The People's Pharmacy

Do you run out of go-power in the middle of the morning? Maybe you find it hard to focus and your ability to call on your memory is strained. Or perhaps you suffer from an after-lunch slump. Some people find that their brain fog is troublesome most of the time. While there are some medical conditions that produce brain fog, you just might find that changing what you eat could help your mental clarity and reduce brain fog.

At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.

How You Can Listen

You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 17, 2026, through your computer or smart phone (wvtf.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 19, 2026.

How Could Eating Better Reduce Brain Fog?

Our guest, Dr. Uma Naidoo, is a leader in nutritional psychiatry. She found in her practice that what people eat can make a big difference for their mood and even their cognition. Breakfasting on coffee and donuts is often a preamble to needing (not just wanting) a coffee break mid-morning. Evidence has been growing that people may perform differently depending on the type of breakfast that they had. This could well vary from one person to the next. Some thrive on a bowl of steel cut oats with yogurt and berries, while others notice that it doesn’t carry them through the morning. Dr. Naidoo suggests that in most cases a low-carb breakfast with plenty of protein will serve us better than the typical Danish and coffee.

The Impact of Sugar on Cognitive Health

A fascinating study published earlier this year demonstrated the surprisingly persistent effects of consuming sugar. The investigators took advantage of a natural experiment occasioned by the rationing of sugar during and after World War II (NPJ Aging, July 22, 2026). They compared people born between 1951 and 1956. Some of these were exposed to sugar rationing only while in utero, some were exposed to it in utero and up to age two, while the third group was conceived and born after sugar rationing had stopped.

Those babies are now in their 70s. Those with their first thousand days under sugar rationing have dramatically lower risk for developing dementia–a 27% lower risk for any type of dementia and a 46% lower risk for Alzheimer disease. We don’t have any studies showing that limiting sugar in adulthood can benefit the brain in the same way, but the evidence we do have suggests eating less sugar might reduce brain fog.

Is Your Medicine Causing Brain Fog?

When psychiatrists prescribe pills to treat depression, anxiety or other mental illnesses, they are aware that one of the effects might be confusion or lack of mental clarity. These are not the only types of medication that can cause trouble, though. Many people rely on over-the-counter sleep aids night after night. Nearly all of these contain diphenhydramine (DPH) as their active ingredient.

DPH counteracts the activity of a neurotransmitter called acetylcholine. As a result, pharmacologists classify it as an “anticholinergic” drug. Even by itself, but certainly in combination with other anticholinergic medicines, DPH can lead to brain fog. If you are interested in exploring what those other anticholinergic drugs are, you will find a list here.

The Insomniac’s Dilemma

Many people who frequently have trouble sleeping feel like they’ve been put between a rock and a hard place. To function at their best, they need adequate sleep. But the sleeping meds they rely on, whether they contain DPH or a Z drug like zaleplon (Lunesta), zolpidem (Ambien) or eszopiclone (Sonata), may lead to next-day fuzziness or eventually chronic brain fog. When possible, lifestyle measures such as early-morning light exposure, vigorous exercise during the day and avoiding caffeine after midday might help a person avoid this difficult dilemma.

What Diet Is Best to Reduce Brain Fog?

If you want to improve your mood and mental alertness, what diet should you choose? Recently, we spoke with a nutritional psychiatrist who is enthusiastic about a ketogenic diet for treating anxiety or depression. Dr. Naidoo says a thoughtful approach can allow for a keto diet, or a paleo diet, a vegetarian diet or a vegan diet. The keto diet can be effective, but it requires a great deal of attentive management, which may be just too much for some patients.

It is very important that the diet be based on whole foods rather than highly processed foods. It should also be tailored to the individual’s cultural preferences. Doctors often recommend a Mediterranean diet because so much evidence points to its benefits. But other diets, such as a Nordic diet (in Scandinavia) or a North Indian diet (in Punjab, for example), can also be healthful within a cultural context (Journal of Clinical Lipidology, Nov-Dec. 2025).

Do Hormones Affect Brain Fog?

