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Ask Dr. Mike: Ridges in Your Nails & Is Acetaminophen Dangerous?

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans. Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

I have had ridges in my nails in my thumb and ring finger for years. My friend says I should see my doctor, is that true?

Usually a ridge is perpendicular in your nail. If this has developed very quickly and you have other symptoms like feeling chronically fatigued, constipation, and/or brittle hair, you may want to see your doctor, because these are signs of an issue with your thyroid.

However, even if you've had these ridges for over a period of time, you should still talk to your doctor and ask for a thyroid panel and test your B12 levels.

New research says the dangers of Acetaminophen are "underestimated." This concerns me because I use it and give it to my kids. Should I stop?

Acetaminophen can deplete glutathione, an important antioxidant in your liver. Once it's depleted, your liver becomes more prone to damage from the toxins in your body that it's trying to detoxify in the first place.

This doesn't mean you should completely stop taking it. You just have to be aware of how much acetaminophen you're using. When it comes to over-the-counter drugs, you have to read the label of all the medicine you're taking to make sure you're not overdoing it.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it. or call in, toll-free, to the LIVE radio show (1.877.711.5211) so he can provide you with support and helpful advice.

RadioMD Presents:Healthy Talk | Original Air Date: March 4, 2015
Host: Michael Smith, MD

RadioMD. It's time to Ask Dr. Mike. Do you have a question about your health? Dr. Mike can answer your questions. Just email: This email address is being protected from spambots. You need JavaScript enabled to view it. or call now: 877-711-5211. The lines are open.

So, the first question is about the health of the nails. It's an interesting question because I did an article a long time ago, actually, and I think it was published by Life Extension. It was more like a blog, so it was online and it had one of the largest number of shares and stuff. People are very interested in this and how hair, nails, and skin can really reflect overall health, even the oral cavity like the tongue. Even your eyes. How that can reflect what else might be going on in your body. So, here's the question:

"I have had ridges in my nails--my thumb and ring finger--for years. A friend said that I should see my doctor. Is that true?"

Well, you know, it kind of depends. I think if there is a ridge, and usually a ridge is perpendicular to your finger. That's what a ridge usually is and if it develops quickly, then, yes. I think that's something you want to check. If it's been there a long time and you don't have any other symptoms, I don't know.

I'm not sure how to answer that. It wouldn't hurt. There are some things your doctor can check, but, definitely, if it's something that develops pretty quickly and you have other symptoms, like you feel tired, constipated, or maybe you're having some hair issues, like brittle hair--not just brittle nails, but brittle hair as well—those could be signs of hypothyroidism. So that would be one thing that I would check.

So, again, if the ridges develop quickly, yes. Definitely go see your doctor and your doctor is probably going to want to do a thyroid panel and maybe check your B12 status. One thing about the thyroid panel, too. When I say "panel", I mean, panel. I think too many times conventional doctors only check something called TSH—thyroid stimulating hormone. That's not enough. TSH is just not very sensitive at picking out hypothyroidism. It's weird, the higher the TSH, the lower the thyroid production. So, the higher the TSH means hypothyroidism—low thyroid production. The problem is, is most conventional doctors allow a TSH to get up above 4 on a test and that can test too high.

I think an optimal TSH that reflects probably optimal thyroid health is probably around 1 or 2. But, I think you should do more than just a TSH. If you have ridges in your nails that develop quickly, go get a thyroid panel. That would include TSH, but also a total T4. T4 is the hormone that's actually made in the thyroid gland and then a free T3. See what happens is, the thyroid gland produces T4. That travels out to the tissues and it's converted to T3. T3 is really the active form of the hormone. So, a thyroid panel really should be looking at TSH, total T4 and a free T3.

You might also throw in there some antibodies to make sure you don't have something called "Hoshimoto's". So, maybe ask your doctor for a Hoshimoto's check and they're going to look for thyroid antibodies. Hoshimoto's is the most common cause of low thyroid in this country and it's an autoimmune disorder. So, you might want to check that as well. So, do a thyroid panel.

