[randistuart]

#1060076

My son (14) seems to have Plummers nail on both ring fingers. He has Graves, and is on 5mg Methimazole a day. His levels look good the last few months so we think he has stabilized. Not sure why all of the sudden this is popping up when everything else seems to be under control. The only other physical Grave’side effect is sore joints. Does anybody else have experience with nails getting pits, and lifting up? If so what was your treatment? My sons Endo will just tell me it is not Grave’s related like he says about everything. I will take him to his G.P. but she doesn’t have Grave’s experience, so any info I can get before going in is helpful. Thanks! Randi

[snelsen]

#1180144

Hi Randi.
Darn, just lost my whole post by looking up something else re plummer’s nail.

I suggest you make two copies, one for each doc, the following article from the Journal of Clinical Endocrinology, written by docs from Johns Hopkins. Plummer’s nails are associated with Graves’, hyperthyroidism, and sometimes with hypothyroidism.

So you better not hear that it is not Graves’ related!

http://jcem.endojournals.org/content/90/4/2428.full
This article has several references, all stating the same thing.
It even mentions the ring finger.

And even Wikipedia agrees! Ha!
http://en.wikipedia.org/wiki/Plummer’s_nail

Most of the literature suggests that it goes away when Graves’ is under control. I could not see any specific treatment.

Regarding him, the labs look good, and he feels pretty good except for sore muscles? How long has he been on methimazole?

Always good to hear from you
Even with problems.
Good forum for that
And, of course the usual caveat, I am not a doc, “just” a fellow Graves’ person
Shirley

[randistuart]

#1180145

snelson, His levels have just recently stabilized within the last 2 months. He has been on Methimazole since Dec. Yes his ankles and wrists ache. Endo thinks it might be from Methimazole, as that is a side effect. He is also on 50,000IU Vit. D. as he was deficient. So the aching might be from that deficiency. It is puzzling because his nails just started getting worse, but he is stable. That’s what I can’t figure out. We are seeing a new Endo in Aug., and I will discuss this with him, but need to get things under control until then. Thanks for the links!

[Raspberry]

#1180146

It is common for doctors to allow their Graves patients to become hypothyroid during treatment with methimazole. I suspect this explains many of the problems that develop in the months after hyperthyroidism is successfully managed with MMI/PTU. I had about one week of glorious health when my thyroid levels were perfect on their way down from being hyper, but they kept sinking and it’s been complicated ever since in various odd ways including joint pain. Perhaps ask your doc to take another look at your son’s FT4 and FT3 values in addition to TSH to make sure he’s not going too low?

[Gabe]

#1180147

Hi Randistuart… this happened to me (my baby toenail just fell completely off while on vacation; freaked me out) while I was doing the Methimazole roller coaster. If I remember right it was during the time when I was a little hypO on meds. Had a TT recently and haven’t had this happen again. Wonder if it could be related to the Grave’s antibodies vs. the hypo/hyper status or Meth dosage? I know my antibodies are off the charts. Just a thought…
Karen

[Stymie]

#1180148

Hi

I just looked up what this plummers nail is and realized I had this on my pinky last summer!

Was pulling the clothes out of the washer and my nail just about came off !

Didn’t really hurt at all either. And I’ve felt alot of my nails were just not attached properly if that makes any sense, but it’s the best way to describe it.

Diane

[Author]

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