Hacking Fluoroquinolone Toxicity via the Nervous System

I recently read Hacking the Nervous System, about how vagus nerve tone is connected to chronic illness.

The vagus nerve is a huge nerve that connects the brain to the various organs throughout the body. Our autonomic nervous system (ANS) is controlled via the vagus nerve. It connects the digestive tract to the brain and when you feel butterflies in your stomach, that feeling is traveling from your stomach to your brain via your vagus nerve. Breathing and heart rate, as well as other ANS functions, are controlled through the vagus nerve.

The brain coordinates ANS functions using the vagus nerve, and how smoothly those functions are being coordinated is referred to as the “tone” of the vagus nerve.

Hacking the Nervous System goes over the hypothesis that inflammation is related to vagal nerve tone, and that vagal nerve tone has a lot to do with chronic, multi-symptom illnesses, like autoimmune diseases. I wonder if vagal nerve damage has something to do with fluoroquinolone toxicity, and I wonder if things that improve vagal tone can help floxies to heal. I suspect so on both counts.

Vagal nerve tone is important, and “Research shows that a high vagal tone makes your body better at regulating blood glucose levels, reducing the likelihood of diabetes, stroke and cardiovascular disease. Low vagal tone, however, has been associated with chronic inflammation.”

Little is known about how vagal tone relates to health. One of the scientists interviewed for Hacking the Nervous System stated, “We don’t even know yet what a healthy vagal tone looks like.” They are looking into it though, and vagal nerve stimulating implants are being used in clinical trials. (Read Hacking the Nervous System for more information about the implants.)

Improving Vagal Tone

Things that are less drastic and invasive than a vagal nerve stimulating implant can improve vagal tone. For example, meditation can improve vagal tone. “Those who meditated showed a significant rise in vagal tone, which was associated with reported increases in positive emotions. ‘That was the first experimental evidence that if you increased positive emotions and that led to increased social closeness, then vagal tone changed,’ Kok says.”

To drastically oversimplify a complex process, things that make you feel good, socially connected, happy, relaxed, etc. improve vagal tone. Conversely, stress and trauma decrease vagal tone. Many things that helped me through my fluoroquinolone toxicity journey were things that are purported to improve vagal tone – meditation, healing arts (e.g. dancing and music), mindfulness, acupuncture, chiropractic, and eliminating stressful stimuli from my life (e.g. getting off the internet). An article in Psychology Today, “How Does the Vagus Nerve Convey Gut Instincts to the Brain?” notes that, “Using positive self-talk and taking deep breaths is a quick and easy way to engage the vagus nerve and parasympathetic nervous system to calm yourself from both the top-down and from the bottom-up.”

Additionally, exercise also improves vagal tone. Playful exercise is best, but regardless, movement is good for vagal tone.

Vagal Tone and GABA Neurotransmitters

A decrease in vagal tone may be connected to damage to GABA neurotransmitters. The article in Psychology Today, “How Does the Vagus Nerve Convey Gut Instincts to the Brain?” notes that, “The most exciting discovery of this study is that under closer scrutiny of the rats’ brains, the researchers found that the loss of signals coming up from the abdomen via the vagus nerve altered the production of both adrenaline and GABA in the brain.” The article Selective antagonism of the GABAA receptor by ciprofloxacin and biphenylacetic acid published in the British Journal of Pharmacology noted that, “Ciprofloxacin (10–3000 μm) inhibited GABAA-mediated responses in the vagus nerve with an IC50 (and 95% CI) of 202 μm (148–275). BPAA (1–1000 μm) had little or no effect on the GABAA-mediated response but concentration-dependently potentiated the effects of ciprofloxacin by up to 33,000 times.” Let me highlight and reiterate: BPAA, which is a derivative or an NSAID, potentiated the harmful effects of ciprofloxacin on GABA receptors by up to 33,000 times. (WHOA!).

The ANS dysfunction that many floxies experience is likely connected to vagal nerve health, as the ANS is controlled via the vagus nerve.


A Hypothesis for Fluoroquinolone Toxicity

A possible hypothesis for fluoroquinolone toxicity is that people who get floxed have an underlying, dormant hiatal hernia (they’re pretty common) that is exacerbated by the FQ and the massive amount of oxidative stress induced in the gut by the FQ. The hiatal hernia irritates the vagus nerve and triggers ANS dysfunction that is self-perpetuating. The damage to the vagus nerve also alters the production of neurotransmitters, especially GABA, and hormones.

