Fighting nail fungus

April 18, 2013 By

Q: On February 12th I began taking Terbinafine HCL (250 mg tablet once daily) prescribed for a fingernail fungus that I have had for years.

After four weeks of treatment, blood tests determine the medicine was not adversely affecting my liver; therefore, my doctor authorized a refill. I stopped taking the medication on March 19th because I became alarmingly aware that it had seriously affected my ability to taste – this, along with dry mouth and throat. Although it has been two weeks since I stopped taking Terbinafine, I have yet to regain my sense of taste and the dry mouth and throat persist. All food consumption is akin to what can only be described as eating cardboard or unadulterated wax. I have to force myself to eat anything and have gone from 120 pounds to 115 pounds.

Please share your thoughts and knowledge regarding this awful side effect. Can you tell me if you know of other individuals who have taken this medication and were similarly affected. What percentage found it to be permanent.

A: Terbinafine is an anti-fungal that prevents fungus from growing on the skin. The topical form is used to treat ringworm infections, athlete’s foot, jock itch and other skin infections, while Terbinafine Hydrochloride is prescribed to treat fungal infections of toenails and fingernails. Results may not be apparent for several months, essentially because it takes that long for new nails to grow. The topical form available in cream or gel solution is 1%; the oral form of the drug comes in 250 mg tablets. Oral granules are available in 125 and 187.5 mg strengths. Dosing is commonly one tablet daily for six weeks for fingernails, 12 weeks for toenails; with topical applications, once daily for ringworm or jock itch and twice daily for athlete’s foot for a week. The medication should not be discontinued abruptly.

Side effects may cause body aches, flu-like symptoms, fever, chills, joint pain, diarrhea, swollen glands, a butterfly-shaped rash over cheeks and nose, hives, difficulty breathing,weight loss because of a taste disturbance, loss of smell, hepatic failure, and more. Because of the potential for liver failure (that can occur with countless prescription drugs), your physician correctly had you tested. Taste disturbances are typically noticed five to eight weeks following the initiation of therapy, returning to normal within five weeks of stopping the drug. Many people on Terbinafine do not experience serious side effects. When they do occur, a physician should be advised.

Alcohol consumption should be limited and for some, a sun sensitivity might occur. Therefore, prolonged exposure to the sun’s rays when out of doors, the use of tanning booths and sunlamps should be avoided. Because the medication passes into breast milk, it should be not be prescribed for women who are nursing. Individuals with a weakened immune system, lupus, psoriasis, food or medication allergies, on herbals or dietary supplements should advise their physician of such prior to initiating Terbinafine.

There are numerous medications available over-the-counter without what appears to be too many potential side effects. For example, Miranel that contains tea tree oil, Iodides Tincture (decolorized iodine), Mercuroclear, medicated chest rubs, and cider vinegar have all be used successfully to treat nail fungus. To the best of my knowledge, all the products but the last are available at Wal*Mart and other large chains, while cider vinegar can be purchased at your local grocery store.

My guess is that your residual symptoms should dissipate shortly, at least I certainly hope so. The reported incidence of people similarly affected is 3%, but your word is now out. Topical medications are not as effective as are those taken by mouth but there are other drugs such as the nail lacquer amorolofine that has gained some recent popularity. Still other treatment includes surgical removal of the nail. If other readers choose to share their experiences, pro or con, I will do a follow-up in the near future.

Readers who are interested in learning more can order Dr. Gott’s Health Report “Compelling Home Remedies” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Gott’s Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

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Mouth fungus needs further investigation

April 8, 2013 By

Q: I have been dealing with a fungus in my mouth off and on for almost a year. I have been to my doctor and she sent me to an oral surgeon. He said there are many things that can cause it. I know cinnamon does. He said I might have to deal with it off and on the rest of my life. He said cigarettes are one cause but I quit over 18 months ago. They were treating me with Mycelex 10 mg trochee 5 times a day. It was working but not any longer. Any help would be greatly appreciated to clear this up permanently.

A: There are many types and causes for fungus to appear. For example, thrush is caused by the candida fungus, an infection that generally appears in the mouth but can also occur as a diaper rash in infants and as a yeast infection in women. Small amounts of the candida fungus are present even in healthy people throughout the body – from the mouth, through the digestive tract, and skin – and are kept in check by microorganisms and other bacteria in the body. When that balance is knocked out of whack, the fungus grows out of control, causing thrush. Thrush can be exacerbated by the habit of smoking, having the herpes simplex virus types 1 or 2, uncontrolled diabetes, a weakened immune system, poor oral hygiene, dry mouth, stress, birth control pills, antibiotics, acidic foods, cinnamon flavorings, and the use of corticosteroids.

Symptoms may appear suddenly and unfortunately, as you have discovered, can last a long time. There may be raised lesions on the roof of the mouth, tonsils, gums, back of the throat, tongue or inner cheeks that are creamy white in color and slightly raised. The lesions may bleed when the teeth are brushed and they may be painful. Severe cases may spread to the esophagus, the muscular canal that connects the mouth to the stomach. When this occurs, the individual may experience pain, fever and dysphagia (difficulty swallowing).

Diagnosis can generally be made by visual examination of the inside of the mouth, or sometimes with the help of a simple scraping of the material examined under a microscope. When the lesions extend to the esophagus, a culture may be performed or endoscopy may be ordered.

Treatment is generally initiated with anti-fungal medications available in tablet or liquid form, or as lozenges taken for about two weeks. While the ingestion of yogurt or taking acidophilus capsules might not rid your body of oral thrush, these products may work toward restoring the normal flow of bacteria within the body.

