Doctor Warns Nail Changes Can Signal Iron Deficiency

British family doctor Dr. Amir Khan is urging people to watch for unusual changes in their nails, saying they can be a warning sign of iron deficiency and anemia. He said one especially noticeable clue can appear at the fingertips, and should prompt medical evaluation. Iron is essential for making hemoglobin, the protein in red blood cells that carries oxygen around the body.

A common nail sign is brittle nails or a spoon-shaped curve called koilonychia. Khan said that instead of growing flat, the nails can look sunken inward like a spoon. Cleveland Clinic notes that in some cases the indentation can be deep enough to hold a drop of water. The condition is most often linked to iron-deficiency anemia, but it can also occur with diabetes, heart disease, or hypothyroidism.

Khan said iron deficiency can be caused by too little iron in the diet, heavy or prolonged periods, celiac disease, inflammatory bowel diseases, and sometimes cancers. He warned that many women assume heavy menstrual bleeding is normal, but it is not always the case and should be checked by a doctor.

Other symptoms include ongoing fatigue and weakness, shortness of breath, chest pain, dizziness, cracks at the corners of the mouth, hair loss, and restless legs. Because low hemoglobin means less oxygen reaches the tissues, the body struggles to produce energy, muscles tire faster, and the heart has to work harder. Khan said iron-rich foods such as red meat, liver, seafood, shellfish, lentils, beans, pumpkin seeds, nuts, and seeds can help, but diet changes alone are not always enough, and anyone who suspects iron deficiency should get tested.