It’s possible, and I believe that the vagus nerve is a big part of the FQ toxicity puzzle. However, please know that I have not found much scientific research to support this hypothesis. Also, other possible causes for fluoroquinolone toxicity mentioned in the post, What is Fluoroquinolone Toxicity? have more supporting evidence supporting. However, all of these causes are not mutually exclusive, and may all play a role.

Measuring Vagal Tone

In Hacking the Nervous System it is noted that:

The strength of your vagus response is known as your vagal tone and it can be determined by using an electrocardiogram to measure heart rate. Every time you breathe in, your heart beats faster in order to speed the flow of oxygenated blood around your body. Breathe out and your heart rate slows. This variability is one of many things regulated by the vagus nerve, which is active when you breathe out but suppressed when you breathe in, so the bigger your difference in heart rate when breathing in and out, the higher your vagal tone.”

Another term for the relationship between breath and heart rate is respiratory sinus arrhythmia breathing (RSA breathing). I found the following passage from A Headache in the Pelvis to be interesting:

RSA breathing is a description of the relationship between heart rate and breathing and refers to the heart rate varying in response to respiration. RSA is a phenomenon that occurs in all vertebrates. You can experience the phenomenon of RSA by taking your pulse and noting that when you breathe in, the heart rate increases slightly and when you breathe out the heart rate decreases slightly. There is considerable research that indicates that when there is balance and health, the heart rate and the breath move robustly together as inhalation occurs, heart rate increases as exhalation occurs, heart rate drops.

Under circumstances of mental or physical disease the relationship between breathing and heart rate is disturbed. When individuals suffer panic attacks for instance, RSA is lower and disturbed. When they recover from panic disorders their RSA breathing becomes stronger, more balanced, and robust. The higher and stronger the heart rate variability is in relationship to appropriate respiration, the higher is the general level of health and well being. For example healthy children generally have very robust RSA breathing in which the heart rate can sometimes vary 40 beats or more between inhalation and exhalation.

Reduced RSA is thought to be an indicator of an adverse prognosis for people with heart disease. Generally disturbed RSA is indicative of early problems in the healthy functioning of the autonomic nervous system as it relates to a number of diseases. It has been suggested that one measure of the therapeutic effect or safety of a drug is whether it positively or negatively affects RSA.” (emphasis added).

Vagal tone and RSA breathing are either one and the same, or, at the very least, highly related. As doctors Wise and Anderson note in A Headache in the Pelvis, the effects of pharmaceuticals on RSA (or vagal tone) should be measured and noted, and those drugs that have deleterious effects on RSA should only be taken in extreme circumstances. The effects of fluoroquinolones on RSA breathing and vagal tone are unknown.

Coordinating Breathing with Heart Rate

I’m a huge fan of breathing exercises for health. The post Breathing Exercises for Health goes over some thoughts on breathing exercises for floxies. The easiest breathing exercise that I use is just saying, “OM” – take a deep breath in and let it out slowly while singing/chanting/groaning “OM.”

To get my heart and breath regulated, I took a Chinese herb called Suxiao Jiuxin Wan. It’s supposed to improve heart qi. (Heart qi? What? I’m not sure of this, but I suspect that “heart qi” is related to vagal nerve tone, but people who know more about this can either prove or disprove this notion.) Suxiao Jiuxin Wan has been shown to help people with angina and it calmed my racing heart dramatically. I’m not a doctor or Chinese herb specialist, so please do your own research, but it helped me immensely.


Fluoroquinolone toxicity is an incredibly complex disease with many facets. Is the nervous system involved? Absolutely. Is the vagus nerve involved? Almost certainly. But, unfortunately, not much research has been done on how fluoroquinolones relate to either the vagus nerve specifically or the nervous system generally.

Improving vagal tone has multiple health benefits for floxies and non-floxies alike. Most of the things that can be done to improve vagal tone are pretty simple and inexpensive. Meditate – be socially connected – exercise – do breathing exercises – minimize stress – think positively. None of those are magic bullets, they’re all processes and practices. They’re all good for you, free, and certainly worth a try.


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37 thoughts on “Hacking Fluoroquinolone Toxicity via the Nervous System

  1. andrea cornell June 13, 2015 at 11:23 am Reply

    I stared having seizures and my neurologist gave me a drug called Gabapentin and all of my neuropathy symptoms are gone. I just thought Gaba receptors and Gabapentin have to have a connection.

