Published May 29, 2020 Have you been experiencing yellowing fingernails lately, wondering what this could mean about your overall health? This is an important signal from your body that can give you a deeper clue about what’s going on systemically, which is why it’s one of the 6 signs from my nail series (you can read the full post right HERE). If you came here from that post wanting to know more about this particular clue, let’s dive deep into the root causes behind yellow fingernails and how you can reverse this issue naturally! YELLOW FINGERNAILS & DARK NAIL POLISH Just to be sure we’re not sounding the alarm without reason here, think about when you first started seeing this discoloration on your nails. Did it appear out of nowhere, revealed only after taking off your nail polish? Do you wear dark nail polish often (sometimes leaving it on for a bit too long)? Nail polish (specifically darker, richer shades) is the most common culprit when fingernails turn yellow, especially when it’s affecting the entire nail from top to bottom. Solutions: Always make sure you’re using a clear base polish first to add a layer of protection between your fingernails and the colored polish. Consider taking a break from polish in general until the discoloration subsides. Traditional Chinese Medicine (TCM) is not the biggest fan of consistent nail polish use in the first place, as it doesn’t let the nails “breathe” properly. On top of this, as I explained in my original post, nails are connected to the liver meridian. Keeping them covered all the time with a thick layer of paint isn’t exactly ideal, especially if you have symptoms of Liver Qi Stagnation. I personally keep my use of nail polish to a minimum, saving it for special events and summer pedicures when my feet are always in open sandals. DIGGING DEEPER: FINGERNAIL FUNGUS VS. NAIL PSORIASIS If this is not the cause and you find your nails are continually getting worse even when abstaining from polish, there are two possibilities you’ll want to explore. The first is nail fungus, which is often accompanied by a progressive distortion/deterioration in nail shape and even a foul odor as the infection progresses. Nail fungus: The second is nail psoriasis, which involves the nails detaching or lifting from the nail bed rather than a distortion of shape. You’ll notice a chalky white buildup right where the nail is lifting due to hyperkeratosis (an overproduction of keratin, most likely prompted by the underlying inflammation present in autoimmune disorders). There will also be pain present when the nail is lifting due to psoriasis, which doesn’t usually happen in the case of nail fungus. Nail psoriasis: source: Cutis. 2013;92:129-135 How do you differentiate between the two, and what can you do to remediate each condition? Let’s explore the distinct differences and how to find out which one is affecting your nails. FINGERNAIL FUNGUS First of all, it’s important to note that fungal infections usually affect the toes, not the fingernails. This is because the feet are more likely to come into contact with fungus from walking barefoot, especially in gyms, saunas, pools, and other damp areas. However, people who get regular manicures or whose hands are often wet are equally vulnerable to fungal infections of the fingernails. Some characteristics of fungal infections include: a single spot of hyper-pigmentation in the nail where the infection begins nail shape changes (the nail usually breaks and flakes over time rather than displaying the pitting common in nail psoriasis) darkening of nail color foul odor One of the early signs of a fungal infection in the nails is a single spot of hyper-pigmentation or discoloration. The infection may begin as a faint gray, green, yellow or brown spot that gets darker and wider over weeks or months (psoriasis on the other hand does not typically cause dark spots on the nail – it often begins with the nail lifting from the nail bed and turns yellow over time as the condition progresses). Eventually, you may see more symptoms if the cause of your yellowing nails is fungal. These include flaking and weakening of the nail as well as an unpleasant odor as the fungus breaks down the components of the nail. FINGERNAIL FUNGUS: SOLUTIONS If your fingernails are yellow due to a fungal infection, you’ll want to see your doctor or health care practitioner to get an accurate diagnosis. Depending on whether they employ conventional or alternative treatment methods (perhaps even a mix of both), they’ll either put you on an oral antifungal medication, or an herbal protocol to tackle the infection. This would generally involve consuming antifungal herbs via tinctures, teas, or capsules and applying topical preparations such as poultices, soaks or salves. Once you have a proper diagnosis, there are several options for treatment depending on the paradigm used to understand the infection. The modern biomedical model sees nail fungus as an isolated issue, and sometimes it is! Perhaps you had bad luck with a new nail salon and this is a one time infection, localized to the fingernails or toenails. Over the years, however, I’ve seen that what happens in one area of the body affects (or reflects) the entire system. This is more of a holistic paradigm where the body is treated a whole. For example, in school (where I study traditional herbalism) we’re taught to observe the visible mucous membranes of the body to get an idea of the current state and health of the gut (since that’s one we can’t see). If someone’s nose and eyes are always itchy, dry, and irritated, it’s a good indication that their gut may be dehydrated and irritated as well. Treating the body as a whole by employing soothing, mucilaginous herbal teas (such as slippery elm tea) will improve the health of all mucous membranes, including the intestines! The same applies to the nails. If the infection does not respond to treatment or is recurring, there’s a chance it may be indicative of a body-wide fungal issue (hint: it usually begins in the gut!) In this case I would suggest seeking out a functional medicine practitioner who can a) test your gut for hidden infections including candida using a test like GI Map, and b) walk you through a comprehensive antifungal protocol including nutritional guidelines to starve the overgrowth. NAIL PSORIASIS If the root cause of your yellowing fingernails is nail psoriasis, you’ll see a slightly different set of symptoms. First of all, you’re likely to have nail psoriasis if you have already been diagnosed with psoriasis in