"Blue" fingernails...

OwlCreekObserver · Post by **OwlCreekObserver** » Thu Jul 27, 2006 4:33 am

I've been following this discussion with great interest since I've experienced the same thing from time to time. Every now and then my hands get cold and my fingernails get a blue tint to them. This usually happens during the winter months, but it sometimes happens if the air conditioning has the indoor temperature down around 70 degrees or so. I think it started when I was in my mid-50s but can't say for sure.

I've been on low-dose Zocor for cholesterol for a few years and those numbers are very good. Until recently I was also on low doses of blood pressure medication -- the doc took me off because my numbers had improved for some reason, possibly cpap. My O2 level is always good, staying at 90 or above even during my first sleep study. I'm at the gym three days a week, I take an early morning walk with my bride nearly every day and I watch what I eat.

I've had a stress test, echocardiogram, chest X-ray and a dozen or so other unpleasant pokes and prods and my doc says I'll probably live to see 100. (I hope that he's wrong on that because I know what my retirement savings look like. )

But still there's those darned blue tinted nails and cold hands every now and then. I've decided not to worry about it.

OCO

Offerocker · Post by **Offerocker** » Thu Jul 27, 2006 6:43 am

I agree that your doctor did NOT give you satisfactory examination and explanation for your blue fingernails. You still need to consult another physician, possibly a pulmonary type.

My mother had Raynaud's phonema; her palms looked bruised, in addition to the bluish nails. You could progress to that. The indicator here is the "cold" feeling that you have, which is very real, and I'd suggest wearing gloves whenever you can. This is also a circulation problem. Do you have full feeling/sensation in your fingertips?

Great idea to photograph your hands - both sides.

You need to find out WHY this is happening, and what, if anything can be done about it.

Congrats on all your other numbers!

Have you had a pulse oxymeter on during the day? That may indicate low oxygen levels during the day.

Don't ignore this, please - or allow the doctors to ignore it.

Issac · Post by **Issac** » Thu Jul 27, 2006 8:02 am

I posted earlier about the metals such as copper and will give more information on this when I find the research. I agree that if this is something that other people are bringing to your attention that you did not have blue nails in the past. It is an indication something is wrong and you need to be demanding about your health problems to your doctor. Tell him you want another opinion and stay on top of it. How many people have been sent home from the emergency rooms told they have heartburn because all the test look OK only to heave a massive attack two nights later? too many to count.

krousseau · Post by **krousseau** » Thu Jul 27, 2006 9:04 am

There is an old joke in the San Francisco area about graduates of different schools of medicine; when they all put their ears to the ground and hear hoofbeats one says "ah horses", the nexts says "no zebras", and the doc from Stanford says "your're both wrong it's unicorns". The point is your doc may have graduated from the horse school of thought and looked for the most common causes. Now it is time to look for the less likely causes. Have they looked for; autoimmune pulmonary conditions, emphysema caused by a congenital deficiency in a1 chymotrypsin-both found by easy blood tests. If you have never smoked heavily or at an early age it is unlikely to be cancer-but that needs to be eliminated by chest xrays. One condition that will cause a bluish tinge to nails (also look at your oral mucosa) while you have a normal O2 level is methemoglobinemia. It also causes fatigue & irritability. There are a couple congenital types and an acquired type. One congenital type can be eliminated because it leads to death in infancy. The other congenital type is benign-no treatment considered needed and probably none known. Acquired methemoglobinemia on the other hand is caused by exposure to a few subtances and all you have to do is avoid them; nitrites (a preservative salt used in meat processing esp sausage), a couple antibiotics it is highly unlikely that you are taking (one is for leprosy and one is for malaria-thats all I know-there are probably more). That is the unicorn of the possibilities-unless you tell us you work in a sausage plant. There are a whole bunch of zebras-just type in blue fingernails on your favorite search engine and it will for sure give you hypochondriasis. Just kidding you do need to find out what it is because until you do you don't know if it is serious or not.

NOSE · Post by **NOSE** » Thu Jul 27, 2006 9:14 am

Maybe you are lacking IRON .

