Monthly Archives: September 2017

Autonomic Nervous System Dysfunction from Cipro, Levaquin, and other Fluoroquinolones

Many symptoms of fluoroquinolone toxicity involve autonomic nervous system dysfunction.

The autonomic nervous system (ANS) regulates bodily functions such as the heart rate, digestion, sweating, salivating, respiratory rate, pupillary response, urination, sexual arousal, and certain reflex actions such as coughing, sneezing, swallowing and vomiting. The ANS also controls the balance between the parasympathetic (the “rest and digest” or “feed and breed” system) and the sympathetic (fight or flight system) nervous systems.

Many fluoroquinolone toxicity victims/”floxies” (those who have been poisoned by Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin, Floxin/ofloxacin or other fluoroquinolone antibiotics) struggle with:

  • Digestive dysmotility
  • Either sweating too much or too little
  • Increased heart rate / racing heart
  • Breathing difficulty / air hunger
  • Increased frequency, urgency, and pain with urination
  • Sexual dysfunction
  • Loss of libido
  • Dry mouth and dental problems
  • Dry eyes and vision problems
  • Adrenal dysfunction and fatigue
  • Lightheadedness
  • Loss of balance
  • Anxiety
  • Difficulty regulating blood-sugar levels

ANS dysfunction is also common among those with POTS/Postural orthostatic tachycardia syndrome (“The hallmark sign of POTS is a measured increase in heart rate by at least 30 beats per minute within 10 minutes of assuming an upright position”), EDS/Ehlers–Danlos syndrome (a grouping of genetic connective tissue disorders), and MCAS/Mast cell activation syndrome or MCAD/mast cell activation disorder (an inflammatory immune system disorder that leads to many multi-symptom, chronic illness). ANS dysfunction is also a symptom of each of these illnesses.

Fluoroquinolone toxicity symptoms mimic and overlap with those of POTS, EDS, and MCAS/MCAD. All these disorders are multi-symptom, chronic illnesses for which there is no cure. In addition to causing ANS dysfunction, fluoroquinolone toxicity, like EDS, causes connective tissue damage, and like MCAS/MCAD, fluoroquinolone toxicity involves immune system dysfunction. There is significant overlap in symptoms, and maybe pathology, between fluoroquinolone toxicity, POTS, EDS, and MCAS/MCAD.

You can find many examples of ANS dysfunction (and other symptoms of fluoroquinolone toxicity that overlap with symptoms of POTS, EDS, and MCAS/MCAD) in the stories of fluoroquinolone toxicity on https://fqwallofpain.com/, http://www.fluoroquinolonestories.com/, https://www.facebook.com/groups/floxies/ and here on https://floxiehope.com/. Personally, I experienced several ANS dysfunction symptoms, including digestive dysmotility, increased heart rate, dry eyes, loss of balance, anxiety, adrenal fatigue, difficulty regulating blood-sugar levels, and I didn’t sweat for years after I was hurt by ciprofloxacin.

Most of my ANS dysfunction symptoms, along with all my other fluoroquinolone toxicity symptoms, have improved.

The thing that helped to improve my digestive motility most was supplementing hydrochloric acid (HCL). I think that probiotic supplements and foods, meditation, and time also helped to heal my digestive tract.

A Chinese herbal supplement called suxiao jiuxin wan helped to calm my racing heart. I think that acupuncture, stress reduction, and time also helped.

I can’t pinpoint anything specific that cured my dry eyes, inability to sweat, or loss of balance, but those symptoms have all subsided with time.

Anxiety is common among “floxies,” and it can be severe. The post, Treating Fluoroquinolone Anxiety, goes over some suggestions as to how to deal with it. Magnesium and uridine supplements helped me to get through fluoroquinolone-induced anxiety, and those supplements have helped others too. In addition to reading Treating Fluoroquinolone Anxiety, I also suggest reading some of the recovery stories from people who have recovered from fluoroquinolone toxicity anxiety, especially Marcela’s Story, Ruth’s Story, and Nick’s Story.

I still struggle with adrenal fatigue and difficulty regulating my blood-sugar. I tend to feel better when I reduce my stress levels, avoid caffeine, avoid alcohol, and cut out sugar. I’m imperfect about those things though.

ANS dysfunction, and the diseases associated with it (fluoroquinolone toxicity, as well as POTS, EDS, MCAS/MCAD, etc.) are serious, and often the symptoms of these diseases are severe and life-altering. They are not trivial, and there is no easy or simple “cure” for ANS dysfunction or any related diseases.