  2. Linda Livingston June 13, 2015 at 11:34 am Reply

    ” Let me highlight and reiterate: BPAA, which is a derivative or an NSAID, potentiated the harmful effects of ciprofloxacin on GABA receptors by up to 33,000 times. (WHOA!).” Whoa is right! My cardiologist made me sound like a petulant child because I refused NSAIDs for the pericardial effusion that I believe was yet another side effect. (I took every natural anti-inflammatory known, including turmeric, boswellia, garlic, tart cherry, etc and still no change, so I don’t believe NSAIDs would have made a difference anyway, other than aggravating my FQL toxicity.)

    • Bj June 13, 2015 at 12:35 pm Reply

      Linda, how long since you were floxed? What are you currently using for inflammation?

      • Linda Livingston June 13, 2015 at 12:54 pm Reply

        BJ, February 16. In that short time I lost 30 pounds, suffered severe depression, insomnia floaters and blurred vision, excruciating back pain, numbness in fingers and toes and swelling over the nerve on the wrist, bladder pressure (in fact got another UTI—and didn’t know because there was always pressure there), pericardial effusion and most troubling, horrific, suffocating breathing problems, unrelated to the lungs (mostly likely mitrochondrial damage to the heart muscles/automnomic nervous system damage/nerve pressure in chest and neck.) After a dozen unsuccessful visits with MDs, who wanted more and more tests and only made things worse by adding so much stress with their disbelief, I finally went, for the first time in my life to a naturopath for IVs. Within the two months since seeing the naturopath I have almost no numbness in fingers and it is going away in toes. I have regained 10 pounds and am moving around almost normally (I had to shuffle, bent over, because of the breathing problems). The breathing has gone from terrifyingly suffocating to not normal, but bearable. The back pain is less and much more frequent. And here’s an unexpected “benefit.” I have been on asthma inhalers all my life, and the only ones they have now for prophylactic use are inhaled steroids. I have gone from using it twice in the morning and twice in the evening, tapering down to not using it at all–thanks to H2O2 IVs.

        As for the anti-inflammatories, as I said, I don’t think NSAIDs would have worked for the effusion, given the amount of natural anti-inflammatories I have been taking: Boswellia (which has be compared to advil), tart cherry, EPA fish oil, tumeric, ginger, garlic, magnesium and an anti-inflammatory diet eg garlic, salmon, olive oil.

    • Marcos April 13, 2018 at 1:24 pm Reply

      Linda any feedback on how your doing today

  3. Linda Livingston June 13, 2015 at 12:55 pm Reply

    oops, should have said back pain is much more INfrequent

    • Bj June 21, 2015 at 2:19 pm Reply

      What are your back issues associated with fq’s? Do you have any literature on this?

      • Linda Livingston June 21, 2015 at 2:58 pm Reply

        BJ-my back issue was one singular deep pain under my shoulder blade. Interestingly, it is the site of a former scapula fracture, that happened in 2011. However, once it healed, I NEVER felt any pain there and totally forgot about it—until I was floxed. The pain was as bad if not worse than when I cracked my ribs. It was dull, deep and excruciating. My theory is that it activated that old injury. It was near constant for over a month, and then intermittent. Since getting IVs, it is all but gone. I get an occassional twinge, but on a scale of 1-10 it is about a 2 and very brief. I have no literature, but I know the FLQs attack dna, mitochondria, collagen, bone, muscle, tendons and pretty much everything as well as causing major nerve damage. I can’t specifically say which IV helped, since I am not sure of the source of the pain–nerve damage or tissue damage, or both. The high vitamin C is supposed to help with collagen repair (and coincidentally pain relief), the phosphatydilchonline (and I’m going to spell that correctly one of these times) helps with nerve damage and mitochondrial damage. Hope that helps. What does your back pain feel like?

        • Marcos April 13, 2018 at 1:27 pm

          I really need help understanding what I’m going through I recently got floxed and it’s been really hard on me please give me call please (956)5086606 I really need help!

  4. Bonnie Jacobus June 21, 2015 at 3:29 am Reply

    Hi, Do you have any studies on fq and spine, disc, or bone association? Thank you. You are a great resource! Bonnie

  5. Victor Cheng June 21, 2015 at 11:03 am Reply

    Hi Everyone, I know that the vocal cord paralysis is one of the serious side effects of taking Avelo. Has anyone complained about this side effect?

    • Gary Gibson July 6, 2015 at 11:24 am Reply

      One of my many problems since ciprofloxacin is paralysis of my left vocal cord. I have had a constant sore throat for 15 month due to the left vocal cord inability to close. Also a raspy voice that gets progressively worse as the day goes on.

