If you’re seeing differences in your nails compared to months before, longer-term hormone fluctuations or changes could be one of the reasons. (Because of how long the nail cycle is, the rise and fall of hormones during your menstrual cycle shouldn’t have a large effect.)
Your thyroid hormones are involved in nail growth and changes to those levels can result in obvious nail changes over time. The sex hormones estrogen and progesterone also affect nail growth and health, and so does testosterone. Testosterone plays a role in synthesizing keratin (the protein your nails are mostly composed of). In times of ongoing stress, nails can also be impacted by chronically high levels of stress hormones like cortisol.
When you’re pregnant, it’s not a myth that nails (and hair) grow faster. You can thank higher estrogen and progesterone levels for that. But even though some women enjoy more growth and strong nails, others find that they have more splitting and tend to get grooves in the nails.
Perimenopause and menopause
In your mid-thirties, changes in your sex hormone levels happen–even if you don’t realize it yet. Progesterone production starts to taper. For some women, this occurs more abruptly and menstrual cycle changes and other symptoms make it noticeable. Other times, it occurs gradually.
As you enter perimenopause, progesterone continues its decline. Estrogen levels drop too. You might really begin to notice changes in your nails as you transition to menopause. This is because estrogen and progesterone are involved in reproduction, but that’s far from all they do. Estrogen plays a part in the hydration levels of your cells. With less estrogen, your skin and nails can become dryer. You might notice that your nails look brittle, too.
Accepting that your nails won’t look quite the same as when you were in your 20s or early 30s is important as you age. But there are some things you can do to help them look better and have less breakage. Make sure you’re getting more calcium in your diet and consider a supplement. Our bodies just don’t absorb nutrients as well as we you age, so you may need more than you did 10 years ago. Also, you’ll want to have your vitamin D status checked and think about adding a supplement to your routine.
When you are chronically stressed, you’ll see a lot of difference changes in throughout your entire body. It’s common to have digestive issues, insomnia, higher insulin, micronutrient deficiencies, low progesterone, and so much more because your body is diverting important resources away from non-essential functions to ensure survival.
When your levels of the stress hormone cortisol are high, your zinc levels get run down. Tiny white spots pop up on your fingernails. If you start to see spots like these on your fingernails, you should reach out to your doctor and ask about a zinc supplement (and ways to reduce your stress response!). If you’re taking a zinc supplement, you probably also need to start vitamin B6 as well. Look for its active form, pyridoxal-5-phosphate.
Whether your thyroid is overactive (hyperthyroidism) or under-active (hypothyroidism), you’re in for some changes with your nails, but treating your thyroid condition can help. Without the right treatment, you can experience nails that grow faster (hyperthyroidism) or slower (hypothyroidism) than normal. Your nails may feel dry, brittle, or even like they could just crumble.
Sometimes, you might even see the skin at the base of the nail appear swollen or curved upwards. Also, you may see the nail plate, which exists to protect the nail bed, break apart from the nail bed. (This is called onycholysis.)
If you have concerns about your thyroid function, you’ll want to ask your provider for testing. Many providers only test thyroid-stimulating hormone (TSH), but that doesn’t really provide a complete picture. We recommend a full thyroid panel: TSH, free and total T3, free and total T4, thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies (TgAb), and reverse T3. In many cases, assessing cortisol is helpful too. It’s also worth saying that, if you’re thinking of getting pregnant, you need thyroid testing whether you have signs and symptoms or not.
Polycystic ovarian syndrome, or PCOS
High levels of androgen hormones like testosterone, which is seen in PCOS, also make a difference in nail growth and and health. If you have PCOS and hypothyroidism (which is fairly common) or blood sugar irregularities, you’ll be extra susceptible to the nail plate separating from the nail bed. It’s also possible to see your nails develop vertical ridges or split vertically (onychorrhexis).
Because PCOS is a chronic, multi-system condition, you’ll want to make sure you have a great team in place to help you manage it. You can also check out our other PCOS articles with expert advice on:
- what to eat for PCOS,
- how to treat PCOS naturally,
- if you should take metformin,
- lifestyle changes for PCOS,
- yoga for PCOS,
- if PCOS goes away after menopause,
- and how acupuncture can help.
No matter which type of diabetes you have, the condition affects how your body uses glucose and leads to changes throughout your body. It’s completely possible to have diabetes or prediabetes and not be aware of it yet. With diabetes, it’s really important to monitor the health and appearance of your nails and to report any changes to your physician.
If you have diabetes, you might see that your nails are looking a little yellowish. The nail beds can also start to take on a bluish tint due to a lack of blood flow to the fingers (or toes). Some people have their nail plate separate from the nail bed or change shape (which also changes the shape of your nails).
Remember: nail growth and health changes aren’t just cosmetic
It’s really natural to see changes in your nails and to worry about their appearance first. But any differences in nail appearance or growth need to be checked out. If you love a good manicure or pedicure, make sure to give your nails some time off between your appointments. This will give you a few days to really assess their health and for any changes that might be starting.