The People's Pharmacy

Joe Graedon, M.S.,and Teresa Graedon, Ph.D.

Q. Can you recommend a good cure for toenail fungus? I have tried various over-the-counter remedies without success.

A. We have been writing about nail fungus for decades, and yet there is no perfect solution that works for everyone. The Food and Drug Administration has approved several prescription products. However, according to a published review, the cure rates are unimpressive. Itraconazole taken as a pill resulted in a complete cure about 14% of the time after nearly a year (F1000Research, June 25, 2019). Over the same 48 weeks of treatment, terbinafine pills cured 38% of nail fungus cases.

Topical medicines were less effective. Tavaborole (Kerydin) had a cure rate of 6.5%, ciclopirox (Loprox, Penlac) got up to 8.5% and efinaconazole (Jublia) to 17.8%.

It’s not surprising that many readers try home remedies. Like prescriptions, they don’t work for everyone.

One reader recently shared this experience with an OTC antibiotic for thick, hard toenails:

“I tried home remedies for nail fungus with limited results. OTC liquids and athlete’s foot creams didn’t work either. The fungus always returned. Oral Lamisil helped, but I had to stop it due to abnormal liver function tests.

“A few weeks ago, you wrote about Neosporin for stubborn nail fungus. So I tried it. Almost overnight, my nails look better than they have in 20-plus years! The thick, whitish-yellow, crusty, crumbly nails are now pink and healthy looking. Black spots on two smaller toes are growing out. My podiatrist was amazed.”

Q. I hope you can help with an embarrassing problem. In the afternoons I often have very loud gas.

I do eat breakfast, but sometimes skip lunch. Different over-the-counter meds have been mostly useless. The flatulence happens throughout the evening. What can you suggest?

A. The first step in overcoming gas is to keep a “fart chart.” People can be sensitive to different foods. For many, legumes are the culprit. For others it is wheat or barley, especially if they are sensitive to gluten. Milk sugar (lactose) is another potential problem. That’s why keeping track of flatulence and food triggers can be helpful.

You didn’t mention whether you are taking any medications. A surprising number of drugs can trigger flatulence.

Many OTC products advertised to treat gas contain simethicone. One review notes, however, that: “Simethicone does not appear to reduce the actual production of gas in the GI tract” (StatPearls, July 21, 2021).

To learn more about the food and symptom diary as well as medications that may cause gas, you may wish to read our eGuide to Overcoming Digestive Disorders. This online resource can be found under the Health eGuides section at www.PeoplesPharmacy.com.

People who have difficulty digesting milk sugar (lactose intolerance) may get benefit from probiotics and lactase enzyme replacement in the form of pills (Diagnostics, June 2020).

If legumes are the problem, the oral enzyme alpha-galactosidase could be beneficial. A randomized, double-blind, placebo-controlled trial found this treatment “can improve gas-related symptoms in children and adolescents” (BMC Gastroenterology, online, Sept. 24, 2013). This enzyme is found in Beano and other OTC digestive aids.

(In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla. 32803, or email them via their website: www.PeoplesPharmacy.com.)

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