The People's Pharmacy

Do you suffer with anxiety, depression, or another mental illness? Millions of people do. The usual treatment is a prescription medication. If that doesn’t work, the healthcare provider may offer a different one. Diet is certainly not the first topic on the provider’s mind. But what if, in addition to appropriate pharmacological treatment, you were able to nourish, protect and energize your brain with your diet? Our guest offers evidence that you can heal your mind with a ketogenic approach to eating.

We need to acknowledge that this approach is quite different from the plant-rich eating pattern advocated by last week’s guest, Dr. Will Bulsiewicz. Humans around the world have adopted a wide range of dietary regimens that support health. Listen to Dr. Georgia Ede explain why she thinks a paleo or ketogenic diet is helpful for bolstering brain health.

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, August 22, 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 August 24, 2026.

Can You Heal Your Brain with Food?

We live in stressful times. More than 50 million Americans take prescription antidepressants, and millions more are on anti-anxiety medication. Unfortunately, while these drugs can be life savers, they don’t always work as well as we would like. In some cases, antidepressants are only about 10 percent more effective than a placebo.

Dr. Georgia Ede is a psychiatrist who began her investigation into how food affects mental health serendipitously. She was experimenting with her own diet to address some physical health issues. She used a food and symptom journal to discover the best dietary choices for her own health. To her surprise, the “upside-down” diet that helped her feel better physically also improved her sleep and her ability to focus. She started looking into evidence that a paleo or ketogenic diet could benefit people with mental health challenges.

What Is Metabolic Psychiatry?

There is evidence that people consuming unhealthy diets full of fast food or ultra-processed products are more susceptible to symptoms of anxiety (Nutrition Neuroscience, May 19, 2026). On the other hand, people participating in a supervised weight-loss program using either a low-carbohydrate ketogenic diet or a low-fat diet reported improvements in mood (Obesity, Jan. 2007). Those on the ketogenic (Atkins) diet reported less hunger and fewer unpleasant symptoms.

Researchers have also tested a ketogenic diet in people with schizophrenia or bipolar disorder (Psychiatry Research, May 2024).  These volunteers also had metabolic disorders, including obesity, which is often an unwanted effect of the ant-psychotic drugs they take to treat their condition. This four-month pilot study saw participants lose weight, reduce insulin resistance and lower their triglycerides. Even more impressive, they had a 32 percent reduction in the Brief Psychiatric Rating Scale. They also reported better sleep and improved life satisfaction.

You may find this recent article from National Geographic of interest: https://www.nationalgeographic.com/health/article/metabolic-psychiatry-keto-diet-brain-science. Unfortunately, it might be behind a paywall.

How Does Food Affect Our Brains?

Most of our body tissues are accustomed to getting energy from glucose, with the help of insulin. However, years of exposure to high levels of these compounds often makes the tissues less sensitive to the effects of insulin. The consequence is that the body–and therefore also the brain–is flooded with high levels of glucose. This exposure can result in the formation of advanced glycation end products in the brain, which can be harmful.

The brain evolved to use either glucose or a flexible mix of glucose and ketones. These are the result of burning fat rather than sugar. A paleo diet will naturally provide more ketones and less glucose. Dr. Ede and colleagues have found that a ketogenic diet can be very helpful even for people with relatively serious mental problems. In one study (which was not placebo-controlled), patients hospitalized with severe persistent mental illness were given a ketogenic diet. Most did well and had significant improvements in their depression and psychosis symptoms (Frontiers in Psychiatry, July 6, 2022).

Is Ketosis Dangerous?

Ketosis itself simply means that you are burning fat as fuel rather than sugar. This can be achieved by following a diet that is high in animal fat, with moderate amounts of animal protein and low amounts of carbohydrate derived from plant foods. Ketosis is not inherently dangerous. However, Dr. Ede urges anyone who wants to heal their brain with diet to ask a healthcare provider to monitor and supervise the process. Prescription drug doses may require adjustment, and people may need support as they adopt a paleo or ketogenic diet. That is why this is not a do-it-yourself approach.

