Fingernails

[mejohn1]

Over the last 3 months I've developed very brittle fingernails. They all have lines running from front to back. I do a lot with my hands and have torn 3 nails past the bed just in the last couple of weeks. I've kept my nails short over the years to avoid this (because it hurts!) and have rarely had a torn nail. But 3 in a short time? Coincidentally, 3 months ago lamictal was added to offset breakthrough seizures. I now take 3,000mg Keppra and 50mg lamictal daily. Are brittle nails a potential side effect? I've also been told that vitamin supplements are helpful for epileptics, are there any you recommend to help with this?
Thanks!

 

[Cint]

Have you had your thyroid level checked? Hyper or Hypothyroidism could cause brittle nails and splitting of the nails. Some of the anti-seizure meds can effect the thyroid.

 

[Nakamova]

Are your toenails also affected? If so then the problem is likely systemic (i.e. thyroid issues or nutritional deficiencies). If only the fingernails are affected, then the cause is more likely to be environmental -- exposure to particular chemicals or repeated wetting and drying of the nails (as with dishwashing).

Even though your brittle nails coincide with the starting Lamictal, the med probably isn't to blame. Nutritional deficiencies (even those caused by medications) usually take several months to show up in things like hair and nails. How long have you been on Keppra? That might be also be the culprit.

If you can rule out environmental exposure, fungal infections, or thyroid issues, then nutritional deficiencies to consider are: iron, zinc, protein, calcium/D3, biotin (a b-vitamin). A good first step is to take a look at your diet -- are there ways you could make it more balanced? Are you drinking a lot of sodas or eating a lot of processed foods? You could ask your doctor to run a basic CBC (blood test) -- it can indicate if you are iron-deficient.

As for supplements: I think it's worth considering either a solo biotin (B7) supplement, or good B-Complex vitamin that includes biotin, since Keppra can decrease levels of biotin, folic acid (B9) and vitamins B6 and B12. Lamictal can interfere with folic acid absorption as well.

 

[epileric]

Came across this...

Mejohn1, You didn't mention any of the listed antconvulsants that cause deficiencies but were you on any of them previously for a longer period of time? Like Nakamova said, it does take a while for nails to become brittle & form ridges so the cause probably isn't related to anything too recent.

The University of Maryland Medical Center had some good info on it

Antiseizure Medications
-- Taking antiseizure or anticonvulsants medications for a long time can lower biotin levels in the body. Valproic acid can cause biotinidase deficiency, which may be helped by biotin supplements. Ask your doctor before taking any supplements, however. Anticonvulsant medications include:

Carbamazepine (Carbatrol)
Phenobarbital
Phenytoin (Dilantin)
Primidone (Mysoline)


Source: Vitamin H (Biotin) | University of Maryland Medical Center http://umm.edu/health/medical/altmed/supplement/vitamin-h-biotin#ixzz2nqftGuc6
University of Maryland Medical Center
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http://umm.edu/health/medical/altmed/supplement/vitamin-h-biotin