Hello, dear readers, and welcome to the monthly letters column. We are well into the third month of the new year, and for some of us -- the data say it’s probably most of us -- the resolutions we made on Jan. 1 have already fallen by the wayside. We have been hearing from readers asking for encouragement, and have also had readers sharing tips that are helping them stay on course. We’ll have a resolution reset column coming soon. And now, onward to the mail.
A column about how research shows the gut microbiome gradually recovers after the use of antibiotics has caused a reader a bit of confusion. “This column says that probiotics can delay recovery after antibiotics, but it also says taking fermented foods with live cultures is helpful,” he wrote. “Are these live cultures not considered probiotics? Please clarify what is meant by ‘probiotics.’”
When you take antibiotics, both the pathogen that made you sick and the beneficial bacteria living in the gut are killed off. After treatment, it takes a month or two for the microbial colonies of the gut microbiome to be restored. Probiotic supplements, which you can buy at drug and grocery stores, and fermented foods both contain probiotics. However, supplements contain high amounts of a limited variety of microbes, and because the gut is basically a clean slate after antibiotic treatment, taking a supplement can lead to an off-balance colonization of the gut. Researchers have found that this actually slows down the natural recolonization of the gut. Fermented foods also contain probiotics, but in a wider variety and smaller numbers. Eating them creates a gentler and more natural path to recolonizing the gut with your unique microbial profile.
We get a lot of letters about toenail fungus, a common infection that is notoriously difficult to cure. We recently heard from a reader who has been struggling with it for several months. “Last fall, I started getting a yellow and crumbling nail on the big toe of my right foot. I used Vicks VapoRub every day and soaked with tea tree oil, and it went away,” he wrote. “About a month after I stopped treating it, the yellow color started coming back. Why did that happen?”
Unfortunately, the scenario described is quite common. It is possible to manage a toenail fungus infection with topical treatments so that the appearance of the nail improves or even returns to normal. However, the chances the infection has been eradicated are small. Topical treatments can’t adequately penetrate the tough nail to completely kill off the fungus. Oral anti-fungal medications, while more effective, are not always completely successful. If you do wish to try that route, your doctor can prescribe the medication, explain the possible side effects and guide you through the treatment.
We are hearing from a lot of new readers, so it’s time for a reminder that we can’t look at medical records, comment on medications or treatments or offer a second opinion. And, as always, thank you for your letters. We love hearing from you.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