Is Coconut Oil Helpful to Heal Your Brain?

Dr. Ede described the benefits of medium-chain fatty acids produced in digesting fat. You may recall a video from a few years back in which a doctor described helping her husband recover from Alzheimer disease, at least partially, by giving him coconut oil. Some researchers consider Alzheimer disease to be a form of diabetes because the AD brain does not metabolize sugar effectively. Dr. Ede suggested that the benefits may be real, but getting medium-chain fatty acids from the diet rather than be taking coconut oil might be preferable. After Dr. Ede told us about Fran, who overcame significant memory problems by changing to a ketogenic diet, we hope there will be trials on this.

Future Trials on Diet to Heal Your Brain

Dietary trials are notoriously difficult to conduct. People often don’t stick to the prescribed diet, and it can be difficult to find an appropriate placebo for comparison. Nonetheless, Dr. Ede is looking forward to results from a large trial of the keto diet for people with schizophrenia or bipolar disorder. This study is being conducted in Australia.

This Week’s Guest

Dr. Georgia Ede is a globally recognized expert in nutritional and metabolic psychiatry. Her 25+ years of clinical experience include 7 years at Harvard University, where she was the first psychiatrist to offer nutrition-based approaches to mental health conditions. Dr. Ede co-authored the first inpatient study of the ketogenic diet for serious mental illness, developed the first medically accredited course in ketogenic diets for mental health, and is a recipient of the Baszucki Metabolic Mind Award. Current research collaborations include pilot studies in pediatric bipolar disorder, adult ADHD, and PTSD. Her internationally bestselling book Change Your Diet, Change Your Mind: A Powerful Plan to Improve Mood, Overcome Anxiety, and Protect Memory for a Lifetime of Optimal Mental Health is being translated into 11 languages and is recommended by the New York Times Book Review.

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).

Dr. Georgia Ede, author of Change Your Diet, Change Your Mind

Listen to the Podcast

The podcast of this program will be available Monday, August 24, 2026, after broadcast on Aug. 22. In this week’s podcast, we’ll learn how vegetarians can follow a ketogenic diet. How does the evidence Dr. Ede has collected accord with the chemical imbalance theory of mental illness? We also discuss why the standard American diet is not good for mental wellbeing, and we find out what might be in Dr. Ede’s own shopping cart. 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.

When you decide to grab a bite to eat, do you think about how to feed your gut microbes? Most of us don’t. Even if we did, their only means of stating their preferences is somewhat after the fact. Do you end up feeling less than well? Perhaps the denizens of your gut aren’t happy. In this episode, we consider how to support your microbiota and whether that can reduce the inflammation that seems to accompany modern life.

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, August 15, 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 August 17, 2026.

Feed Your Gut Right to Fight Inflammation

Dr. Will Bulsiewicz is a gastroenterologist who urges all of us to focus on a healthful fiber-rich plant-strong diet to maintain our microbiome in good shape. He has described his own evolution from a busy medical student relying heavily on processed food products to a whole-food plant-based enthusiast. Eating a wide variety of plants is one of the easiest ways to make sure we are getting the nutrients our gut microbes need.

Why are the trillions of microbes in our large intestine so important? Dr. Bulsiewicz (aka Dr. B.) shares the story of a patient who was overwhelmed by a serious C. diff infection. A course of clindamycin for a skin infection had decimated her normal microbiome and left an open field for C. diff to flourish. Instead of treating her with surgery and even more potent antibiotics, Dr. B. and his colleagues utilized a fecal transplant. She got poop from a healthy person into her colon and left the hospital a few days later in good health herself.

What Is the Link Between the Microbiome and the Immune System?

