White areas on fingernails can have various causes, ranging in severity from 'troubling' to 'generally fatal'. Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.
Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms. In order to diagnose white areas on fingernails, we could:
|Mercury Toxicity||1%||Ruled out|
|Chronic Renal Insufficiency||1%||Ruled out|
|Iron Deficiency Anemia||1%||Ruled out|
|Metal Toxicity||1%||Ruled out|
|Nephrotic Syndrome||1%||Ruled out|
Do you have any white areas (not spots) on your fingernails that are not due to nail injury/trauma?
Possible responses:→ No / don't know
→ Pink at the base, turning white towards the ends
→ 80% or more of nail beds are white, including base
→ White lines from side to side, do not move
→ White lines from side to side, move as nails grow
Leukonychia (partial or completely white nails) is a sign of renal failure.
Mainly white nails, or Terry's Nails, are a significant indicator of hepatic cirrhosis. [Terry (1954) Lancet, 1:757]
Muehrcke's Lines (side-to-side parallel white lines that do not move with nail growth) are caused by a nail bed abnormality, which in turn is probably due to hypoalbuminemia.
Hypoalbuminemia (A low albumin level) also suggests the following possibilities:
Hypoalbuminemia can be caused by certain heart conditions such as congestive heart failure or pericarditis that lead to low albumin levels in the blood.
All heavy metals cause Mees' lines on the nails. These usually begin a few months after significant exposure starts and may be useful in identifying the source of exposure – dental amalgams or some unrecognized source – if you remember when they started.