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What Causes Spooned Nails?

author avatar Dr. Eric Berg 08/31/2023

Let’s talk about spooned nails, or koilonychia, which is when your actual nail starts bending backwards. At its root, a problem with spoon-shaped nails signifies a larger iron deficiency in the body.

There are many reasons why you may be deficient in iron, and a few things you can do to reverse this deficiency. Let’s dive in.

In this article:

  1. Causes of Iron Deficiency

  2. How to Resolve Iron Deficiency


Causes of Iron Deficiency

Ulcer or Hemorrhoids

Stomach ulcer can cause iron deficiency

Oftentimes, iron deficiency can be caused by some kind of malabsorption problem in the intestines. In more extreme cases, ulcers and hemorrhoids can cause this malabsorption. See, if you have a severe ulcer or hemorrhoid, you’re constantly losing blood in the stomach, intestines, or rectum.

This kind of slow, chronic blood loss can ultimately cause iron deficiency anemia. That means that you don’t have enough iron to produce hemoglobin. Hemoglobin is essential for carrying oxygenated blood throughout the body. Not having enough can lead to:

  • Extreme fatigue

  • Weakness

  • Pale skin

  • Cold hands and feet

  • Headaches or dizziness

  • Unusual cravings for things like ice, dirt, and starch

And, of course, the spooned nails.


Inflammation of inner lining of colon

Colitis, or inflammation of the inner lining of the colon, is a condition that can cause malabsorption of many nutrients, including iron. This disease has many possible causes, including infection, inflammatory bowel disease (IBS), food poisoning, autoimmune problems, and poor blood supply. Other symptoms of colitis include:

  • Diarrhea that may have blood

  • Frequent, small bowel movements

  • Abdominal pain or cramping

  • Constipation

Low Hydrochloric Acid (HCL)

You also need a strong, acidic stomach to absorb these minerals. Normally, in your stomach, you have a very powerful acid called hydrochloric acid (HCI). As you age, this acid begins to deplete.

In fact, hydrochloric acid is probably the single most common deficiency that I see in a lot of people, especially as they get older. This condition can cause a lack of protein digestion along with an overall lack of mineral absorption.

This makes a lot of sense when you think about the purpose of stomach acid and the stomach in general. It’s there to break down proteins. If you’re not breaking down proteins, you’re going to get putrification - things like gas, indigestion, acid reflux, GERD, and indigestion. This all happens when the stomach is in a low acid state.

That’s why it’s so important to get that stomach really working well. Some things to help you solve this condition include:

  • Take apple cider vinegar tablets or drink it

  • Limit processed foods and consume more leafy vegetables

  • Eat fermented vegetables like kimchi and sauerkraut

  • Eat ginger

  • Increase your zinc intake


If you’re a vegetarian, you may get non-heme type iron from sources like yellow beans, spirulina, spinach, lentils, ginger, and sesame seeds. But those are only absorbed a certain amount. The actual active form of iron that goes into the blood and helps carry oxygen comes from more animal products like:

  • Seafood or fish

  • Clams (which actually have the highest amount of iron)

  • Pork liver

  • Lamb kidney

  • Oyster

  • Octopus

  • Mussels

  • Red meat

In short, it’s a lot of the foods that people probably don’t consume enough of this iron on a regular basis. So it could be just some basic malabsorption problems in the intestines.


Symptoms of anemia iron deficiency

If you have a parasite, it’s going to essentially suck away a big chunk of the blood and nutrition that’s supposed to go to you. This blood loss can lead to iron deficiency and anemia. Other symptoms of a parasite include:

  • Unexplained constipation, diarrhea, or other symptoms of IBS

  • Skin irritation or unexplained rash, rosacea, or eczema

  • Fatigue, exhaustion, or apathy

  • Feeling unsatisfied after meals


How to Resolve Iron Deficiency

In summary, if you have a concave or spooned nail shape, it's usually due to an iron deficiency (though other causes include trauma or working with petroleum-based products).

You’ll want to find the ultimate cause behind your low iron content. It's the same with any fingernail or toenail problem, including nail clubbing, nails that are brittle, white spots on the nail bed, or vertical ridges. You can't just observe the problem - you have to understand the root issue at the bigger health problem at hand.

When it comes to spoon-shaped nails, the iron is rarely lacking in the diet. Instead, it’s mainly due to one of the common causes above.

That's why, if you have koilonychia, you’ll want to start consuming more iron. Now, if you have one of these larger underlying conditions, you’ll have to treat that as well, but iron supplementation is a good start.

If you want to take an iron supplement, we recommend the food-based ones - something like grass-fed liver pills. That said, it’s always preferred that you get your nutrition from whole food sources of you have the chance.

Let us know if you have any questions.

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Disclaimer: Our educational content is not meant or intended for medical advice or treatment.

Editor’s Note: This post has been updated for quality and relevancy.

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