Inflammation is one of the primary signs that the immune system has gone into action to fight off a perceived foe. There is a close relationship between the gut microbes, the gut barrier and the cells of the immune system. Between 70 and 80 percent of immune system cells are present in the gut (Nutrients, March 9, 2021).  There is just one layer of cells in the gut barrier, firmly attached to each other through tight junctions. If those tight junctions break down, pathogens and toxins can get from the gut into the bloodstream and activate the immune system into creating inflammation

Medicines That Harm the Intestinal Barrier

Diets that are high in salt have a negative impact on the integrity of the intestinal barrier (Nutrients, Nov. 25, 2025). In fact, a diet high in salt can reduce the number of Lactobacilli in the gut by 90%. This also affects the permeability of the gut barrier, which can contribute to auto-immune conditions.

When we asked about inflammatory bowel disorders such as Crohn disease or ulcerative colitis, Dr. B. told us he thinks it’s a mistake to classify them as auto-immune conditions. Instead, he suggests we should consider these conditions as due to the immune system rejecting the microbiome. Some of them might be initiated and perpetuated by failures in the gut barrier that allow certain organisms or their toxins into systemic circulation.

A number of medications can also harm it, most notably the nonsteroidal anti-inflammatory drugs (NSAIDs). Agents like ibuprofen, naproxen, celecoxib and meloxicam may disrupt the tight junctions that keep the intestinal barrier intact (Gastroenterology, Feb. 2018).  In some cases, they may also upset the balance of microbes.

Four Keys to an Anti-Inflammatory Diet

There are several different dietary patterns that allow you to feed your gut and fight inflammation. Good evidence supports a DASH diet, a Mediterranean diet, pescatarian, flexitarian, vegetarian and some vegan diets. We asked Dr. B. to summarize the four features healthful eating patterns share. They include adequate fiber, plenty of polyphenols, healthy fat and fermented foods (think of sauerkraut or kimchi).

Fiber and Flatulence

One drawback of a high-fiber diet is that when microbes in the colon ferment the fiber we can’t digest, they produce gases. It has to go somewhere, or it will cause sensations of cramping and bloating. Consequently, fiber is often associated with flatulence. Dr. B. suggests that there may be more gas, and it may be loud, but it shouldn’t be stinky. Smelly farts are born of sulfur, which is more common in a diet containing garlic, onions, crucifers like broccoli or cabbage, fish, eggs or meat.

Plant-Powered Plus

We wondered what might be included in the “plus” category when you feed your gut and fight inflammation. Dr. B. offers a few things that you might not expect in a book about diet, but they are related to reducing inflammation. One is to go outside early in the day, every day, to get your circadian rhythm in sync. Another is to maintain your emotional connections with family and friends. Still another, just as important, is to nurture your spiritual core.

This Week’s Guest

Dr. Will Bulsiewicz describes how a plant-powered diet can fight inflammation

Will Bulsiewicz, MD, is a New York Times bestselling author, award-winning gastroenterologist and internationally recognized health expert. Dr. Bulsiewicz directs the Gut & Microbiome Center for Excellence, a physician-led executive medicine and telemedicine practice based in Mount Pleasant, SC. Dr. Bulsiewicz is the author of several books, including his latest book, Plant Powered Plus: Activate the Power of Your Gut to Tame Inflammation and Reclaim Your Health. His website is https://theguthealthmd.com/books/

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).

Listen to the Podcast

The podcast of this program will be available Monday, August 17, 2026, after broadcast on Aug. 15. In this week’s podcast, you get to peek into Dr. B’s shopping cart. Are you buying the same vegetables he does? We also get insights on his favorite recipes for grains like farro. And we discuss the effect of coffee on the gut microbes. If you want to feed your gut to encourage certain microbes, remember that consistency is crucial. You can’t eat a specific food once and expect it to make a difference. But consuming it several times a week will ultimately add up. We also discuss antidotes for flatulence, if you are interested in that. 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.

You may have heard about antibiotic-resistant bacteria. They can greatly complicate the treatment of infections. But have you ever heard of antifungal-resistant fungus? Infectious disease experts knew nothing about a scary fungus, Candida auris, in 2008. But in less than two decades this dangerous fungal infection is making waves around the world. It has acquired resistance to a number of potent antifungal medications. Consequently, it now poses threats of hard-to-treat infections in many corners of the globe.

