Cholesterol buildup in the lower limbs can, over time, affect blood circulation and may also be reflected in changes to the toenails. While high cholesterol itself is often an asymptomatic condition, the risks increase as it progresses and it is closely linked to several other diseases that do produce noticeable symptoms.
One of the earliest visible conditions associated with high cholesterol is peripheral artery disease (PAD), which involves the narrowing of arteries in the limbs due to plaque buildup. If left untreated, PAD can significantly increase the risk of serious complications, including limb ischemia and, in severe cases, amputation.
One of the most characteristic signs of PAD is intermittent claudication — pain or cramping in the legs that occurs during physical activity and improves with rest. This symptom often limits daily activities and is difficult to ignore.
According to cardiologist Oleg Varfolomeev, in comments to MedikForum, about 5% of patients with PAD may eventually face limb amputation, while the most severe manifestation of the disease is critical limb ischemia (CLI). In CLI, the arteries of the lower extremities become severely narrowed, which significantly increases the risk of limb loss.
The cardiologist also noted that onychogryphosis, sometimes referred to as “ram’s horn nails,” may be a potential sign of impaired circulation in the legs. This nail disorder affects nail growth and is characterized by thickened, opaque, yellow-brown nails that become elongated and curved over time.
Onychogryphosis is more commonly associated with conditions such as diabetes and foot trauma, but when combined with other signs of PAD, it may indicate underlying circulatory problems.
It is important to note that up to half of people diagnosed with peripheral vascular disease may have no noticeable symptoms. Among those who do experience symptoms, the most common early sign is leg pain or cramping during walking or activity that eases with rest.
Medical experts advise that persistent leg pain, changes in nail appearance, or signs of poor circulation should prompt a medical evaluation, as early diagnosis and management of cholesterol levels and vascular health can help reduce the risk of serious complications.