Also, look at your B12 level. B12 is a little bit tougher because in many cases, if you absorb B12 really well, even just eating fruits, your B12 level can shoot way up and a lot of doctors will look at that and they'll be like, "Oh, my gosh. What are you doing? How much B12 are you taking?" and it doesn't really mean you're overdoing it with a supplement or food, it just means you absorb it really well. B12 is very transient in the body. It goes up and down really quickly. On the flipside of that, some people have really low levels which might be a sign that they're not absorbing B12 really well. So, what we're really looking at in the case of ridges in the nail is that low level and you might want to consider having a B12 level checked. But, if it's high, don't worry about it. If it's low, that might be an indication that you're having ridges.

Now, you can't just take B12 if it's low because what's probably happening is B12 requires something called the "intrinsic factor". It's a protein in the gut to absorb into your bloodstream. So, a lot of people with low B12, you could do all the B12 supplements you want. You can eat all the B12 food you want, but you just don't have that intrinsic factor to absorb it. So, what you need maybe is a shot of B12 or a sublingual B12 that dissolves under your tongue. That would be better than doing a standard supplement. So, check your thyroid. Check your B12. That's definitely for acute ridges.

Now, this question though, is about this person saying they've had ridges in the nails for years. So, it wouldn't hurt, maybe, to check these things so, maybe I'm going to change my answer. Yes. If you get ridges in the nail, whether acute or not, yes. Just go get a thyroid panel. Check your B12. Try to hydrate the cuticles with essential oils. That can help a little bit. If that helps, without doing anything else, then it's probably not your thyroid or not B12, but why not just go get a thyroid panel and B12 check?

Okay. So, yes. I changed my answer. So, the question is, "Should I see my doctor?" Yes. If you've got ridges in your nails. Go see your doctor and have your doctor look at a thyroid pane. and a B12 level and then try some essential oils.

Okay. See, even doctors are allowed to change their mind right in the middle of an answer. How's that?

Okay. We're going to go to a question about acetaminophen. Acetaminophen is an anti-pain, anti-inflammatory. The most common brand name—I'm going to say it. It's okay.—is Tylenol. Just so everybody knows what I'm talking about. So, acetaminophen, the most common brand is Tylenol.

So, the question is: "New research said the dangers of acetaminophen are 'underestimated'. That concerns me because I use it and give it to my kids. Should I stop it?"

Yes. So, there was a report at Life Extension, as the senior scientist, I have the fortunate benefit of seeing a lot of current news stories—health news stories. You know, we produce a daily newsletter and one of my jobs here is to approve the content that's used in that newsletter. I don't think it's daily any more. I think we went to weekly.

So, I'm constantly receiving from the writer of the newsletter, whose name is Dana Dye. She's been with Life Extension for like 30 years. She sends me all this, almost on a daily basis, like, "Here's some ideas. Here's some things I want to write about," and I actually saw this. I saw this, I guess I want to say a couple of days ago, where now a lot of doctors are concerned that we're not teaching people enough about the dangers of acetaminophen. The real danger to this drug is the liver.

What happens is acetaminophen can deplete an important antioxidant for the liver called glutathione. And when the liver loses glutathione, that's really bad because that one antioxidant, glutathione, it's an intrinsic antioxidant. Your body makes it. It's one of the most potent antioxidants known in the human body. It's pretty much used by the liver and when the liver doesn't have any, the liver becomes more prone to damage from all the toxins that it's trying to detoxify. So, glutathione is incredibly important to the liver. Acetaminophen knocks out glutathione levels. There's the problem.

Now, it's all about dose, though, and that's the answer to this question. "Should I stop it?" That's what she's saying. No, I don't think you have to stop it. I just think you have to be aware of how much you're using and here's the problem: acetaminophen is in so many other products. You might get Tylenol that's just pure acetaminophen and then you also get an anti-fever or a cold product that also has some acetaminophen in it that you don't even know about, that you're not even reading the label.

So, it's just really important when it comes to these over the counter drugs, you've got to look at the label and make sure you stick to the suggested dosing of acetaminophen. Don't be mixing it from other products. That's the key thing. And, take some glutathione. That would help.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.