Many people are convinced that hormonal changes can contribute to brain fog. Some women find their focus shifts throughout the menstrual cycle. Others report increased brain fog as one of the troublesome symptoms of menopause. People who have experienced thyroid hormone imbalances have noted that their attention and alertness is diminished until balance is restored.

Favorite Foods from our Guest

We asked Dr. Naidoo about her favorite recipes. As a chef, she is very fond of the French tradition. She also loves the Indian foods she grew up with. One of her favorites is chicken tikka masala. Substituting tofu for the chicken produces a delicious vegetarian dish. She also recommended miso-glazed sweet potatoes and a kaleidoscope salad with multi-colored veggies. For dessert, she suggests an avocado-cacao mousse.

Utilizing Food as Medicine

Dr. Naidoo points out that the gut microbes begin to respond to dietary changes within 24 hours. However, it could take a week or more–up to a month–for a person to notice differences in how they are feeling. Some of her colleagues are quite interested in the opportunities to utilize natural approaches along with or in place of conventional medications. The theme of the 2025 annual meeting of the American Psychiatric Association was “Lifestyle for Positive Physical and Mental Health.” Moreover, Harvard Medical School is in the process of integrating lifestyle psychiatry into its curriculum, so future healthcare professionals are likely to be more open to this approach.

This Week’s Guest

Uma Naidoo, MD, is the founding director of the first hospital-based Nutritional Psychiatry Service in the United States. She is the Director of Nutritional, Lifestyle and Metabolic Psychiatry at Massachusetts General Hospital while serving on the faculty at Harvard Medical School.

Dr. Naidoo is also a professional chef, graduating from the Cambridge School of Culinary Arts and receiving the school’s most coveted award, the MFK Fisher Award for Innovation. She is the author of This Is Your Brain on Food and Calm Your Mind with Food. Dr. Naidoo’s new book, The Mental Clarity Diet: Sharpen Your Focus, Lift Your Mood, and Protect Your Memory with Food will be released in March 2027. Her website is: 
https://umanaidoomd.com/

Dr. Uma Naidoo, Massachusetts General Hospital

Listen to the Podcast

The podcast of this program will be available Monday, October 19, 2026, after broadcast on Oct. 17. You can stream the show from this site and download the podcast for free.

Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Neurological conditions have been increasing over the past several decades, but none more quickly than Parkinson disease. What is this disorder, and what is driving the increase? We’ll discuss symptoms people often miss and find out about treatments.

At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.

How You Can Listen

You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 10, 2026, through your computer or smart phone (wvtf.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 12, 2026.

What Is Parkinson Disease?

This movement disorder is named after the doctor who first described it in a publication in 1817. As we mentioned, it has become more common in recent years, so you may not be surprised to learn of numerous celebrities who have or have had Parkinson disease (PD). Michael J. Fox may be one of the best known because he has worked so hard to gain recognition that PD can affect people in their 30s and 40s. Of course, like most degenerative conditions, it is more common as people age. Parkinson disease is characterized by a relative lack of dopamine. The areas of the brain that would normally produce this crucial neurotransmitter stop making it, for reasons that are not completely understood.

What Dopamine Does

We need dopamine for proper functioning with regard to movement, mood, sleep, attention and memory. This explains why some people with PD may experience cognitive challenges or depression. The FDA approved levodopa (AKA L-dopa) in 1970. It is still a mainstay of treatment for Parkinson disease, often with carbidopa. This therapy is more helpful for movement symptoms than for the other aspects of Parkinson disease, however.

Symptoms People Often Miss

In the past, it wasn’t possible to tell how much dopamine the brain might be making. A person might search for years to get the appropriate diagnosis because symptoms people often miss weren’t noticed.

People do think of tremor as a primary symptom of Parkinson disease, but they may confuse it with essential tremor. The tremor of PD occurs when the person is at rest. For example, the hands may shake while lying in the person’s lap. Essential tremor is completely different and occurs while the person is active, such as applying make-up or putting on earrings.

Another common symptom of PD is slower motion. It may take longer to cook a meal or get dressed. That is because we need dopamine to move. However, under some circumstances, slow-moving people can move remarkably quickly. Joe has noticed this with a tennis partner, and other people have seen it in emergencies.