Hemaglobin needs IRON to make the blood red .

krousseau · Post by **krousseau** » Thu Jul 27, 2006 9:39 am

Iron would have to be very low-but certainly not impossible. Chronic low level blood loss from things like colitis, gastritis, microscopic amts of blood in urine, pernicious anemia/B12/folic acic deficiency could give you a low enough iron level to cause a bluish tinge, but probably low O2 as well, and a very high heart rate to compensate for the low O2.

Do you have any chemical exposures in your work or hobbies-cyanide compounds, chloramines. There is a photographic developing chemical that is associated with methemoglobinemia-think it was the "fixer" but can't remember the chemical.

krousseau · Post by **krousseau** » Thu Jul 27, 2006 12:43 pm

Forget the photographic fixer connection-it is sodium thiosulfate and it is used as a treatment for methemoglobinemia caused by chloramines.

Guest · Post by **Guest** » Thu Jul 27, 2006 3:43 pm

krousseau wrote:...sodium thiosulfate and it is used as a treatment for methemoglobinemia caused by chloramines.

You are under the mistaken notion that we are either chemists or in the medical profession - how about cryoglobularenama? But then, I'm not out to impress.

krousseau · Post by **krousseau** » Thu Jul 27, 2006 4:42 pm

Guest....sorry-It was in an earlier post. I had previously suggested a connection that was incorrect. If Josh has exposures like the ones mentioned earlier I'm just alerting him to possibilities. He said he has bluish coloration but normal O2 levels-not many things do that-so it could be a good basis for differentiating causes. I'm not trying to impress-I'm lost when SWS starts talking about machine algorithms, or when RG gets into how to interpret data and what changes to make in treatment.

If you register you can PM me & we can discuss it some more-this thread is for Josh.

josh · Post by **josh** » Thu Jul 27, 2006 5:10 pm

Thank you all for the information.

I am going to see my sleep doc next Friday, perhaps she may have some insight.

I have a dug well, from which I do not drink, (I drink all bottled liquids). I am exposed to experimental inks at work, I work in the printer industry. However, none of my co-workers have the same issue as me. I think I will start taking pictures in the mean time. My diet has not changed at all, and I don't try any exotic foods and what not. So for now, I just don't know.

But thank you...

krousseau · Post by **krousseau** » Thu Jul 27, 2006 5:57 pm

That just seems very suggestive that it comes from some work contact. I'm retired and it's a heat wave here-I'll put the computer in front of the air conditioner and look for info.

Guest · Post by **Guest** » Thu Jul 27, 2006 6:05 pm

josh wrote:I am exposed to experimental inks at work, I work in the printer industry. However, none of my co-workers have the same issue as me.

I think you're on to something here even if none of your coworkers have the same thing.

krousseau · Post by **krousseau** » Thu Jul 27, 2006 6:31 pm

Right!! Maybe for some reason you are more sensitive. There is a condition called Mediterranean anemia or favism that makes a person more susceptible to methemoglobinemia. People with it get sick after eating fava beans-but they are not too common in the US so you may never have eaten them to find out. Also do any of these sound familiar-look at the MSDS book at work-they have to have one: toluene, chromates, aniline dyes, chlorobenzine, sodium hypochlorite, resorcinal, high nitrates or nitrites in well water (city water would be tested).

Read this:
http://www.emedicine.com/EMERG/topic313.htm

Guest · Post by **Guest** » Fri Jul 28, 2006 5:23 am

krousseau wrote:If you register you can PM me & we can discuss it some more-this thread is for Josh.

I beg to differ: this post is for everyone who happens upon it. In the future, would you please explain meanings of terms you used:
a1 chymotrypsin
methemoglobinemia

Thanks; saves looking it up, since you already know what they mean.

GoofyUT · Post by **GoofyUT** » Fri Jul 28, 2006 8:39 am

Diagnosis has NO place in an internet forum such as this, and is irresponsible in a setting that doesn't permit EXAMINATION of the patient. I know that you'll say that you're simply trying to be helpful, and that you're offering SPECULATIONS about what his apparently cyanotic condiition might otherwise be. But, what you're doing is, in fact, baseless, alarming and irresponsible and ought to stop immediately. There are those who will be reading your speculations that will give it more credence than its worth (which is NONE).

Chuck

"Blue" fingernails...

IRON

Speculations