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How Anorexia Nervosa Affects Your Hands

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You may not realize that anorexia nervosa (AN) can literally affect every part of the human body, from head to toe, including your hands. (1)

Between your head and your toes are your hands – and your skin. These two areas of your body may be affected in numerous ways from AN. Changes that occur in your hands, may be referred to as “anorexic hands” by some. It’s not an official medical term though.

How Anorexia Nervosa Affects Your Hands

Eight Changes to the Hands and Skin In People with AN 

There are eight changes known to occur in individuals struggling with AN:

  1. Cold hands 
  2. Bluish tint in the fingertips
  3. Damaged nerves in the hands (and feet), which may cause numbness 
  4. Muscle spasms
  5. Possible bruising
  6. Swelling of the hands
  7. Vertical ridges in the nails, and/or vertical stripes or white spots
  8. Dry skin
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Why Does Someone With Anorexia Nervosa Have These Hand and Skin Changes?

The symptoms mentioned above happen because of a number of things that are changing in the body due malnutrition from to AN. They are listed below.

Change #1 - Cold Hands

When someone does not consume enough energy, the basal metabolic rate (BMR) is affected. The BMR connects directly to the thyroid gland, which is responsible for keeping core body temperature constant. When someone is malnourished or suffering the effects of food restriction such as in AN, the body temperature and basal metabolic rate drops, causing the hands to be cold. (2)

AdditionallyWhen the core body temperature drops, there is a shift in the blood circulation of the body. The body knows it has to make an adaptation to make sure that the person survives and directs the blood circulation to focus its energy on the vital internal organs instead of the hands and feet. This survival mechanism results in cold hands and feet.

Another reason for cold hands in individuals with AN can be from iron deficiency, which contributes to cold hands and feet. (8)

Change #2 - Blush Tint in the Fingertips

As the blood flow is decreased to the fingers, this results in less oxygen reaching the fingertips. When skin or tissues are oxygenated, they should have a healthy pinkness that indicates vitality. With less oxygen, the normal pink color changes to blue.

Change #3 - Damaged Nerves in the Hands, Which May Cause Numbness

If nerves are damaged, they will give out cries for help. One of the signs of nerve damage is numbness which happens when you may not be able to feel the part of your body that is affected. It’s possible that AN may damage nerves in the hands. This may also result from a vitamin B12, vitamin B1 or other nutritional deficiencies including fat and other forms of energy. (3) Any of these deficiencies affect nerves negatively, leaving them open to be damaged.

Change #4 - Anorexic Hands: Muscle Spasms

Muscle spasms may result from a deficiency of calcium, magnesium, and from electrolyte imbalances. (4) Vitamin and mineral deficiency are common in AN, as are electrolyte imbalances. 

Change #5 - Possible Bruising

Bruising of the hands may occur due to vitamin C deficiency. (9) Bruising could happen even though there is no trauma to the hands. In fact, the person may go to sleep at night and then wake up with bruises.

This occurs because when a person has vitamin C deficiency, the type of collagen that builds the capillaries is not at adequate levels. This leaves small blood vessels weak and prone to rupture. In anorexia nervosa with a vitamin C deficiency, the small capillaries in the body will burst and cause bruising.

Change #6 - Swelling of the Hands

It’s also common for those with AN to have swelling. (5)

Vitamin C and/or vitamin B1 (also called thiamine) may cause tissue swelling in various parts of the body. Swelling of the hands may be due to a protein deficiency and/or an electrolyte imbalance. Edema which is a form of water retention can occur in a malnourished and dehydrated state, commonly seen in AN. Vitamin B6, vitamin B5 (pantothenic acid), and/or magnesium are among the deficiencies that occur in a person with anorexia nervosa. The kidney and heart are both important at maintaining fluid regulation and may also cause temporary water retention in the body, although not specifically in the hands. Kidney and heart problems are serious medical complications caused by AN. (10)