At last count, 27 states in the US have reported cases. We first reported on this serious fungal infection in 2019. At that time it seemed worrisome, but not widespread. Now, thousands of people have been infected over the last eight months. The CDC consider this scary fungus an “urgent threat.”

Why is Candida Auris Making Headlines This week?

We scan a variety of sources for our People’s Pharmacy “Health Headlines” newsletter. There are an amazing number of scary stories showing up around the country.

The headlines from Forbes (June 30, 2026) really caught our eye:

“A Drug-Resistant Fungus Is Spreading Through American Hospitals”

“Candida auris, a drug-resistant yeast, saw clinical infections more than double from 2022 to 2024, reaching 6,197 cases. This fungus primarily threatens immunocompromised patients, resisting common antifungal treatments.”

Researchers at the University of California, San Francisco describe in the journal Science, (August 6, 2026) why it is so hard to get rid of this infection once it has set up house keeping on a patient’s skin. When the fungus gets into and around hair follicles, it creates a kind of nest that protects it from an attack by our immune system.

Once it is embedded, Candida auris can be extremely hard to eradicate. That’s true in hospital environments as well in a personal environment, such as a hair follicle.

Most healthcare professionals believe that the problem exists primarily within nursing homes. Older people, who are immune compromised, are especially vulnerable. But millions of Americans are immunosuppressed. Many may not even realize they are at risk.

What Is Candida Auris?

New York Times journalist Matt Richtel was looking for a suitable topic for a series of in-depth reports. When he asked the experts at the Centers for Disease Control and Prevention, they suggested he investigate Candida auris.  They were more worried about this scary fungus than about most other health problems, and when you listen to his story, we think you will be, too!

Candida auris was first identified in the ear of a Japanese woman almost two decades ago. It wasn’t making her sick. Nonetheless, before long infectious disease experts started finding people who were very sick with this fungus. Because several strains have developed resistance to multiple common antifungal medications, the infections can be quite difficult to treat.

Who Is at High Risk?

People whose immune systems are compromised seem to be at highest risk. That includes the elderly, especially those living in nursing homes. However, millions of people taking medications that can suppress their immune systems are also in danger. These are drugs used to treat autoimmune conditions such as rheumatoid arthritis, Crohn’s disease, inflammatory bowel disease or plaque psoriasis. What actions do we need to take to protect them? With the development of antifungal resistance, simple surgical procedures could pose life-threatening risks.

This Week’s Guest:

Matt Richtel is a reporter at the New York Times. He won the Pulitzer Prize for national reporting with a series of articles he expanded into his first nonfiction book. Ultimately, it became a New York Times bestseller, A Deadly Wandering.

Matt Richtel’s latest book is An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives. His website is www.MattRichtel.com/ You can find his series on Candida auris at The New York Times.

The photograph of Matt Richtel is by Simona Deac.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

Download the mp3

You can also listen to the streaming audio by scrolling to the top of the page and clicking on the arrow under Matt Richtel’s photograph.

Perhaps the best option would be to download the podcast from Apple at this link. That way you can listen at your leisure. I promise you that this is a memorable interview that you do not want to miss. And remember, The People’s Pharmacy was informing you of this threat years before most people had even heard of this scary fungus.

Our kidneys do an incredible job filtering our blood every hour of every day. Most of us have two kidneys, and each one has about a million microscopic filters called glomeruli. Unlike the filters in our HVAC system, though, these filters cannot be replaced. But they do their work so well and unobtrusively that most of us don’t even think about our kidney function. Although 37 million Americans have kidney trouble, the majority are unaware of their situation. Two tests could reveal how well the kidneys are working. What are they, and how often should you ask about them?

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, August 8, 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 August 10, 2026.

What Are the Two Tests That Reveal Kidney Trouble?