general. Psoriasis shows up as red, itchy, irritated scales on the skin or scalp. It is considered an autoimmune condition so in holistic terms, the entire immune system must be treated with herbs and diet/lifestyle interventions that: a) calm the body (to get the immune system and HPA axis out of high alert mode), and b) modulate the immune response (to bring it down when it’s overactive) Nail psoriasis is different from nail fungus because it usually involves the nails lifting and separating from the nail bed. When this first happens, the lifted area will look very white and have a chalky white residue due to overproduction of keratin. As the disorder progresses, the lifted white areas may turn yellow or brown. One thing that really distinguishes nail psoriasis from nail fungus is the pain that comes along with this lifting. Fungal infection comes with an odor, whereas nail psoriasis comes with tenderness and discomfort! Another characteristic sign that comes with nail psoriasis is “pitting” or tiny indents in the nail, which often show up as an early sign before nail psoriasis fully manifests. source: dermweb In fact, both nail pitting and white spots have a strong association with psoriasis and other autoimmune disorders such as alopecia. I talked about this in depth in my full post about what those pesky white spots mean! NAIL PSORIASIS: SOLUTIONS If your doctor or practitioner determines that you are indeed dealing with nail psoriasis, there are several measures you can take to calm and modulate your immune response in order to lessen or reverse your symptoms. Although it’s very difficult to “cure” an autoimmune disease, you can experience an improvement in quality of life or even enter remission by implementing a gut healing diet and replenishing many of the nutrients that are commonly deficient in autoimmune patients. 1. Vitamin D Have you ever seen this study done in Brazil on patients with the autoimmune diseases psoriasis and vitiligo? The results are shocking to say the least. Here’s what happened in 6 months when one psoriasis patient supplemented with 35,000IU Vitamin D daily: source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897595/ And this is just one of the psoriasis patients. In terms of the vitiligo patients, two out of sixteen showed no repigmentation of the affected areas, four patients showed 1‒25% repigmentation, five patients showed 26–50% repigmentation, and another five showed 51‒75% repigmentation. A Vitamin D deficiency is particularly problematic for autoimmune patients as Vitamin D plays a crucial role in immunomodulation. It regulates and prevents autoimmunity by stimulating regulatory T cells (Tregs), which are responsible for differentiating between what is foreign (invaders) and what is of the self. When Vitamin D stimulates the production of these cells, it teaches your immune system to develop tolerance towards your own tissue! I take liquid Vitamin D3/K2 daily and always feel the difference in inflammation when I miss a few doses. Food source include fatty fish, grass-fed or pasture-raised beef, and organ meats. DISCLAIMER: Only take a high dose of Vitamin D3 with your doctor’s monitoring and approval (and of course, you need to know if you’re actually deficient first). At one point in my life, I couldn’t get my levels up no matter what I did. With the help of my doctor’s watchful eye, I did my own high dose experiment (~30,000 IU/day for 6 weeks) and finally got myself in range. We ran consistent blood work to make sure I wasn’t overdosing, and when my levels became slightly elevated we cut back to 5,000 IU every other day for maintenance. 2. Omega 3s Studies have shown that omega 3 oils enhance B cell activation and select antibody production, which can lower the inflammatory response present in autoimmune disease. You can either supplement with a trusted source or up your intake of wild fatty fish such as sardines, salmon, etc. 3. Magnesium Magnesium deficiency has been shown to cause an increased production of proinflammatory cytokines (such as IL-6 and TNF-α), which raise systemic inflammation and contribute to the development of autoimmune disease. I make a magnesium kit in my store called the Anti-Stress Kit. Food sources of magnesium include leafy greens, dark chocolate, almonds, and pumpkin seeds. Most importantly, magnesium is greatly depleted by sugar so you know the old saying – waste not, want not! If you decrease the amount of added sugar in your diet, you won’t burn through your magnesium nearly as fast. 4. The AIP Diet The Autoimmune Paleo Diet (AIP) is one of the best interventions out there for disorders like psoriasis, and has helped many people put their autoimmune disease into remission. As I mentioned in my adrenal fatigue series, I started eating AIP earlier this year as an “elimination diet” to understand my individual food intolerances that were unknowingly triggering inflammation and messing with my sleep. The inflammation involved in autoimmunity can often be traced back to gut inflammation or more specifically, leaky gut. Some hypothesize that longstanding gut issues are a trigger of autoimmune disease in the first place, and I would have to agree! By eating strict AIP for about 2-3 months (and then experimenting with reintroductions), I discovered that I am intolerant to nightshades (such as tomatoes), corn, and several nuts. Avoiding these foods keeps my inflammation in check and keeps my immune system from going into overdrive as it’s not reacting to my unique food allergies. If you want to learn more about what AIP is and how it helps heal your gut and manage autoimmunity, this is a great place to start! 5. Liver Support Going back to my original nail series intro post, all disorders that affect the nails involve the liver in some capacity. With autoimmune conditions such as psoriasis, it’s very important to support the liver and work on skin health from the inside out. Turmeric is my favorite (not to mention one of the safest) herbs for this purpose as it improves liver phase II detoxification while drastically lowering inflammation. (I would postulate that the reduction in inflammation is partly due to that uptick in liver detox, but that’s a different post for a different day!) This 2015 study on patients with psoriasis found that serum levels of the proinflammatory cytokine interleukin-22 were cut in half in participants who were assigned assigned to 12 weeks of daily oral curcumin. IL-22 levels remained unchanged in the control group who was taking a steroid alone with no curcumin supplementation.