New technology called DAT spect scan (for dopamine tags) makes it possible to tell if the brain is producing dopamine. The doctor may also order a MRI to make sure that the problem is with the dopamine area of the brain and not caused by a stroke or a tumor. After a diagnosis is established, the doctor may ask the patient to perform toe-tapping and finger-tapping exercises to assess how they are doing.

How Do Doctors Treat Parkinson Disease?

When we asked our guest, Dr. Nina Browner, what is at the top of her prescription pad for PD patients, she told us it is not a treatment but a conversation. Understanding the person and what is important to them is crucial in guiding the treatment. For example, one of her patients likes to run with his grown sons. This is their way of connecting. For this patient, treatment to maintain mobility is key.

High-Intensity Exercise for PD

Research, specifically the SPARKS 3 study, has shown that after 17 minutes of vigorous exercise, the brain produces more dopamine. Consequently, the recommendation is to exercise beyond 17 minutes and then stretch to loosen the muscles. For best results, people with PD need much more exercise than other individuals; 30 minutes three times a day provides a good baseline. For even greater efficacy, people might increase their activity up to 150 minutes a day. They can benefit from a wide range of activities, ranging from bicycling to boxing, from tai chi chuan to ping pong, Zumba or dancing. The social aspects of ping pong and Zumba might be especially helpful.

Beyond Movement to Symptoms People Often Miss

Levodopa, the prescription drug used to replace the missing dopamine, helps improve movement but it does little or nothing for the symptoms people often miss. Dr. Browner may refer patients for other treatments, such as speech therapy. Digestive difficulties (especially constipation) are very common, although people may not necessarily associate them with Parkinson disease. Patients frequently need help dealing with that.

Another area that can pose challenges is sleep. People with PD may be prone to something called REM sleep behavior disorder. As a result, instead of being immobilized during a dream as most of us are, they may act out their dreams, kicking, punching or leaping out of bed. Needless to say, this can result in injury for either the patient or their bed partner. The doctor may prescribe clonazepam for some of these sleep difficulties.

Cutting Edge Treatments

People with Parkinson disease may benefit from a treatment known as deep brain stimulation. This surgical procedure implants wires into the part of the brain most affected by PD. The battery to power the stimulation remains outside the body so that it can be changed when necessary. Those who undergo this procedure often benefit for an extended time.

Another nonpharmacological treatment is focused ultrasound. This acts similar to surgery, but it uses sound instead of a scalpel. You can hear more about this treatment in Show 1462: Using Focused Ultrasound Against Parkinson Disease and Tremor.

This Week’s Guest

Nina Browner, MD, is the Bryson Distinguished Professor of Neurology at the UNC School of Medicine and Director of the UNC Parkinson Foundation Center of Excellence. A nationally recognized expert in Parkinson’s disease and movement disorders, she leads clinical, research and educational programs dedicated to improving care for people living with neurological disease.

Dr. Nina Browner, Bryson Distinguished Professor of Neurology at the UNC School of Medicine
Photo credit: UNC Health

Listen to the Podcast

The podcast of this program will be available Monday, October 12, 2026, after broadcast on Oct. 10. You can stream the show from this site and download the podcast for free. This week’s episode contains discussion of alpha-synuclein, an abnormal protein involved in Parkinson disease and Lewy body disease. We will learn more about Lewy body dementia and whether we should worry that taking L-dopa will reduce the body’s natural production of this crucial compound. We consider chemical exposure as a risk factor for PD and list some helpful resources.

Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Birth rates have been dropping for years. This is happening in many parts of the world, not just the US. Demographers estimate that women need to have 2.1 children, on average, to replace the population. (The US is currently at about 1.7 or 1.8 children per woman.) Where the average number of babies falls below replacement, the country may end up with more elderly people than children. Eventually, this can have economic and social consequences. In this episode, we explore the baby bust. Why is fertility falling?

At The People’s Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.

How You Can Listen

You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 3, 2026, through your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 5, 2026.

Why Is Fertility Falling?

Fertility in the US is at a historical low, according to our guest, Dr. Linnea Zimmerman. Whether or not this baby bust constitutes a crisis depends upon your perspective, however. Those who see young people primarily as eager working hands could perceive the economic effects of falling fertility as a future crisis. Others who worry that we are straining the ecological limits of the planet might view a decline in fertility more positively.

