Rapamycin and toenail fungus onychomycosis

[Agetron]

Rapamycin, a new bio-chemical compound that contained potent anti-fungal properties was first used for its anti-fungal properties by Dr. Surendra Nath Sehgal PhD in 1972. Which brings me to toenail fungus also called: onychomycosis.

I was a sufferer for two years, and I hoped that merely orally taking rapamycin (based on its anti-fungal properties) would irradicate my toenail fungus… it didn’t. But wait, it can be cured.

Fungal toenail infection is thought to affect somewhere between 2% -14% of the adult population. It is most common in older people and those with diabetes. Toenail fungus (there are multiple forms) causes thickened, brittle, crumbly, or ragged nails. So, assuming those statistics a few on the site or those they know are challenged by this – read on, I have a new skunk works and it involves rapamycin.

Treatment: Current guidelines recommend terbinafine or itraconazole as first-choice treatments, but consider terbinafine more effective. WARNING: Most cases of acute hepatic injury from terbinafine resolve within 3 to 6 months of stopping the medication. In some instances, however, the injury is severe and unremitting.

Terbinafine costs about $20 per month. Mine with insurance is about $4.50

Terbinafine Link: Terbinafine is probably first choice oral drug for fungal toenail infection.

Terbinafine helps a new nail grow free of infection, slowly replacing the infected part.
You typically take this type of drug daily for standard course of oral treatment is three months, and it may take as long as six months to a year to treat infection successfully. I started in Mid-April – and my positive results took 4-months.

But, according to medical sites: You won’t see the end result of treatment until the nail grows back completely. It may take four months or longer to eliminate an infection. Treatment success rates with these drugs appear to be lower in adults over age 65. And even if your nail condition improves, repeat infections are common.

So, this is where my skunk works comes in. Remembering Dr. Surendra Nath Sehgal success in applying rapamycin topically and getting cures (Radiolab: The Dirty Drug in the Ice Cream Tub), I crushed three of my rapamycin 2 mg pills and mixed with pure 99.9 DMSO – scentless variety. In conjunction with the nightly 250 mg terbinafine tablet - applied each morning after showering my DMSO/rapamycin concoction to my toenail - over, around with a Q-tip, to each toenail on my affected left foot. And on my unaffected right foot for good measure. My topical solution lasts about a month. Not too bad.

The results have been amazing. I plan on stopping the terbinafine after one more month, but will keep applying the rapamycin mixed with DMSO for a few more months. I am pretty sure this is going to permanently kick the fungus. See pics before treatment April - during treatment June and now August.

April 2023

June 2023

August 2023

Pure DSMO and rapamycin 6mg solution.

[vegasallen1]

@Agetron

Terbinafine

I think I’ll give this a try. I have a new shipment coming from India. It’s the first time I’ve ordered this much (200 tablets) with 30 dasatinib so I hope it goes thru.

[sol]

@Agetron

I crushed three of my rapamycin 2 mg pills and mixed with pure 99.9 DMSO – scentless variety.

This is pretty intriguing. Thank you.

Question: doesn’t this end up being a systemic daily dose of rapamycin? Or do you think the rapa transported with DMSO is only going skin deep? What’s your model of what is happening here?

[Agetron]

As you can see… major reversal of toenail fungus. I am no longer embarrassed to walk barefoot again.

I am not sure… but I think I got it at a nail salon. Out of the blue - I decided to treat myself to a pedicure… soaking scrub… all kinds of trimming tools. About 2 weeks later… my big toe nail started turning yellow… and over a 2 year period transfered to all my left foot toenails. My right foot nothing. It became unbearable to look at the rot. Particularly this past year. I tried every over the counter treatments. Did absolutely nothing… it actually got worse.

Finally in desperation, I asked my GP and he said that he could prescribe terbinafine… but likely after I stopped taking it… the fungus would return. He said it’s tough to cure once you get it.

That’s when I thought about using a topical DMSO with rapamycin with the oral terbinafine might be a winning combination. Attack the fungus inside and out. Definitely working and fairly quick.

[Agetron]

You asked: Do you think the rapa transported with DMSO is only going skin deep?

Yes, only surface deep. It a very light amount like painting your toenails with polish…is just enough to be moist.

The quantity lasts about 30 days - I use it in the morning after I shower. Then pull on my socks!

The topical rapamycin is getting diluted… or delved out 1 mg (on toe surface) every 5 days and only around the toenails.

Something comparable is rapamycin .2 percent have used 2 years+ on my face and neck. Clinical trails showed it didn’t get into blood. Chung.

Human clinical trial topical rapamycin on skin Link: Topical rapamycin reduces markers of senescence and aging in human skin: an exploratory, prospective, randomized trial - PMC

[vegasallen1]

Agetron: A couple questions… Where do you get your dmso? And you mix the rapamycin into how much dmso? Many years ago I took terbinafine and got total clearance only to have the fungus return. 2 or 3 years ago I tried it again at a less frequent dose but quit because I didn’t think it was working. Some point later I noticed that I have 1 clear nail on each foot and this time it’s stayed clear which is very surprising to me. So this time I have some hope this will work.