With the severity of ANS dysfunction and related diseases noted, I’m going to make a suggestion that I hope doesn’t seem too trite:

Love, connection, community, laughter, and peace can all help to heal the autonomic nervous system. Meditation and breathing exercises are helpful too. Anything that you can do to bring love, connection, community, laughter, and peace into your life will be helpful in healing your autonomic nervous system.

Before you accuse me of being too hippy-dippy, hear me out on the logic behind suggesting that love and peace are healing. When you are stressed, or when you feel unsafe or threatened, your sympathetic nervous system–the fight-or-flight system–is activated, and subsequently, your digestive system shuts down, you either sweat profusely or stop sweating, your heart races, your breathing becomes shallow, etc. You have an acute moment of ANS dysfunction. For most people, this situation resolves itself as soon as the stressful moment passes, and the parasympathetic nervous system is re-activated. However, people with ANS dysfunction (whether it is caused by fluoroquinolone toxicity, POTS, EDS, MCAS/MCAD, or something else), get “stuck” in a state of sympathetic nervous system activation and parasympathetic nervous system disengagement. Love, connection, safety, community, laughter, peace, meditation, and more, activate the parasympathetic nervous system, and shut off the sympathetic nervous system that is shutting down your ability to digest food, have sex, see clearly, etc. Activation of the parasympathetic nervous system helps to relieve symptoms of sympathetic nervous system overdrive, and helps to relieve symptoms of ANS dysfunction.

Exercises and practices that activate and heal the vagus nerve–the long nerve that connects your brain to your digestive tract and various organs, and controls your autonomic nervous system–can also help to heal your ANS, and relieve symptoms of ANS dysfunction. The post, Hacking Fluoroquinolone Toxicity via the Nervous System, goes over the connections between the vagus nerve and fluoroquinolone toxicity, and the post, 32 Ways to Stimulate Your Vagus Nerve (and Symptoms of Vagal Dysfunction), goes over some ways that you can stimulate your vagus nerve, which activates the parasympathetic nervous system, and reduces symptoms of ANS dysfunction. Love, laughter, connection, breathing exercises, acupuncture, etc. help to activate and stimulate the vagus nerve.

ANS dysfunction is complex, and it is not an easy thing to fix or “cure,” and I hope that my suggestion of love and stress-reduction as helpful in symptom alleviation isn’t seen as trite or dismissive.

I wish that ANS dysfunction, and the symptoms associated with it, were more acknowledged as symptoms of fluoroquinolone toxicity. They are serious, severe, and cause significant pain and suffering. Even though I am suggesting that peace, love, and meditation are helpful (they are), they are not simple cures that can be implemented in a short period of time. They are processes and practices, and despite doing their best to meditate regularly, love heartily, etc. many people are still very ill with fluoroquinolone toxicity, and other ANS dysfunction diseases. Neither peace nor love are cures for multi-symptom, chronic, illnesses like fluoroquinolone toxicity. Of course love and stress-reduction are helpful, but they’re not cures. We need more cures… and love… and acknowledgement.

 

 

Fluoroquinolone Toxicity Article – Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications

I’m so excited to share this article, “Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications” by Krzysztof Michalak, Aleksandra Sobolewska-Wlodarczyk, Marcin Włodarczyk, Justyna Sobolewska, Piotr Woźniak, and Bogusław Sobolewski, with you! It is the first article of its kind that I’ve seen. While there are thousands of articles about fluoroquinolones, many of which focus on the damaging effects of fluoroquinolones, and many case-studies that note the adverse-effects of fluoroquinolones (hundreds of articles about fluoroquinolones are linked HERE), this is the first article that acknowledges that fluoroquinolone toxicity (referred to as both Fluoroquinolone Associated Disability (FQAD) and fluoroquinolone toxicity throughout the article) is a disabling syndrome, that also goes over the mechanisms by which fluoroquinolones can cause fluoroquinolone toxicity/FQAD, and even gives recommendations on how to treat fluoroquinolone toxicity/FQAD (while also acknowledging that there are no cures or verified treatments). The article even calls for more extensive research to be done into fluoroquinolone toxicity, and the various mechanisms through which fluoroquinolones hurt people.

It is an enlightening article, and I encourage you to print it out and give it to your doctors, family members, and anyone else who is interested in what fluoroquinolones do and how they hurt people. In this post, I’m going to go over some highlights from the article, but I recommend that you read it yourself (you can access it through THIS LINK, after clicking on the “provisional pdf” link).