We asked Dr. Zimmerman about the sources of this baby bust, and she explained that the factors are complex. Although there will almost certainly be some economic consequences of a steep drop in fertility, economic considerations are also important for people considering parenthood. Housing is expensive, and so is childcare. Do they feel confident about their healthcare coverage?

It is not clear that the lifetime fertility rate of American women has declined as steeply as the statistics suggest. One good aspect of the current situation is fewer teenage pregnancies. In addition, many women in their 20s, when past generations would have been bearing babies, may be waiting until they feel more settled in their lives, or until they find a suitable partner to raise children with. This can take time.

Has Environmental Contamination Affected Fertility?

We asked Dr. Zimmerman if we could attribute fertility falling to exposure to environmental factors such as forever chemicals. While PFAS compounds are certainly not good for humans and should be avoided as much as possible, we don’t yet have evidence that they are contributing to a baby bust.

What Can You Do About Fertility Challenges?

We turned to Dr. Genevieve Neal-Perry to learn about what options people might have if they discover they need help conceiving. According to Dr. Neal-Perry, the available technology has improved greatly over the years, and fertility specialists are frequently able to help a woman conceive and carry the pregnancy to term. Moreover, many more people now have fertility benefits as part of their health insurance. In past years, this was much less common.

The source of a fertility challenge is not always obvious. Dr. Neal-Perry suggests that a third of the time, the difficulty lies with the female, a third of the time with the male and a third of the time with the combination. If a woman has endometriosis and is not ovulating, that would need to be addressed first. Men’s fertility begins to drop when they are in their 40s or 50s. Men who take testosterone may have lower sperm counts. In addition, people with very high BMI (40 or above) often have reduced fertility.

How Long Should You Wait for Nature to Take its Course?

Dr. Neal-Perry suggests that healthy women 35 and under could try for a year before seeking out assistance. Beyond that age, six months is a more realistic time frame. Women who plan to freeze their eggs for future pregnancy should also consider doing this while they are in their mid30s, as they have the best chance of retrieving viable eggs for future use at that age.

How Do Medications Affect Conception and Pregnancy?

Obstetricians do not recommend that people undertake major weight loss while they are trying to become pregnant. Although there has been some media attention to the phenomenon of “Ozempic babies,” we do not have safety data for GLP-1 agonists such as semaglutide or tirzepatide during pregnancy. In fact, a preconception review of medications a few months before beginning the attempt for a pregnancy is highly advised.

Interventions to Promote Conception

If the woman has intact fallopian tubes, intrauterine insemination may be helpful. It overcomes barriers that may exist at the cervix and helps the sperm unite successfully with the egg. If the fallopian tubes are not open or not present, the best option may be in vitro fertilization. The eggs are removed and inseminated in the laboratory (“in vitro” implies in glass). The embryos are incubated for the first few days of development. The doctor may then take tiny samples of the embryo to do genetic testing before introducing it into the uterus. As Dr. Neal-Perry put it, the implantation is “out of our hands.”

Throughout the fertility journey, from before conception to after birth, people are encouraged to continue their best health practices: following a well-balanced diet without junk food, getting regular physical activity and sleep, avoiding chemicals that may be harmful.

This Week’s Guests

Linnea Zimmerman, PhD, MPH, is an associate professor of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. Dr. Zimmerman studies family planning and women’s reproductive health, evaluates use and barriers to critical maternal and newborn health interventions. Her website is https://publichealth.jhu.edu/faculty/3046/linnea-a-zimmerman

Linnea Zimmerman, PhD, MPH, Johns Hopkins University

Genevieve Neal-Perry, MD, PhD, is Department Chair of Obstetrics and Gynecology at the University of North Carolina at Chapel Hill. She is the Robert A. Ross Distinguished Professor of Reproductive Endocrinology and Infertility.

Genevieve Neal-Perry, MD, PhD, UNC Chair of OB-GYN

Listen to the Podcast

The podcast of this program will be available Monday, October 5, 2026, after broadcast on Oct. 3. You can stream the show from this site and download the podcast for free. This week’s episode contains additional discussion on over-the-counter drugs to avoid during pregnancy and some possible treatments for the future.

Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

After years of dementia, many people have reduced their communication to minimal levels. Sometimes, they don’t say anything at all, and family members may be tempted to assume that memories have disappeared along with cognitive function. Occasionally, such a person will become surprisingly coherent and able to discuss aspects of their lives for a few minutes or even hours. Because they often die within days of such an episode, researchers have termed the phenomenon “terminal lucidity.” Our guest, Dr. Marjorie Woollacott, suggests that the more inclusive term “paradoxical lucidity” might be more appropriate. What do these unexpected events have in common with near-death experiences? Can they teach us about consciousness?

At The People’s Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.

How You Can Listen

You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, September 26, 2026, through your computer or smart phone (wunc.org).  Here is a link [] so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Sept. 28, 2026.

What Is Terminal Lucidity?

An article by Billy Brennan in the New York Times Magazine (July 15, 2026) was titled, “Why Do Some Dementia Patients ‘Return’ Just Before They Die?” The subtitle explained, “As they near death, some dementia patients recover mental faculties assumed to be long lost. Researchers want to know why.” Coincidentally, the Washington Post also ran a story recently on terminal lucidity: “Some dementia patients grow lucid near the end. Scientists hope it’s a clue.”

We were fascinated by the story Mr. Brennan shares about a conversation with a grandmother a few days before her death. It reminded us of an experience a friend of ours had shared about his own mother. She had dementia and had not communicated much with anyone for a long time. When the nursing home called him and told him she had broken her hip, he expected she would be even more incoherent because of the opioids she would be administered for the pain. So when he arrived at the hospital to find her oriented to time and place and aware of the situation, he was astonished. In this instance, her unexplained clarity continued for a few weeks. We can’t call it “terminal” lucidity, though, as she survived several more years.

Such tales suggest that even a disordered brain is not completely lacking in consciousness. But what do we mean by consciousness?

A Stroke of Insight to Teach Us About Consciousness

Neuroscientists usually assume that the brain creates consciousness, although they haven’t explained exactly how it does so. Some philosophers postulate that consciousness is a fundamental property of the universe. In this view, our brains act as filters so that we don’t become entirely overwhelmed and unable to function. Many years ago, we interviewed Dr. Jill Bolte Taylor, a neuroanatomist, about her brilliant book, My Stroke of Insight. In it, she recounts her own experience and perceptions as she suffered a massive hemorrhagic stroke that affected the left side of her brain. She observed as her brain circuits went offline, one by one. In particular, she was struck by a sense of joy and unity with the entire universe. Our guest for this episode, Dr. Marjorie Woollacott, suggests that during this time, Dr. Bolte Taylor’s stroke removed the usual filters that our brain puts on our consciousness.

How Else Might People Have a Different Access to Consciousness?

Dr. Woollacott is a meditator as well as a neuroscientist, and she describes her initiation into meditation. To her, it felt as though she were participating in a larger consciousness. Meditation might facilitate a lowering of the filters that usually limit our awareness of a broader consciousness. Dr. Woollacott describes this as a spiritual awakening. Sometimes people describe an experience under the influence of psilocybin in similar terms.

Many people who have died and then been revived have described their feelings about such a near-death experience. Dr. Sam Parnia and Dr. Bruce Greyson have both discussed these phenomena for People’s Pharmacy listeners. In such situations, people often accurately depict events that occurred while they were unconscious or technically dead. Most people who have survived a near-death experience consider it a spiritual awakening. They may change their lives from there on.

Near Death in a Healthcare Setting

Not everyone who undergoes a near-death experience is in a healthcare setting where heart rate (or lack of heart beat), brain activity, respiration and so forth can be observed and recorded. In one instance, a woman named Pamela Reynolds required surgery on a brain aneurysm. It was a very delicate operation, and to conduct it properly, the surgical team chilled her body and drained the blood from her brain. She told us about leaving her body and observing the operation from above. The descriptions she gave of the surgical drill and the music the team was playing have been corroborated by the people involved, although Ms. Reynolds had no visual or auditory input and should have had absolutely no consciousness whatsoever.