Chronic conditions like high blood pressure and diabetes put a strain on the kidneys. They are very common problems that signal the need for kidney function monitoring. Our guest expert, Dr. Samir Parikh, suggests that all of us should know our numbers. One is derived from the level of creatinine in the blood. This is normally part of a basic metabolic panel. Usually, the panel results will include a number for the estimated glomerular filtration rate (EGFR) calculated from the value for blood creatinine. The other crucial test is a urine test for protein.

Keeping Kidneys Healthy by Staying Properly Hydrated

One of the simplest tactics to keep kidneys healthy is to provide them with enough liquid. We get some fluid from the food we eat, which may be one reason eating fruits and vegetables seems to be good for us. They are full of water! We also need to drink fluid, and plain water is probably the best choice. It would be smart to use thirst as a guideline and make sure to drink when thirsty. We do avoid overdoing water consumption, though, as overloading the kidneys with more fluid than they can handle is dangerous as well.

Medicines That Are Hard on the Kidneys

We mentioned to Dr. Parikh the experience of an older friend, a devoted runner, who discovered that taking ibuprofen after a run reduced the likelihood of having to get up overnight to urinate. He reminded us and our listeners that nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, celecoxib or meloxicam can be hard on the kidneys. That doesn’t mean we shouldn’t ever take such pain relievers, but perhaps we should try not to make it a habit.

When we asked about other medicines that might be tough on the kidneys, he mentioned PPIs. Proton pump inhibitors such as omeprazole (Prilosec) or esomeprazole (Nexium) are often used to treat heartburn or other digestive symptoms. Regular use can put a strain on the kidneys, although the gastroenterologist recommending the medicine might not warn you of that side effect.

We asked about environmental toxins and learned that heavy metals such as lead or arsenic can harm the kidneys along with other organs. We should make sure that the food we eat and the water we drink are not contaminated with such compounds.

The Possible Benefits of Vitamin B

Dr. Parikh has been studying how the kidneys respond to the B vitamin nicotinamide. The preliminary work he and his colleagues have done so far is promising. However, they have not conducted clinical trials to find out whether the vitamin could help people with early kidney disease.

Because kidneys work so hard, they need a lot of energy to be produced by the mitochondria in their cells. Those mitochondria need NAD+ (nicotinamide adenine dinucleotide) to function at their best. Providing additional nicotinamide appears to help (Nature Reviews. Nephrology, Feb. 2020).  One to three grams a day appears to be safe and may be beneficial.

Medications That Can Promote Kidney Health

Some medicines initially developed for other conditions are proving to be helpful in treating kidney disease. In particular, these include diabetes drugs known as SGLT2 inhibitors like dapagliflozin (Farxiga) or empagliflozin (Jardiance). They help slow the decline of kidney function (New England Journal of Medicine, Nov. 4, 2022). GLP-1 agonists may also be familiar because they too are used to treat diabetes. Medications such as semaglutide (Ozempic, Rybelsus, Wegovy) and tirzepatide (Mounjaro, Zepbound) have made headlines as weight loss and diabetes meds, but they also can reduce the risk of kidney failure and other bad outcomes (Lancet. Diabetes & Endocrinology, Jan. 2025). The benefits of these types of drugs should give us hope that we can go from slowing the progression of kidney disease to stopping it in its tracks

Taking Care of Your Kidneys

We asked Dr. Parikh what we should be doing to care for our kidneys and keep them healthy. He urged us once again to know our numbers: most importantly, the numbers from the two tests we discussed, blood creatinine and urine protein. Other numbers that are important for kidney are our blood pressure and, for those with diabetes, HbA1c. In addition to paying attention to all those numbers, we need to embrace a lifestyle that will help keep them where they belong. That means following a heart-healthy diet, staying physically active and getting adequate sleep.

This Week’s Guest

Samir M. Parikh, M.D., FASN, is Professor of Internal Medicine and Pharmacology and Chair of Internal Medicine at the University of Texas Southwestern. He holds the Donald W. Seldin Distinguished Chair in Internal Medicine and the Ruth W. and Milton P. Levy, Sr., Chair in Molecular Nephrology.

