DEAR DR. DONOHUE: I have a pedicure every couple of months, but recently I have been plagued with ingrown toenails on both big toes. The podiatrist says that to temporarily cure it, he could cut the sides of the nails off, or as a permanent cure, he could remove the entire nails. This sounds extreme to me. Do you know of any other way? – C.T.

ANSWER: The podiatrist’s suggestions are not extreme if the ingrown nails constantly recur.

I trust that you are cutting your nails straight across, with no downward curve to the sides of the nails. And I trust that your shoes don’t squeeze your toes. Both encourage ingrown toenails.

Soak your feet three times a day in soapy, tepid water. Then gently wedge a piece of cotton under the part of the nail that’s digging into the skin. It can take a week or more before you see results.

Or get some half-inch bandage tape. Start the tape on the skin right next to where the nail is cutting in. Wrap the tape under the toe and end it on the base of the front of the toe. Then run a piece of tape lengthwise down the toe and over the first strip to keep it anchored. Run a third strip of tape over the lengthwise strip and parallel to the first strip. This pulls the skin away from the nail. Again, it takes a week or more to see results.

DEAR DR. DONOHUE: I have a problem with having to get up an average of four times every night to urinate. I am 90 years old. I will be very grateful for your help. – S.M.

ANSWER: One reason why older people have frequent nighttime trips to the bathroom has to do with a change in the production of a hormone called ADH (antidiuretic hormone). It slows urine production. At younger ages, more ADH is produced at night, and urine production slows. In older ages, less is produced at night. People make more urine and are forced to rise to empty their bladders. In addition, the bladder shrinks with age and holds less urine, and that adds to the problem. Some doctors give people with this problem the ADH hormone to take before sleep so they can have an uninterrupted night of rest.

There are other causes for this, too. In men, an enlarged prostate gland is the chief reason for nocturnal visits to the bathroom. In both men and women, an overactive bladder is another reason why people are roused from sleep to empty the bladder. The bladder’s muscular walls contract violently with only a small amount of urine in the bladder, and that makes people dash to relieve themselves, night and day. Medicines can help control this.

If you are producing large volumes of urine, then diabetes, heart failure, kidney failure, low blood potassium or high blood calcium could be the problem. These conditions increase day and night frequency of urination.

It helps to cut down severely on the amount of fluid you drink after the evening meal. Don’t drink alcohol or caffeinated beverages from late afternoon to bedtime.

DEAR DR. DONOHUE: I have a negligible amount of vitamin D in my blood. I take 600 IU of the vitamin every day, and in addition, my doctor has me on 50,000 IU weekly. I am afraid of the massive doses of this vitamin because I have read of its toxic side effects. What am I to do? – M.E.

ANSWER: The recommended daily vitamin-D intake for those between 19 and 50 is 200 IU; for those between 51 and 70, 400 IU; and for those 71 and older, 600 IU. The upper daily limit has been set at 2,000 IU.

Excessive amounts of the vitamin draw calcium from the bone into the blood, and that can disturb the kidneys, harden arteries and affect the heart.

In spite of your high dose of vitamin D, your blood levels of the vitamin are low. The vitamin is not getting into your blood, so you will not suffer from vitamin-D toxicity. The reason why your system isn’t absorbing the vitamin has to be found. You might have one of the many intestinal malabsorption conditions that keep blood levels low. Why not bring this up with your doctor?

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.