Dr. Bettina Peyton Comes Back

Dr. Woollacott described another, more recent incident in which a patient who should have had no awareness described watching her own resuscitation. Bettina Peyton, a physician, needed a C-section to deliver her third baby, but the operation went badly and she started to hemorrhage. She described accessing a much broader consciousness and then being commanded to live. When she revived, she was able to relate the events that had occurred in the delivery room although she had not been able to see or hear them. Could we use such case histories to teach us about consciousness?

Do Nonverbal Children Participate in Nonlocal Consciousness?

Dr. Woollacott has been interacting with parents and family members of certain children with autism who do not speak. They do communicate through other means. Some of these youngsters describe meeting and communing with other autistic kids on The Hill. They describe it in remarkably similar terms, even though they have not met face to face. Dr. Woollacott believes that these young people may have reduced neural filters. Perhaps that explains why they seem to be more skilled at telepathy than the rest of us. Although it is foreign to our materialist world view, we may need to take the idea of nonlocal consciousness seriously.

This Week’s Guest

Marjorie Woollacott, PhD, is an Emeritus Professor of Human Physiology and member of the Institute of Neuroscience at the University of Oregon. She is Research Director for the International Association of Near-Death Studies and President of the Academy for the Advancement of Postmaterialist Sciences. Dr. Woollacott has published more than 200 scientific articles and written or co-edited eight books, including Infinite Awareness: The Awakening of a Scientific Mind.

The People’s Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you).

Marjorie Woollacott, PhD, author of Infinite Awareness

Listen to the Podcast

The podcast of this program will be available Monday, September 28, 2026, after broadcast on Sept. 26. You can stream the show from this site and download the podcast for free. This week’s episode contains additional discussion on Dr. Ian Stevenson’s research on cases suggestive of reincarnation. What can that teach us about consciousness?

Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Do you worry that your hair is thinning? You may wonder what treatments could make a real difference. After all, you wouldn’t want to spend money on something that has no chance of helping. Many people also have concerns about their nails. Perhaps they are ridged, or loose, or too thick. Could that be due to nail fungus, or might it have another cause? Most importantly, what could you do about it? In this episode, you’ll get a dermatologist’s guide to what actually works.

At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.

How You Can Listen

You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, September 19, 2026, through your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Sept. 21, 2026.

What Actually Works for Hair and Nail Problems

Dr. Chris Adigun practices both general and cosmetic dermatology. We wanted to ask her about nail problems in particular because they are very common and she maintains a specialty in treating them.

We asked her about the most common nail problems she sees, and she named simple onycholysis (pronounced Oh-nick-oh-LYE-sis). In this condition, the nail begins to lift away from the nail bed. You can identify it because the white area at the fingertip becomes much more extensive than usual. Usually, this is due to exposure to acids such as citrus juices or cleaning solutions. Having your hands in and out of irritants or even water (with or without soap) could lead to onycholysis. An overactive thyroid gland could also lead to onycholysis. To prevent it, try to avoid putting your hands into that sort of liquid. If you must do so, use gloves. And of course, a good hand cream to bolster the skin barrier is a very good idea. If these approaches don’t do the trick, especially if there are other symptoms, the doctor may want to test for thyroid function.

Another common problem is allergic contact dermatitis. This could be caused by some of the same irritating substances responsible for onycholysis, but cosmetics are common culprits here. Nail polish and remover, especially nail polish remover, can cause nail problems for some people. If you are one of them, what actually works best might mean finding a less irritating product or, even better, leaving the nails unadorned.

White Spots on Nails

Many people have noticed white spots on their nails. We asked Dr. Adigun what causes these, and she replied that usually they are not worrisome. If you bang your fingertip, as you might if you slammed it in a door or a drawer, the trauma may show up several weeks later as a white spot. (More serious trauma could show up as a dark spot due to blood pooling under the nail; we discussed that with podiatrist Jane Anderson here,  but not with Dr. Adigun.)

What About Ridges on the Nails?

Nail ridges are very common, and the ones that run lengthwise along the same axis as the finger are due to aging. Just as our skin develops wrinkles, so do our nails. Consequently, there are no effective treatments.