[Agetron]

Hey Allen,

My sympathy on the fungus returning.

That is why I think a two prong attack… topical and oral has the best chance of a permanent fix!

I get my unscented 99.9 DMSO on Amazon.com

I fill my bottle with about six dropper squirts of DMSO. And two dropper squirts of tap water. Add 6mg crushed rapamycin pills. The water keeps it all soluble… and from thickening too much.

Let me hear how it goes.

[vegasallen1]

Thanks, I’ll get it all together and see what happens. I am going to try this initially without the terbinafine.

[sol]

The quanity lasts about 30 days - I use it in the morning after I shower. Then pull on my socks!

In a later post, you say you dilute the DMSO with water. Tap water. Are you at all concerned about DMSO bringing tapwater contents into the skin? I am aware of the power of DMSO to bring all kinds of stuff with it, so curious as to your thinking on this.

The topical rapamycin is getting diluted… or delved out 1 mg (on toe surface) every 5 days and only around the toenails.

I don’t understand “every 5 days” here. Are you applying the topical every day, or every five?

Something comparable is rapamycin .2 percent have used 2 years+ on my face and neck. Clinical trails showed it didn’t get into blood. Chung.

As I understand it, DMSO is a powerful transport mechanism; are these trials using DMSO? If not, can you say why you think they are comparable to using DMSO?

Really appreciate your time, here! I know it’s work to reply. For those of us with seemingly incurable toenail fungus challenges, this is really interesting. Thank you.

[KarlT]

@Agetron im a tad confused. Why did you add the Rapa? To speed up treatment or increase chance of success or something else?

[vegasallen1]

Rapamycin is an antifungal.

[desertshores]

I sprayed my rapamycin/transcutol mixture on my big toenails which appeared to be developing some fungus around the edges. After about one week it completely disappeared.

[Agetron]

Sol wrote:

Tap water. Are you at all concerned about DMSO bringing tapwater contents into the skin?
I am aware of the power of DMSO to bring all kinds of stuff with it, so curious as to your thinking on this.

I almost suggersted distilled water - lol, which my wife keeps for ironing in the laundry room. Of course that is a better option. But, here in northern Missouri. Our tap water is very clean, healthy and not treated to death with chemicals, so I personally just take it from the tap or from a fresh bottle of drinking water. Again - it is not necessarily getting into the blood stream. And, it is a very small amount even on the surface. A good observation. Trying to keep my skunk works simple.

Sol wrote: I don’t understand “every 5 days” here. Are you applying the topical every day, or every five?

If you use 6mg divided by 30 days that is .2 mg per day - every day! that is 1 mg every 5-days. And by end of the 30 days/month it is 6mg total applied around and to the toenail surface. A fairly miniscule amount… on the surface, so not much evidence of it going much deeper than the skin’s surface - which is all you need.

Hope that helps!

[Agetron]

Karl and anyone else who has not listened to this podcast - I think it is a must. I first listened when it was posted by RapAdmin.

Radio Lab The DIrty Drug in the Ice Cream Tub.

http://www.wnycstudios.org/story/dirty-drug-and-ice-cream-tub/

I have listened to this so much I can almost recite it - and yet - it never bores me. The whole story of rapamycin’s discovery and all the important players.

Here is the anti-fungal part:
AJAI SEHGAL: And he began to try to isolate unique compounds from that soil sample.

AVIR MITRA: So he basically takes the soil.

AJAI SEHGAL: They examined it under the microscope.

AVIR MITRA: And eventually, Suren and his team…

AJAI SEHGAL: They go, oh, that’s interesting. They isolated a compound that was not seen before, and it had a very interesting molecular structure.

AVIR MITRA: And it’s kind of this clear, white, crystalline-type of powder-looking thing. And Suren’s like…

AJAI SEHGAL: I wonder what it does.

AVIR MITRA: And so…

AJAI SEHGAL: They test it.

AVIR MITRA: …They put the compound on different petri dishes, and…

AJAI SEHGAL: They exposed it to certain bacteria, certain fungi.

AVIR MITRA: To kind of see how they’ll react to the compound.

AJAI SEHGAL: And then they observe.

AVIR MITRA: And after a few days, they notice…

AJAI SEHGAL: Any fungus they put it in contact with…

AVIR MITRA: Would just stop growing.

(SOUNDBITE OF MUSIC)

AVIR MITRA: It’s like time had just kind of frozen.

LATIF NASSER: Huh. Like, he would have expected that, like, that amount of fungi would just keep, like, dividing and - boop (ph), boop, boop, boop, boop, boop, boop.

AVIR MITRA: Exactly. Yeah. By this point, it should have coated the whole plate, just covered in fungi, just like if you leave, you know, old yogurt in the fridge, it’ll just get covered in mold, you know? So that’s what should have happened, but instead, it didn’t happen. So he’s like, ooh, maybe this could be an antifungal.

AVIR MITRA: So for the next few years, Suren is just, like, trying this stuff out on mice, basically, you know, giving them fungal infections and then seeing if rapamycin works. He tries it on dogs. Ajai even says he tried it on a friend’s wife who had a fungal infection on her arm.

Wait. Can you even do that?

