My over-the-counter drugs are a one-a-day multi-vitamin, calcium 1000 mg plus D daily, and calcium citrate 315 mg with 200 IU of vitamin D.

Years ago I noticed hair loss and attributed it to the metoprolol. The problem keeps increasing and, in fact, if it continues, I will need a wig in another year. I mentioned the problem to my doctor and her reply was that all medicines make people lose hair. Would I be wrong in asking my doctor to take me off the metoprolol and prescribe another medication for my high blood pressure? I showed her the drug information provided by my pharmacy indicating hair loss as a side effect.

I recently changed primary care physicians since my first doctor wasn’t concerned at all about my hair loss. What can I do?

DEAR READER:
Let me begin with some general information. Medications must go through several clinical studies before being approved. This is done by giving thousands of people a drug, while others are given a placebo. During the studies, no participant knows if he or she is taking the real thing or a placebo. An adverse consequence in more than 1% of the people studied in both categories is referred to as a common side effect, while less than that amount is referred to as rare. Once a drug is approved, it is no longer studied.

Now for the bad news. You are on lisinopril, metoprolol and prednisone. Rare side effects of all three drugs list hair loss as a possibility. Steroids are known to precipitate hair loss in men, yet all women have some male hormones. Therefore, of the prescription medications you take, all three share a similar consequence. The good news, according to my resources, is that the hair loss is generally reversible once a drug is discontinued.

It could be difficult in your situation to determine which drug might be causing your hair loss, unless you kept meticulous records indicating when the pattern began. As we age, we suffer wrinkles, heart problems, hypertension, arthritis and more. It’s difficult enough dealing with the problems over which we have little control. We shouldn’t have to deal with balding when it might be preventable. I recommend you speak with your new primary care physician who might be able to prescribe different medications in each instance without such an emotionally devastating side effect, no matter how rare it might be.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines”. 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.

Can you please advise me about what else I can do? Do I still have non-medication options? Should I now consider using those expensive anti-fungal pills?

I am a 60-year-old female, 50 pounds overweight and take metoprolol, simvastatin, Wellbutrin, L-tryptophan (for my depression, it works great), and several vitamin supplements. I try to eat healthfully and exercise by walking, meditating and doing Tai Chi. I have a stent but a recent stress test and echocardiogram show no blockages. I used to smoke a pack a day for 25 years but quit (which is when the extra weight came on).

I would appreciate any suggestions you can give me.

DEAR READER:
Toenail fungus can be especially difficult to treat. You appear to have unsuccessfully tried several home remedies.

Only one of your medications, simvastatin, lists changes to hair or nails as a side effect but I doubt that this is the cause of your nail problems. Interestingly, both simvastatin and metoprolol list depression as a side effect. With your history, I wonder if these medications are appropriate choices for you. Another fact to consider is that Wellbutrin can cause cardiac problems. Because you have a stent, perhaps this is also not the best choice. L-typtophan is an amino acid that naturally occurs in the body. It is a precursor to serotonin, which may be why you have had success using it for treatment of your depression.

Now to your nail fungus, there is a new over-the-counter ointment that you may wish to try called Miranel. It works similarly to Vicks but has the added benefit of being able to penetrate the skin and nails more easily, allowing it to work more effectively. Remember to keep your nails trimmed short for faster results. The kit which contains a nail file for easy nail trimming, a brush for a less messy application and the ointment is available at Wal-Mart and most pharmacies. You can also purchase it online at www.MiranelBrands.com.

In my opinion, however, now is the time to consult a podiatrist. This specialist will be able to take samples of your nail fungus and determine what type it is. This will also then allow him or her to give you treatment options. Not all nail fungus is the same. You may have a particularly resistant or uncommon type. That being said, a pharmacist recently wrote to me saying that those “expensive anti-fungal pills” were available as a generic at Wal-Mart for $4. So while the medication may not be as expensive as it once was (if you live near a Wal-Mart, at least), it still is not my top choice. You must have blood work before starting the treatment to ensure there are no problems with your liver, and both during and after treatment to ensure that your liver was not adversely affected by the pills. Nail fungus is not harmful, it is simply ugly. I recommend you avoid medication until you have exhausted every other option.

To give you related information, I am sending you copies of my Health Reports “Dr. Gott’s Compelling Home Remedies”, “A Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet” and “Consumer Tips on Medicine”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).