      • Victor Cheng July 9, 2015 at 7:42 pm Reply

        Gary, Thank you so much for your response to my question. My best wishes for your recovery. I am sorry for mistyped the word “Avelox” as “Avelo”. My dad has started developing the voice hoarseness and excess mucus symptoms right after taking the Avelox antibiotic medication for 20 days. He has been having these two big and difficult symptoms for more than one year.

        • Linda Livingston July 9, 2015 at 8:25 pm

          Wow—it just dawned on me–I had pneumonia a few years back and it was followed with a paralyzed vocal cord. I wonder if I had been floxed once before? (It would explain why I got hit so hard this time, which I have attributed (and rightly so) to being given prednisone at the same time. Anyhow, I tried some homeopathic things for the raspiness, and I never did a follow up with the ENT but my voice went back to normal several months later, so I guess it repaired itself. (When it happened I was just about to open in a show, so the doctor gave me a shot of botox or something like that, in the cord.)

      • Tobias September 6, 2016 at 7:17 am Reply

        Dear Gary,
        have you found a solution for your voice-problems? I’ve been having the same problems as you for almost 2 years now (after taking Levofloxacin).

      • Mary September 28, 2017 at 10:25 am Reply

        I saw an ENT doctor because of choking, he told me the muscle in the throat that is supposed to relax so swallowing can happen is not working also he said I have no gag reflex, very scary, I asked if this was due to Cipro poisoning, of course, he said, no.

        • L September 28, 2017 at 10:33 am

          Grrrr. So sick of the dismissiveness of doctors. I have had a choking sensation (more like strangulation, on the outside.) It has been suggested it is either from mitochondrial damage, or something with the nervous system. I would guess yours is as well.

  6. Brian July 4, 2015 at 2:51 pm Reply

    That’s a really interesting hypothesis regarding hiatal hernias. I have a hiatal hernia and believe that some (if not all) of my remaining issues may be due to my hiatal hernia and its effect on the vagus nerve. I may have exacerbated my hiatal hernia by over-exercing during a period in which I thought I had healed significantly from FQT. As you point out, no way to prove this…

  7. Victor Cheng July 10, 2015 at 7:44 pm Reply

    Linda, Thank you so much for taking the time to response to my post! I am very happy to hear that you recovered from your paralyzed vocal cord problem. As far as I know, the Recurrent Laryngeal nerve branches from the Vagus nerve that runs from the brain down to the vocal cord and controls the muscle movement of the vocal cord. The vocal cord paralysis is caused by damaged to the Recurrent Laryngeal nerve and results in difficult speaking, breathing, and swallowing. I hope someone can shed some light on the excess mucus symptom that my dad has been suffering from since last year after taking Avelox antibiotic medication.

  8. John September 9, 2015 at 6:25 pm Reply

    What is being floxed?

    • L September 9, 2015 at 6:55 pm Reply

      Having toxic side effects from a fluoroquinolone drug like Cipro or Levaquin. The “flox” comes from the manufacturer’s drug names like CiproFLOXacin.

    • Lisa Bloomquist September 9, 2015 at 8:56 pm Reply

      Thanks for asking, John! If one is “floxed” they are suffering from an adverse reaction to ciproFLOXacin, levoFLOXacin, moxiFLOXacin, oFLOXacin, or other fluorouqinolone antibiotics. Fluoroquinolone toxicity is a multi-symptom, often chronic, illness that is similar to autoimmune diseases, CFS/ME, fibromyalgia, etc. You can find out more information by looking at the home page, the links & resources page, and the stories on this site. Please let me know if you have any questions. Thanks!

  9. lizois October 18, 2015 at 6:11 pm Reply

    Thank you again for what you wrote. It is really great how you put the pieces together. When I was recently in the hospital after my 15th FQ prescription in four years they also gave me a nebulizer and my breathing blood pressure and heart rate went absolutely wildly dysfunctional and I refused any further medication. Even though I don’t usually take drugs I subsequently took one diclofenac And my central nervous system went berserk. I will never touch that drug again. It is also great what Linda wrote and I was wondering if gabapentin is the same as taking GABA .? I would also want to mention that one of the most helpful things I have to discovered in recovery phase is an Ayurvedic medicine called dhanvantaram 101. It has yielded immense benefits for my nervous system and also so did two homeopathic remedies…..alum followed by lathy-s. I am taking those at the moment. I must say this has been a nightmare like never before. I do see improvements and they are very hard won.
    Again Lisa with all my heart I would like to thank you aGain for all that you do I feel incredibly grateful as all that has gone awry improves in focus.

    • Lisa Bloomquist October 18, 2015 at 7:47 pm Reply

      Thank you so much for your comment and the input regarding the Ayurvedic and homeopathic remedies that helped you!