AJAI SEHGAL: Yeah.

(LAUGHTER)

AVIR MITRA: He’s carrying it around, like, in his back pocket. And he pulls it out at this family friend’s house, and he puts it on her arm.

AJAI SEHGAL: And she tried it, and it completely eliminated the fungal infection.

Now you know why I figured this would work on toenail fungus - and it did!!

[JuanDaw]

It is a short post, so I will quote entirely. But the link is below.

An economical cure

N=1

I am a retired physician whose left big toenail became heavily colonized by an unidentified fungus with resultant thickening, opacity and deformation. A respected dermatologist confirmed my diagnosis, but we decided not to initiate any treatment. The cost of oral treatments ranges from about $250 to $500, and there are many serious side effects.1–3

Shortly after the consultation, I decided to undertake a trial of topical iodine. I obtained a bottle of 2.5% iodine tincture at a cost of $3.27, and applied one drop of the solution daily, with occasional lapses, to the tip of the affected toenail. The iodine travelled rapidly into the depths of the affected subungual tissues.

After 2 weeks, a sliver of normal-looking nail appeared at the proximal end of the affected nail. Encouraged, I continued the treatment. The nail grew at the normal slow rate, and the diseased area gradually moved distally. The nail is now apparently normal.

The total cost of the treatment was $3.27, and half of the original bottle of iodine solution remains for further treatment, if required. In view of the efficacy of the treatment in this isolated case, it would seem reasonable to institute a trial with a larger number of patients to obtain scientifically acceptable results. However, blinded trials would be difficult, given the telltale colour and odour of iodine. No side effects were observed in the case described.

[desertshores]

Personally, I don’t like DMSO because of the theoretical possibility of carrying contaminates into my bloodstream, but as one person’s historical observation:

Back in the days of CB radio,(Mainly 1970s) is where I first heard DMSO mentioned.
I heard a truck driver extolling the virtues of DMSO to his buddies. DMSO became quite the craze and people everywhere were slathering it on and even drinking it. Old people especially were praising its virtues for curing all kinds of aches and pains.
I remember a few vague warnings from the health officials, but I don’t remember anyone suffering any dire consequences from using it. And, I knew plenty of people trying it, including my mother. Of course, we didn’t have the internet then so maybe adverse consequences were not widely reported. Mostly they were not using USP grade either.
I suspect the actual risk is lower than the theoretical risk.

[aalyman]

For what it’s worth, I’ve had this problem for many years. I suspect it’s related to a lifetime as a distance runner. Tried lots of different remedies, then the Mrs. got me a tub of Emuaidmax, an ointment made from natural oils of varying amounts, she had heard about. Son of a gun - amazingly, it has worked. The fungus is gone - all that is left is for the nails to grow out fully. I’d suggest giving it a try.

[Agetron]

Hey Karl… I never really directly answered your question. "Why did you add the Rapa? To speed up treatment or increase chance of success or something else?

I figured it would speed up the treatment and increase chance of success in not getting a re–infection of fungus.

Scorched earth the toenail fungus!

As I mentioned, my two prong effect of daily oral terbinafine and topical pure DMSO with pure rapamycin dabbed around the nails with a Q-tip has been an unequivocal success.

Glad to have that chapter of life over.

[Jay]

JuanDaw, This may work for some, but it did not work for me. I even added DMSO according to this article: Onychomycosis treated with a dilute povidone–iodine/dimethyl sulfoxide preparation - PMC . I’ve had toenail fungus several times over the last 10 years and in the process I’ve used just about every home remedy I could find through my research. None of them worked. The only thing that partially worked was a topical cream from Blaine Labs that contained about 25% undecylic acid, tea tree oil and a few other ingredients. I used it for several years. The name of it was Terpenicol, but I don’t think it’s manufactured any more. I finally gave in to my fears of terbinafine tablets a few months ago and went to my dermatologist for a prescription. She noted that liver problems were quite rare and that blood tests would be done to check for any problems. None were found. I followed the protocol of one 250 mg tablet daily for three months in a row and the fungus appears to now be gone. I wish I had done it years ago instead of suffering with the problem for so long and experimenting with so many useless home remedies. In the meantime I have acquired another supply of tablets and will now follow an alternative second plan noted here just because I want to be thorough: A Week of Oral Terbinafine Pulse Regimen Every Three Months to Treat all Dermatophyte Onychomycosis - PMC. The plan I will follow, which is noted in this article, is 500 mg terbinafine daily for 7 days in a row at the beginning of each month for 3 to 4 months in a row. This article may also mention other plans, but I don’t plan to follow them. The one remedy I did not try was the rapamycin + terbinafine + DMSO topical which sounds like a good idea. I do, however, continue to treat twice daily topically with a 25% undecylic acid product I found on Amazon. Once cured I’ll probably continue the topical once daily to help prevent a new infection. If the rapamycin + terbinafine + DMSO was commercially available I would use it instead of the undecylic acid.

[JuanDaw]

Just shared the above because it came from a physician.

I had a toe infection (toe, not toenail). I tried iodine. It alleviated it, but the itch kept recurring for months. Used OTC cream tolnaftate (Tinactin). That fixed it.