Nail ridges in children are a different story. They might show up as nails having the texture of sandpaper, or they could be horizontal ridges. Such nails should be seen by a physician, as they could signal an inflammatory condition called lichen planus or even an early sign of psoriasis. While we don’t have cures for these conditions, there are effective medications to manage them.

Hangnails and Cuticle Problems

Are you surprised that dermatologists have a fancy term to describe cuticle problems and other trouble affecting the skin around the nail? They call it paronychia (PEAR-oh-nick-ee-ya). If it is caused by an infection, it might be treated with an antimicrobial compound. The best preventative is not to pull, bite or clip off hangnails or rough spots in the cuticles, the skin near the nails. Instead, moisturize and possibly cover the spot with a bandage to remove the temptation while it softens and heals. Instant glue is another simple remedy that really works for hangnails.

Treating Nail Fungus

When the nails are thick, ugly and hard to trim, often people blame nail fungus. But surprisingly, it isn’t always the culprit. Mechanical trauma can also create thick nails that are hard to cut. If the nail is thick because it is on a hammer toe so it bumps against the insole of the shoe, antifungal treatment won’t help. If a healthcare professional addresses it when it first appears, it may be treatable, but once the body has grown accustomed to producing that thick nail, there may be no effective treatment.

Some nail infections are bacterial as well as fungal. Both may show up together, or the infection may be one or the other. A dermatologist has techniques for diagnosing whether the problem is due to a fungus or to bacteria such as Corynebacterium. Different types of antimicrobial medicines are effective for these infections. Athlete’s foot also needs a real diagnosis, since it too might be bacterial rather than fungal in nature. OTC athlete’s foot medicines target fungal infections.

Handling Hair Loss

Both men and women experience hair thinning, and no one is pleased about it. The patterns differ, with men noticing a receding hairline and less hair on their temples. Women’s hair loss tends to form a Christmas-tree pattern, with the tip of the tree right behind the hairline and the base spreading out over the crown of the head. Women are also prone to hair loss after giving birth to a baby. However, while that may be alarming in the moment, it often corrects itself without treatment over the following months.

Hormonal Treatments for Hair Loss

With men, scientists have identified testosterone metabolites as contributing factors. Drugs such as finasteride (Propecia) or dutasteride block those metabolites and help men regrow hair. Dr. Adigun has begun using these compounds in women who are beyond childbearing. (They are off limits for a person who might become pregnant because they could interfere with the normal development of genitals in a fetus.)

A different hormonal treatment for hair loss is spironolactone. Dermatologists have long used it to treat female pattern hair loss. A review found that spironolactone is an effective and safe treatment option for hair loss” (Cureus, Aug. 16, 2023). Besides boosting scalp hair growth, however, it can also cause itchy scalp, facial hair growth and menstrual problems.

Another approach that actually works for hair loss is minoxidil (Rogaine). Most people are familiar with this as a topical product to be applied twice daily. That might get old after a while. Also, some people react to the product with contact dermatitis, irritation or itching. Low-dose oral minoxidil seems to work as well as topical minoxidil without the irritation. Another possible option which is better than placebo but not as potent as full strength topical minoxidil is rosemary oil. It is less likely to cause itching, however.

This Week’s Guest

Chris G. Adigun, MD, FAAD, is a board-certified dermatologist and the President and Medical Director of the Dermatology & Laser Center of Chapel Hill, which she founded in 2016. Dr. Adigun practices both general and cosmetic dermatology, with a strong emphasis on minimally invasive treatments that deliver natural, impactful results. She has devoted much of her career to increasing public awareness of skin cancer and the harmful effects of UV exposure—both medical and cosmetic—and maintains an academic specialty in nail disorders.

Chris G. Adigun, MD, FAAD, Dermatology & Laser Center of Chapel Hill

Listen to the Podcast

The podcast of this program will be available Monday, September 21, 2026, after broadcast on Sept. 19. You can stream the show from this site and download the podcast for free. This week’s episode contains additional information on hair loss due to chemotherapy and why it may grow back with a different color or texture. We also discuss red light therapy for hair growth, along with biotin supplements. Those call for caution, as they can interfere with the results on tests for thyroid function.

Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.