Healthtips

Q: I went to my doctor for treatment of toenail fungus. After drawing some blood, he told me that my liver tests were high and that it wouldn’t be safe to take the medicine by mouth, so he gave me an expensive prescription to apply to the nails. It doesn’t seem to be working and my nails look the same. When the nails get that bad do they affect the liver?

First off, let me reassure you that your nail disease, a fungus, doesn’t have anything to do with your liver blood tests being elevated. What your doctor is concerned about is the high liver tests AND that the medications taken orally can potentially make them worse or injure the liver in some way. The process of finding out WHY your liver tests are high is important. It can be from a meal (you may not have been fasting when your blood was drawn), medications, alcohol, or even an infection from a virus. Speak to your doctor about “working up” your abnormal liver tests. It may be something simple but not dangerous or alarming.

As for the toenail fungus, topical treatments are a fair alternative but don’t seem to have the effectiveness of the medications taken by mouth. Interestingly enough, it was one of my patients who made me smile and let me know that applying, get this, VICKS VAPOR RUB, to her toenails twice a day, got rid of the fungus. Now, some fungi are more likely to be knocked off by topical treatments, especially if they are not “deep rooted” but I thought that this was just another home remedy. I told her to call the company and let them know as a testimony. They might even give her a lifetime supply of Vicks…..which would be what, maybe two jars…? Anyway, I did a search and sure enough, even the company that makes Vicks knows of its’ anti-fungal properties but they don’t promote it for such. Hey, it would at least make your feet smell good!!

A prescription product called Pen-Lac may be what you are using and it is completely safe. In all fairness though, you must use the product for about 4-6 months. It will take an additional 4-6 months for the nails to grow out “normal”. Toenails grow at about 1 mm. per 7-10 days. For the large toenail, that maps out to just about 20-28 weeks depending on how big your foot may be.

There was a study quoted a few years back that showed about 85% of people have fungus BETWEEN their fourth and fifth toes but only a certain percentage will actually get infections. It seems to be a combination of microtrauma to the skin or nails and just the right setup for the fungus to take hold. I always thought it strange that people would come in with the nail fungus affecting the big toe on each foot, but not any toenails next to them. The large toe is the one most affected probably because of it’s length and the pressure against it from the inside of the shoe. Sometimes nails can be so thick that a run-of-the-mill nail clipper just won’t do the job. I remember in high school, the father of one of my friends used to use a wire cutter to clip his toenails. He would do it while we watched TV in the den and we would have to be careful to avoid one of these flying pieces of keratin. Note: keeping the nails trimmed and filed is important but if you have to use wire cutters, or you have diabetes or your nail or toe becomes painful, bleeds, or gets infected, you should seek the professional help of a podiatrist. Good luck and good health.