Change #7 in Anorexic Hands - Vertical ridges in the nails, and/or vertical stripes or white spots

The symptoms an individual with AN is experiencing in their hands can occur due to multiple aspects of nutritional deficiency commonly seen in people who are restricting their intake. The vertical ridges that develop in the nails of someone with anorexia nervosa is due to the multiple B vitamin deficiencies that occur. The white stripes or spots in the nails are due to a zinc deficiency. (6)

Change #8 - Dry Skin

In AN, the percentage of body fat decreases. Fat stores in the body are used up as a source of energy. The individual isn’t eating enough, and the nervous system as well as the skin thrives on fat in the diet. This means these tissues go ‘hungry’ for the fat. 

Dry skin is known to be caused by a lack of fat in the diet and dehydration. (7) Dry skin may occur in early stages of AN. The dry skin can be temporarily helped by topical creams, but these won’t replace the oils and fats you need from balanced nutrition. Skin needs to be nourished from within.

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Treatment for Symptoms Occurring in the Hands of an Individual With AN

There are two primary types of treatment that are needed for anorexic hands: 

  1. Nutrition counseling
  2. Medical treatment

Nutrition counseling is especially important because it’s going to take the complete nutritional rehabilitation to completely heal AN is a psychiatric disorder that affects the entire body, and can cause many medical problems if left untreated. 

However, medical treatment is also especially important because of the seriousness of the condition. It’s common for those withAN to have electrolyte imbalances, which can could cause death without immediate medical attention 

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A Word of Encouragement

Many people who have struggled with AN have been able to recover from the disorder. Recovery can be intense, as there are a lot of things to address simultaneously – nutrition, medical issues, psychiatric issues, family issues, and emotional issues. 

Make a vision of what you want your life to be like when you are fully healed – maybe creating a vision board for yourself, could be helpful for you to progress in recovery. Give yourself time. Envision your healing and then take the actions to make it happen, one step at a time. With attuned treatment, including nutritional guidance, psychotherapy, and medical management, it is possible to see continual progress.

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  1. Sidiropoulos M. Anorexia nervosa: The physiological consequences of starvation and the need for primary prevention efforts. Mcgill J Med. 2007 Jan; 10(1): 20-25. 
  2. Lakier Smith L. The central role of hypothermia and hyperactivity in anorexia nervosa: a hypothesis. Front Behav Neurosci. 2021;15:700645. 
  3. Staff, H. H. P. (2022, March 23). Vitamin B12 deficiency can be sneaky and harmful. Harvard Health. Retrieved June 10, 2022, from 
  4. Elizabeth Shimer Bowers and Moira Lawler, Lebow, H. I., Kennedy, K., Bedosky, L., & Rapaport, L. (n.d.). 7 common nutrient deficiencies. Retrieved June 10, 2022, from 
  5. Derman O, Zinnur K E. Edema can be a handicap in treatment of anorexia nervosa. Turk J Pediatr. Nov-Dec 2009; 51(6):593-7. 
  6. DiBaise M, Tarleton SM. Hair, nails and skin: Differentiating cutaneous manifestations of micronutrient deficiency. Nutr Clin Pract. 2019 Aug;34(4):490-503.
  7. Christiansen EN, Skara BB, Sorensen E, Grav HJ. Serum lipids in children with xeroderma from an inland district of Sri Lanka. Ann Nutr Metab. 1995;39(1):9-15. 
  8. Walle, G. V. D. (2022, January 17). 14 signs and symptoms of iron deficiency. Healthline. Retrieved June 10, 2022, from 
  9. Julson, E. (2018, May 25). 15 signs and symptoms of vitamin C deficiency. Healthline. Retrieved June 10, 2022, from
  10. Bouquegneau, A., Dubois, B. E., Krzesinski, J.-M., & Delanaye, P. (2012). Anorexia nervosa and the kidney. American Journal of Kidney Diseases, 60(2), 299–307.
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