Dr. Samir Parikh, University of Texas Southwestern

Listen to the Podcast

The podcast of this program will be available Monday, August 10, 2026, after broadcast on Aug. 8. This week’s podcast has additional information on a possible role for sodium bicarbonate (baking soda) for kidney function. We also discussed medical silos, and how that leads to gastroenterologists overlooking the kidney risks from PPIs. Also, what should prospective kidney donors consider? 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.

Millions of people suffer with foot trouble. Some have heel pain when they first get out of bed. Others complain of flat feet or bunions. Athlete’s foot is very common, though it doesn’t always respond as expected to antifungal medications. Speaking of fungus, toenail fungus can be extremely stubborn. What are your feet trying to tell you about what they need? How can you keep them healthy, especially in the summertime?

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, August 1, 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 August 3, 2026.

What Are Your Feet Trying to Tell You?

Most everyone looks forward to summer vacation, but that special time away from the usual routine may pose challenges for your feet. Whether you are hiking in the mountains or running on the beach, you may need to pay attention to your tootsies.

Time at the Beach

Beach time can inspire long walks on the sand, but soft sand could really put a strain on foot muscles that aren’t accustomed to it. Our expert guest, podiatrist Jane Andersen DPM, recommends wearing good running shoes for walking long distances on sand. Choosing to walk where the sand is hard-packed when the tide is low can also be helpful.

Possibly the most important but easily overlooked step to protect feet at the beach is to apply sunscreen. The tops of the feet are easily overlooked, but they can burn pretty readily. And if you are planning to spend time sunbathing prone, you might even want to apply sunscreen to the bottoms of your feet. They never see the sun, and walking on sunburned soles could be quite painful.

Protecting Bare Feet

Another consideration at the beach is how you will get from the parking lot or boardwalk to the water. How hot is the sand? If it is hot enough to burn the soles of your feet, you might consider using water sandals.

In general, going barefoot can be risky. Whether you’re at the beach, at a campground, in your own backyard or even inside your home, there are potential hazards underfoot. Bits of glass shards, little pieces of wire, tiny pebbles or nails could all cause havoc if they end up embedded in a sole. Protecting your soles by wearing good flip-flops makes a lot of sense. To find a list of flip-flops that provide appropriate arch support as well as sole protection, consult apma.org.

Treating Black Toenails

During this episode, Joe describes a trip to the beach with a long walk. By the time he removed his shoes, his longest toe had a black toenail that was rather painful. Although the pain faded before too long, it took about a year for the dark color to disappear from the nail. Dr. Andersen suggests that it often takes at least nine months to regrow a toenail. She emphasizes that if the nail turns black due to sudden trauma (like dropping something heavy on the toe), a podiatrist should check it out. Sometimes there is a fracture under that discolored nail that requires medical attention for proper healing.

What Is the Story on Flat Feet?

Joe has always had flat feet. Perhaps your feet are flat, too. The condition is pretty common. If Joe gets out of a bathtub or swimming pool and leaves footprints, they are almost oval. There is very little indentation in the center. Other people with higher arches may leave footprints that are nearly C-shaped. Flat feet can benefit from arch support such as orthotic inserts for shoes. High arches can also cause trouble, especially if they are linked to a genetic condition called Charcot-Marie-Tooth. It is a nerve disorder that can also lead to muscle weakness. Consequently, people with high arches may also need podiatric care for their feet to stay comfortable and healthy.

Plantar Fasciitis Is a Pain

The bottoms of your feet have thick connective tissue called fascia that run from the heel to the ball of the foot. Inflammation of this tissue causes pain, typically at the heel but sometimes along the arch. Often, more supportive footgear or special orthotics can help. Getting a shoe with the correct heel drop is important. That is the difference between the height of the shoe at the heel and at the toe. A podiatrist can recommend the most appropriate heel drop for your feet.