      I’m so sorry for all that you went through as well! 15 FQ prescriptions? Ugh! That’s horrible! I’m so glad that you have found some things that help you!

      Gabapentin is not the same as GABA. Gabapentin is a prescription drug that is prescribed for neuropathy. GABA is a neurotransmitter. The term GABA can also be applied to a supplement that is supposed to increase the amount of the GABA neurotransitter. The supplement has mixed reviews.


      • Elise April 19, 2017 at 1:39 pm Reply

        Is it ok to take if you have been floxed?? I’ve been taking it about 24 days and yesterday I started getting the feeling of a relapse and especially today and I don’t know if i went wrong somewhere or what or if it’s the gabapentin

        • Elise April 19, 2017 at 1:43 pm

          I did have to drink bad water for three days last week could that be what’s causing it instead?

    • Linda October 18, 2015 at 7:59 pm Reply

      Too many moving parts! Too many connections! Trying to fix one thing with supplements, only your GI tract is shot so you don’t know if the supplements are actually being utilized. I have read a bunch on the vagus nerve but not sure I am any closer to figuring out how to deal with it. Seems like every time I seem to improve in one area, another rears its ugly head. Cipro whack-a-mole. (Lizois—that’s pretty—is it french for Liz?)

  10. Linda July 30, 2016 at 7:58 am Reply

    Wow…..I am so excited to have found this info. I am a MESS. On multiple doses of IV DRUGS, MULTIPLE DOSES OF PREDNISONE AND OTHER ANTIBIOTICS. STARTING after a episode of encephalitis & meningitis, in a 5 day coma.,10 days in ICU continual IV of Rocephin & Vancomycin. When I woke from my coma I was completely amnesic Hands tied to the bed rails, in a posey jacket, tied into the bed. My memory returned very slowly.I wasin the hospital 28 days total. Home nursing twice a day. Vancomycin & Rocephin 1 bag of each
    piggy backed twice a day. Since then, from coma effects….I developed the the following….



    My endroconologist wants me to go to seean infectious disease Dr. NEVER MIND. I AM
    be giving blood now

    Can I benifit .

    • L July 30, 2016 at 9:09 am Reply

      Linda, I would URGE you to see a naturopath or integrative MD. You need to get off all the pharmaceuticals. (I have to say though, of the dozen or so doctors I saw post cipro, the ONLY one who was at ALL educated on their side effects was a doctor at UCLA.) I also had prednisone with the cipro which I think exacerbated all the side effects. You might want to try Whittaker Wellness in Newport Beach. Not sure if they have treated floxies before, but I have heard excellent things about them, and Dr Julian Whittaker. (He is an integrative physician, merging both allopathic and more natural therapies.)

      • Heather April 2, 2018 at 9:59 am Reply

        Does anyone know of a doctor in Maryland that is versed in helping floxies?

        • Laurs April 2, 2018 at 10:04 pm

          It might be worth calling dr Andrew heyman’s office in Virginia and asking. They treat environmental & other acquired illnesses/conditions. And I believe they do phone consults.

  11. […] via Hacking Fluoroquinolone Toxicity via the Nervous System […]

  12. Tammy scott August 9, 2018 at 11:02 am Reply

    Ok, my sons situation is very different from a typical person. He is 31 years old and has Cerebal Palsy. Plus some other medical issues. In February 2018 he had Flu B that turned in to Pneumonia. He came home with oxygen for over 3 months because his O2 was staying low. After all of this, he then got strep. They put him on Ciprofloxin and he had a reaction to the medicine. He itched, wouldn’t sleep and very irritable and combative. These are things that we have never had a problem with before. We stopped the medicine after a few days and he seemed to calm down some, but he was not the same person that he was before the Ciprofloxin. We then felt we had to find out what was going on with him, so we got him scheduled for a Endoscopy. This is where we found out he has Gastroparesis. The doctor tells us to feed him small meals 6 or more times a day, keep him upright after eating at least 2 hours or more. All of this is very hard because Jake is nonverbal, incontinent (with chronic constipation) and he does not walk or able to sit upright unless he is in his wheelchair. In other words, he has to be laid down quite often to be changed, bathed, etc. He has had numerous endoscopes over the years and I have never been told that he had Gastroparesis, so I’m pretty sure the Ciprofloxin is what has damaged his Vagus Nerve. I have him on the low fat and low fiber diet, but it doesn’t seem to be helping. All the stuff I read is things he cannot do. Like deep breathing, meditation, etc. I’m afraid I’m not going to be able to help him. Please, does anyone have advice for him.

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