Question

I’m in my early sixties and have had fairly stable mild to moderate ME for about 15 years. I don’t have any other health problems. Over the past few months I’ve noticed that some of my finger nails are becoming rather brittle. My energy levels also seem to be lower than usual. Is this yet another symptom of ME? Or just old age? Should I see my GP?

Answer

Brittle nails, which often involve splitting (medical name = onychoschizia) or longitudinal ridging (medical name = onychorrhexis), are quite a common problem, especially among women and older people.

In some cases no specific cause can be identified and, while this is something that may occur in ME/ CFS, there's no research evidence to indicate that brittle nails are more common in ME/CFS.

Environmental factors that can produce brittle nails include frequent exposure to water, detergents, and harsh nail products – all of which strip natural oils from the nail plate. Medical causes include iron deficiency anaemia, hypothyroidism (low thyroid function), and nutritional deficiencies, especially B vitamins.

You should therefore see your GP because management firstly involves making sure that none of the above medical problems, which can also cause fatigue, are present.

Minimising exposure to irritants, and promoting hydration of the nail plate through emollients and biotin supplementation (which helps to produce keratin) can be helpful. It's also sensible to wear gloves when cleaning or washing dishes, and to avoid frequent manicures with aggressive filing or use of acetone-based removers.

See Also: Diet and Nutrition: Malnutrition

More Information:

• You may find our booklets on Vitamins and Vitamin Deficiency