Stretching is also useful, particularly pulling the toes toward the knee or stretching the calf in a runner’s stretch pose and holding for 30 seconds or so. Rolling the bottom of the foot on a frozen water bottle helps with the stretch at the same time that the cold eases the inflammation. Plantar fasciitis is common and treatable. If left untreated, it may last a long time.

What Can You Do About Stinky Feet?

A couple of listeners shared their experiences with smelly feet, and we asked Dr. Andersen for her opinion. Jan described using a topical erythromycin antibiotic prescription that came as a roll-on. She also got rid of all her stinky shoes and is careful to wear socks that will wick sweat away. Dr. Andersen noted that erythromycin is very effective against a bacterial infection with Corynebacterium minutissimum. This organism glows coral under ultraviolet light and can definitely raise a stink.

Sophia wrote about developing smelly feet after walking around in wet shoes. She finally solved the problem by treating her feet with rubbing alcohol. Dr. Andersen agreed that rubbing alcohol could be helpful. So can soaking the feet in a strong solution of tea. Other tips include cleaning the floor of the shower stall frequently and always wearing socks that wick–not cotton, which absorbs sweat but traps the moisture. Acrylic or wool work better. Another tactic is to alternate shoes; don’t wear the same shoes day after day but give them at least a day to dry out.

How Should You Treat a Sprained Ankle?

There has been controversy lately about the standard RICE protocol for a sprain: rest, ice, compression and elevation. Some experts now recommend warmth instead of ice and gentle motion rather than rest immediately after a sprain. Of course, the first step is to ascertain that it is really a sprain and not a fracture. The treatment for those two injuries is completely different and the person suffering the problem may not be able to tell just from the way it feels. An X-ray is prudent.

Bunions and Hammer Toes

If you don’t suffer from bunions, you might not know what they are. In a bunion, the bone that supports the big toe (the metatarsal) moves out of alignment and starts to point more towards the midline of the body. To compensate, the rest of the big toe ends up pointing back toward the rest of the foot. This creates a bump on the edge of the foot that might be painful. There doesn’t seem to be any clear correlation between the size of the bump and the amount of pain it causes. Bunions seem to be hereditary, at least to some extent. Conservative management entails choosing footwear with a roomy toe box, not pointy-toed shoes. Podiatrists also correct bunions surgically. They can choose from a wide range of surgical approaches.

In hammer toes, one of the toes (typically the second toe) curls over so that the end that would normally face forward points downward. This too can be corrected surgically, but the recovery can be pretty lengthy. A roomy toe box is also a good bet for living with hammer toe.

Taking Care of Your Feet

We asked Dr. Andersen for general advice, and she suggested that one very important consideration is to buy your athletic shoes in person, preferably at a store that caters to athletes. Buy the proper shoes for your activity; in other words, don’t try to play pickleball in running shoes. One nationwide chain that does a good job fitting the shoe to the athlete is Fleet Feet. Locally, she recommends Bull City Running.

This Week’s Guest

Dr. Jane Andersen, Board Certified, American Board of Foot and Ankle Surgery, is in practice at Chapel Hill Foot and Ankle, part of FASMA, Foot and Ankle specialists of the Mid Atlantic, in Chapel Hill, North Carolina. Dr. Andersen specializes in Foot and ankle care for Children, Adults, Athletes and Geriatric Patients including surgery and conservative care. She is a Trustee of the American Podiatric Medical Association. January 18, 2025, Jane Andersen, DPM, was awarded the Edwin B. Martin, Jr., Award for Podiatrist of the Year. https://www.chapelhillfootandankle.com/dr-jane-andersen

Jane Andersen, DPM, Chapel HIll Foot and Ankle

Listen to the Podcast

The podcast of this program will be available Monday, August 3, 2026, after broadcast on Aug. 1. This week’s podcast has additional information on smelly feet as well as foot and nail fungus. What remedies or medications work best? How long does it take for nail to grow out? What are the best toenail clippers? (Miltex) You can stream the show from this site and download the podcast for free.