The first paragraph of the abstract to the article states:

“Long term Fluoroquinolone Associated Disability (FQAD) after fluoroquinolone (FQ) antibiotic therapy appears in recent years a significant medical and social problem, because patients suffer for many years after prescribed antimicrobial FQ-treatment from tiredness, concentration problems, neuropathies, tendinopathies and other symptoms. The knowledge about the molecular activity of FQs in the cells remains unclear in many details. The effective treatment of this chronic state remains difficult and not effective. The current paper reviews the pathobiochemical properties of FQs, hints the directions for further research and reviews the research concerning the proposed treatment of patients.”

To see that in writing, in an academic article, is incredibly validating.

Adverse Effects of Fluoroquinolones

Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications, goes over the documented effects of fluoroquinolones. For tendinopathies and tendon ruptures, researchers have found that:

“FQs are associated with an increased risk of tendinitis and tendon rupture. This risk is further increased in those over age 60, in kidney, heart, and lung transplant recipients, and with use of concomitant steroid therapy.”

Fluoroquinolones cause neurotoxicity, as well as central and peripheral nervous system ailments:

“Taking FQs is associated with their neurotoxicity, as well [5-8]. The main symptoms being correlated to FQ treatment include insomnia, restlessness, and rarely, seizure, convulsions, and psychosis [9-11]. Many reports point to chronic persistent peripheral neuropathy to be generated by FQs [12-18]. Cohen et al. [19] showed that a possible association between FQ and severe, long-term adverse effects involving the peripheral nervous system as well as other organ systems are observed.

Fluoroquinolones also cause cardiotoxicity and an elongation of the QT interval, as well as hepatotoxicity and nephrotoxicity. Fluoroquinolone use has even been linked to type-2 diabetes onset.

Fluoroquinolone toxicity / FQAD is a multi-symptom, chronic illness that affects all body systems. Fluoroquinolones deleteriously affect every muscle, tendon, ligament, nerve, and even bone, in the body. They damage every cell in the body.

Fluoroquinolone Damage Mechanisms

Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications, notes the various mechanisms by which fluoroquinolones cause cellular (mitochondrial) damage, including oxidative stress, and the downstream effects of oxidative stress, including disruptions in the mitochondrial Permeability Transition Pore (PTP) (and the article authors state, “The influence of FQs on the detailed regulation of PTP is the urgent topic for further research.”), Calcium and magnesium homeostasis, lowered ATP production, and more.

Here is a diagram of the mechanisms of fluoroquinolone toxicity (published in the article):

Figure 2. The main ways of FQ toxicity. The positive regulatory loops magnifying the toxicity of FQs are marked with ‘+’. The ‘?’ signs denote the possible but not confirmed effects of FQ toxicity.

The article also notes the epigenetic effects of fluoroquinolones and oxidative stress:

“Beside OS (oxidative stress), epigenetic effects of FQs are of high importance, as well. The epigenetic effects may depend on the methylation of DNA and/or histones, however, ROS contribute also to epigenetic changes [42]. Some authors point also to the similarity of bacterial and mitochondrial DNA, both existing in circular super-twisted helices and gyrase-like enzymes being postulated to be responsible for the organization of mitochondrial DNA, suggesting the possible direct effect of FQs to mitochondrial DNA leading to the disturbed mitochondria regeneration and division [43, 44]. The changes in the cytoskeleton were observed also after FQ treatment [45] and cytoskeleton has been demonstrated to be strictly connected with energy dissipation and organization in mitochondria [46-49].”

Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications, also notes that fluoroquinolones chelate various minerals and metals. The article notes that, “Seedher’s results indicate that chelation formation with bivalent metals can cause significant alterations in the human serum-FQ binding affinity.” The article also describes how fluoroquinolones chelate iron, zinc, magnesium, and other minerals, and how this chelation can have enzymatic and even epigenetic adverse effects.

Fluoroquinolones are GABA antagonists, and the effects of fluoroquinolones are similar to those of benzodiazepine withdrawal. The authors of Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications, describe a potential mechanism through which GABA is depleted by fluoroquinolones:

“One of the proteins which can support PTP opening is Translator Protein (TSPO), called also peripheral-type benzodiazepine receptor or isoquinoline binding protein. TSPO is predominantly located on the surface of the mitochondria where it is postulated to physically associate with VDAC-ANT. It has been suggested that TSPO may activate PTP opening, causing ∆Ψm reduction and leading to apoptosis [80, 81]. Some authors suggest that epileptogenic activity of FQs possibly relates to GABA-like structure of some FQs which may allow them to act as GABA antagonists [82, 83]. Since TSPO is also a benzodiazepine receptor, similar interaction may maybe also take place between FQs and TSPO leading to opening PTP.”