Prevention entails seeing a dentist on a regular basis, limiting the consumption of sugary foods and those that contain yeast, discontinuing smoking if appropriate, brushing twice daily and flossing at least once each day. We don’t always take into account the yeasts we consume on an almost daily basis but bread, beer and wine may contribute or be solely to blame. Speak with your primary care physician or oral surgeon about your diet to determine if this could cause your long-standing problem.

Without knowing your history, I cannot determine if you have other medical problems that should be addressed or even when you last visited a health care professional for a full examination. I stress this because the problem could be the result of an underlying medical condition in another part of the body (such as Sjogren’s syndrome or an immunodeficiency) that has yet to be diagnosed. Have you had lab and other testing within the last year or so? If not, you are overdue and the results just might give some insight into your fungal infection.

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Lysol for fungus

February 3, 2011 By

DEAR DR. GOTT: I am looking for plain Lysol. I can’t find it anywhere. My mother used it to control fungus, ringworm and other contagious skin outbreaks. Where is it available?

DEAR READER: Lysol sells and distributes disinfectant sprays, wipes, no-touch hand soap, all-purpose cleaners, mildew remover, kitchen, bath and toilet-bowl cleaners, but nowhere did I find plain Lysol. Upon calling the company, they indicated they discontinued the original “scent” in January 2010. They have a 12-ounce concentrate, but it is not intended for use on the body; nor is any of their other products. So I guess you will have to improvise. Sorry!

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Rose thorns can be dangerous

April 25, 2010 By

DEAR DR. GOTT: Last spring, I contracted rose-thorn disease. Very painful and extreme swelling occurred in just one finger. I was in the hospital for days under sedation and on antifungal meds. I’m still having stiffness and swelling in that finger now and then. When will this go away? I must say, everything is not coming up roses here.

DEAR READER: Rose-thorn (or rose gardener’s) disease has the technical name of sporothrix schenckii. It is a fungus that resides on hay, sphagnum mosses and the tips of rose thorns. It can cause infection, redness, swelling and open ulcers at the puncture site. The fungus can spread to the lymphatic system and move on to the joints and bones, where it ends up attacking the central nervous system and lungs when the thorn or thorns are deeply embedded.
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Foot itch has many causes

April 22, 2010 By

DEAR DR. GOTT: Recently, after being on my feet for up to 10 hours, I got a rash around my ankles and the tops of my feet, and sometimes it goes up my legs. Tender to the touch, it is more noticeable the longer I am on my feet. It disappears after a few days if I’m not on my feet constantly.

DEAR READER: Common causes of foot rash are dry skin, heat exposure, fungus and spider-vein itch. If your feet are dry, rub them with a lanolin-based cream. If heat could be the culprit, change to footwear such as sandals or canvas sneakers, and wear light cotton socks. Fungal infection might be treated with a topical medicated product or a trip to your physician for a prescription. Spider-vein itch is treated with elastic stockings and alternative remedies.

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Sunday Column

March 9, 2008 By

DEAR DR. GOTT:
I have suffered for a long time with a fungus under my toenail. I’ve read through your column of success with Vicks therapy, but it isn’t working for me. Is there anything else you can suggest?

DEAR READER:
“Fungal” infections under and around nail beds can be caused by yeasts, molds and various fungi. Most are caused by the same type of yeast that causes athlete’s foot. The average healthy individual should not be affected by an infection, other than from an aesthetic view point. Problems arise for diabetics, those with weakened immune systems, and many individuals as they age.

According to many of my readers, Vicks or a store brand mentholated chest rub equivalent takes several months, but has shown promise in controlling fungus for many people. If you aren’t among those reporting success with this product, there are alternatives.

Speak with your primary care physician to determine if prescription medication might appropriate for you. Two better known anti-fungals he or she might prescribe are Lamisil and Penlac. Determine insurance coverage, since some medications can cost in excess of $10 per pill per day and must be taken for three months. This translates to more than $900 with no guarantee of success. A downside is the potential for side effects including skin rash and liver damage. Therefore, if you and your doctor determine prescription medication is appropriate for you, I urge you to have a liver test before beginning and on completion of the course of the drug. Should a rash develop, report to your physician.

Some people have had success with vinegar. There is no scientific or direct evidence that the infection will be eradicated, however, vinegar has been known to inhibit the growth of certain organisms. Experts suggest soaking the affected foot or feet in a mixture of one part vinegar to two parts warm water for 15-20 minutes. Rinse the feet and pat them dry. The process should be performed once or twice a week until the infection is under control.

Still another solution is Miranel Anti Fungal Treatment, a new product available over-the-counter, that kills fungus around and under nails. It is also recommended for control of athlete’s foot and ringworm. While similar to Vicks in that it contains camphor, eucalyptus and menthol, it also has the addition of tea tree oil and miconazole nitrate. This latter ingredient inhibits the growth and reproduction of fungal cells as well as being more easily absorbed through the damaged nail. Unlike standard over-the-counter remedies, Miranel uses natural properties that provide safe yet effective treatment for eradication of nail fungus. With no ingestion of medication, there is no worry of liver damage, and to the best of my knowledge, there have been no reports of skin rash.

While test studies report astonishing success, I again am asking my readers to report their findings with Miranel found at Wal-Mart, but understand it is available at most pharmacies. If it isn’t, ask your pharmacist to order it for you or visit www.MiranelBrands.com.

Since I have mentioned prescriptions and alternatives for control, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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