3/5 toenails have fungus, with no nail left at all on my big toe. Alt/ast are normal. Should I take lamisil (terbinafine)? Podiatrist says no but derm says yes.

Lamisil (terbinafine). The only consistently effective treatment for a nail fungus infection is an oral antifungal (lamisil, diflucan, (fluconazole) or sporanox) with a dermatologist monitoring your labwork. Some podiatrists like to use only topical antifungals, with frequent office visits for nail trimming, but multiple studies have shown that only a small fraction of patients (if any) achieve longlasting improvement that way.
Lamisil (terbinafine) for nails. Yes by all means Lamisil (terbinafine) is the treatment as long as you check your white cells and liver functions.For some reason poditrists like to use local treatment on the nails rather then lamisil (terbinafine).You can take Lamisil (terbinafine) and if it is confimed fungus nail by dermatologist you will achieve cure in approx 8 weeks or more.
Lamisil (terbinafine) You should consider Lamisil (terbinafine) only if you are in good health and are not taking any other medications that can affect your liver. Also drinking alcohol while taking Lamisil (terbinafine) could cause severe side effects.
Maybe... If there are no other contraindications, Lamisil (terbinafine) may be a good option. Discuss it with your physician.