I have always wondered how GABA inhibition is connected to mitochondrial destruction. The article excerpt above answers that question for me.

Fluoroquinolones can lead to chronic illness and permanent disability, which has led many people to question whether or not they remain in the body for an extended period of time (or, if they do damage while they’re in the body that continues long after the drug has left the body). The authors of Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications note that:

“The other important feature of FQs has been presented by V.T. Andrioleet al. [55]. Namely, they estimated the minimum solubility of FQs in neutral pH. They pointed that this class of molecules is characterized by very high melting point, generally >200°C, which indicates that the crystal forms are very stable. All these FQ features strongly support the thesis that FQs can survive in the cell for a long time contributing to chronic, long-term adverse reaction in patients treated with FQs. The question, to what extent takes this phenomenon place and if it contributes to chronic symptoms of FQAD, remains unclear.”

It is acknowledged throughout the article that it is unknown whether or not fluoroquinolones stay in the body for an extended period of time. It is possible, through the mechanism noted above, but no hypotheses about fluoroquinolones remaining in the body after they “should” have been metabolized and fully excreted, have been explored. It’s both possible that they remain in cells, and that they don’t – no one really knows.

The article authors repeatedly call for additional research into the various mechanisms by which fluoroquinolones lead to pain, disability, and chronic illness:

“Summing up, the number of enzymes possessing reduced activity due to their ion-cofactor chelation is probably long and it is the important topic for further research. The separate problem consists the chronicity of ion-chelation by FQs. The presented research does not describe the chronic state of FQAD but the phenomena taking place during FQ application. It must be analyzed, to which degree persistent ion chelation takes place at FQAD patients.”

Fluoroquinolone Toxicity Treatment

Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications is the first article I’ve seen that discusses the treatment of fluoroquinolone toxicity as a multi-symptom, chronic illness. The authors note that the first step in approaching a treatment is to discover why fluoroquinolones are causing chronic illness in the first place. Effective treatment, of course, depends on effective identification of the problem. With that noted, the article authors have enough knowledge to make a few suggestions:

“Until detailed knowledge concerning FQ toxicity would be recognized, the following directions in supporting FQAD patients are proposed according to the known and probable mechanisms of FQ toxicity: A. reduction of the oxidative stress; B. restoring reduced mitochondrial potential ∆Ψm; C. supplementation of uni- and bivalent cations that are chelated by FQs;D. supporting the mitochondrial replication in the cell – pulling the more destroyed to apoptosis and proliferation of the more healthy ones; E. removing FQs permanently accumulated in the cells (if this phenomenon takes place); F. regulating the disturbed epigenetics and enzyme activities”

The article authors note that antioxidant supplementation is a broad topic and that fixing the damage done by fluoroquinolones and oxidative stress is not as simple as just ingesting an antioxidant pill. However, antioxidant supplements that specifically target the mitochondria have shown some promising results:

“The antioxidants which enter easily the mitochondria are the most interesting ones. Lowes et al. [79] shows that the mitochondria targeted antioxidant MitoQ protects against fluoroquinolone-induced oxidative stress and mitochondrial membrane damage in human Achilles tendon cells. In cells treated with MitoQ the oxidative stress was lower and mitochondrial membrane potential was maintained.”

Other antioxidants have also had promising results in repairing fluoroquinolone treated cells. Some of the antioxidants with promising results include N-acetylcysteine, resveratrol, as well as Vitamins C and E. Supplementation of the trace minerals that are important cofactors for antioxidants is also important.

Conclusion

I greatly appreciate the authors of Treatment of the Fluoroquinolone Associated Disability – the pathobiochemical implications. They approach fluoroquinolone toxicity/FQAD as a complex and multifaceted illness. It IS a complex and multifaceted illness, and it is refreshing to read an article that doesn’t over-simplify or downplay the illness. I also appreciate the exploration of what is currently known about fluoroquinolone toxicity/FQAD, and the assertions that more research into fluoroquinolone toxicity is needed (it is!). I think that everyone who is going through fluoroquinolone toxicity/FQAD should read it, and share it as widely as possible.