The People’s Pharmacy

Q: I have read your caution not to use a dilute bleach solution to treat athlete’s foot. My podiatrist recommended a bleach bath for my athlete’s foot, and my dermatologist agreed. Why are you opposed?

A: During World War I, field medics needed a convenient antiseptic to treat wounds. British chemist Henry Dakin developed a topical solution containing dilute chlorine bleach (sodium hypochlorite) and a buffer in sterile water.

Dakin’s solution is still sold in pharmacies today. Once opened, however, it only lasts a few days.

The Department of Inpatient Nursing at The Ohio State University provides this formula: Boil 1 quart (4 cups) of water for 15 minutes. Add ½ teaspoon baking soda and 3 ounces of household bleach. Keep it in a tightly closed sterile jar away from light. Throw away the leftover solution after two days.

Some people are highly sensitive to any amount of bleach and develop a serious skin reaction. That’s why we do not recommend using dilute bleach for fungal infections of the skin or nails.

An over-the-counter antifungal cream with ingredients such as clotrimazole, miconazole, terbinafine or tolnaftate can often clear up an infection. For those who prefer home remedies, soaking the feet in a solution containing dilute vinegar, amber Listerine or Epsom salts may also work.

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Q: I am a physician with low levels of HDL cholesterol and high levels of Lp(a). To address these serious risk factors for heart disease, I started taking niacin 30 years ago.

Niacin can cause flushing and quite a few people do not tolerate this reaction. I have found, however, that if the dose is raised very slowly starting with 50 milligrams twice a day, most people are able to adjust. Taking niacin after meals also minimizes the flush. This regimen raises my good HDL cholesterol and lowers Lp(a).

A: Thank you for sharing your experience. It is estimated that 1 out of 5 people inherits a high level of lipoprotein a, also known as Lp(a). This sticky cholesterol-protein particle contributes to blood clots that can clog arteries. It can also lead to calcification of heart valves.

Diet and exercise do not change Lp(a) levels dramatically. Statins may actually increase Lp(a). On the other hand, niacin raises good HDL levels and lowers Lp(a), LDL cholesterol and triglycerides.

Readers can learn more about niacin and other approaches to lipid management in our eGuide to Cholesterol Control & Heart Health. This online resource may be found under the Health eGuides tab at PeoplesPharmacy.com.

Q: Swallowing a spoonful of mustard works for me to stop muscle cramps. I’ve used it successfully for years.

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As I got older, it started to burn on the way down. I tried taking less, ½ teaspoon, and it still worked. Now, I stir in a bit of honey. It’s like honey mustard and relieves the muscle spasms in my foot, ankles and hip.

I’m grateful to know this home remedy. My doctor and PTs scoff, but they also know how levelheaded I am. They just say, “Glad it works for you.”

A: We are, too. Though a spoonful of mustard may not work for everyone, many readers report good results. We also find it helpful when a muscle cramps in the middle of the night.

We were delighted when Harvard University neurobiologist Bruce Bean explained the possible mechanism. The transient receptor potential channels on cells in our mouth and throat react quickly to mustard and reverse the nerve misfiring that leads to muscle contractions.