DEAR DR. GOTT:
I have had toenail fungus for 15 or 20 years. It has spread to all my toes despite my attempts to cure it. I used tea tree oil for about six months with no change, iodine for about four weeks with little change and soaking my nails in Listerine nightly for six or eight weeks with no change. I have used Vicks VapoRub twice now, the first time for six months with change only in one toe but it didn’t last. My most recent experience with it has not shown any results, despite using it twice a day for one year. I put it on liberally and then put on socks.

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).