According to the wikipedia entry for oxalobacter formigenes, “Quinolone, a broad-spectrum antibiotic, kills O. formigenes. If a person’s gastrointestinal (GI) tract lacks this bacterium, and therefore lacks the primary source for the oxalyl-CoA decarboxylase enzyme, then the GI tract cannot degrade dietary oxalates which on digestion get absorbed easily and after some vitamin B6-modulated partial metabolical degradation in the body, is excreted in the kidney, where it precipitates with calcium to form calcium oxalate kidney stones.”
Basically, this means that quinolones (and some other antibiotics) kill oxalobacter formigenes, a bacteria in the GI tract that is crucial for breaking down oxalates. When oxalates aren’t broken down properly in the GI tract, they move on to the kidneys where they form calcium oxalate kidney stones.
Kidney stones aren’t the only problems that oxalates cause though. Oxalates cause methylation problems that inhibit detoxification. According to Dr. Rostenberg’s article, OXALATES AND MTHFR: UNDERSTANDING THE GUT-KIDNEY AXIS:
“oxalates create biochemical problems that make methylation issues worse. Since oxalate problems cause sulfate problems, the genes most effected will be the SULT and other phase II related pathways. The sulfate molecule is key in order for the liver to perform the daily task of detoxification. If sulfate levels drop, then the body cannot use the SULT pathway to detoxify. Instead it will be forced to use other Phase II pathways which can put greater demand on pathways that are also genetically slowed down. When we consider other slowed Phase II detoxification gene SNPs such as NAT2, ALDH, COMT, GSH, GSS, UGT, and SOUX we can begin to see that a lack of sulfate molecules can have a broad negative impact on all of our detoxification pathways.”
Dr. Rostenberg goes on to say:
“As you will soon see, when oxalate levels are high, sulfate levels drop slowing down detoxification. Low sulfate levels put extra stress into the methylation cycle to provide the body with sulfate molecules. In individuals with an impaired methylation cycle this can provoke methylation issues such as high homocysteine, developmental disorders, gallbladder dysfunction, hormone imbalances, excess inflammation, poor growth and to name but a few. So with oxalate issues and the biochemical chaos it creates, a great deal of stress is placed on the methylation cycle.”
In OXALATES AND MTHFR: UNDERSTANDING THE GUT-KIDNEY AXIS Dr. Rostenberg asserts that a poorly functioning gallbladder is a cause of oxalate overload. While I agree that a well-functioning gallbladder and liver are necessary for all aspects of health, I wonder if the decimation of vital gut bacteria, like oxalobacter formigenes, by antibiotics like fluoroquinolones, is what starts oxalate toxicity damage.
Fluoroquinolone Destruction of Vital Gut Microbes
A floxie friend just noted that she got her microbiome mapped by ubiome and, “my Ubiome results tell me I have NO oxalobacter at all.” Additionally, her results showed that, “I also have NO bifidobacterium strains AT ALL.” (According to the wikipedia article for bifidobacterium, “Different species and/or strains of bifidobacteria may exert a range of beneficial health effects, including the regulation of intestinal microbial homeostasis, the inhibition of pathogens and harmful bacteria that colonize and/or infect the gut mucosa, the modulation of local and systemic immune responses, the repression of procarcinogenic enzymatic activities within the microbiota, the production of vitamins, and the bioconversion of a number of dietary compounds into bioactive molecules.”) Both oxalobacter and bifidobacerium are necessary for many aspects of health.
Might the root of fluoroquinolone toxicity, and possibly other chronic diseases of modernity, be the killing off vital microbes like oxalobacter and bifidobacerium?
Oxalate Overload
The depletion of oxalobacter formigenes, and other microbes, doesn’t just affect the gut. As Dr. Rostenberg noted above, oxalate problems (caused by not breaking down oxalates in the gut – caused, in part, by killing oxalobacter formigenes with antibiotics) lead to sulfate problems, which leads to methylation problems, which leads to detoxification problems, which leads to heavy metal overload and toxicity. Additionally, “Sulfate helps us seal our leaky gut and strengthen our body’s bones, ligaments and tendons; and it is required for Phase II detoxification of all kinds of nasty toxins, hormones and heavy metals. In fact, sulfate is so important for our health that it is the 4th most common nutrient in our blood stream!” (source) Sulfate is also necessary for proper hormonal function, “When sulfate levels are low, the body won’t just have disturbed liver function, it will also suffer with all kinds of hormone problems.” (source) As anyone who has experienced hormonal dysfunction will attest, hormonal disorders affect every aspect of health. In “Fluoroquinolone Antibiotics and Thyroid Problems: Is there a Connection?” it is noted that fluoroquinolones are endocrine disruptors that lead to disruption of thyroid function, and additional information about the effects of fluoroquinolones on the thyroid can be found on http://fluoroquinolonethyroid.com/.
The most thoroughly documented and accepted consequence of oxalate overload is kidney-stones. Kidney-stones are incredibly painful, and they can cause damage to the kidneys. In addition to kidney-stones, it is noted in The Role of Oxalates in Autism and Chronic Disorders that, “Even though oxalate crystals are most common in the kidney, they also can form in virtually any other tissue in the body, including the brain and the blood-brain barrier. Oxalate crystals resembling pieces of glass can form in the heart muscle. As the heart muscle contracts, these pieces of oxalate crystals actually tear into the tissue. If these crystals are deposited in skeletal muscle, normal movement and exercise can be very painful. I’m convinced this is also one of the factors responsible for fibromyalgia. Oxalates may also cause thyroid disease as they react in thyroid tissue.”
In THE DOWN SIDE TO HIGH OXALATES – PROBLEMS WITH SULFATE, B6, GUT, AND METHYLATION, Dr. Rostenberg goes over the connections between oxalates, sulfate depletion (by oxalates), and liver problems, hormonal problems, GI problems including leaky gut, cancer, and autism. Additionally, it’s linked to high homocysteine which is linked to blood clots, strokes, and heart attacks.
Fluoroquinolones and Oxalates
There are literally twenty plausible theories as to how fluoroquinolones cause fluoroquinolone toxicity—a multi-symptom, often chronic, illness that is similar to autoimmune diseases, mysterious diseases like fibromyalgia and CFS/ME, endocrine disruption diseases, and more. Though much of the research into fluoroquinolone toxicity has focused on what fluoroquinolones do to cells (especially mitochondria), as information about the importance of the microbiome emerges, it becomes plausible (and even likely) that the destruction of important microbes by fluoroquinolones is a large contributor to fluoroquinolone toxicity.
In Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues Dr. Martin J. Blaser hypothesizes that the extinction of critical microbes is behind many of the diseases of modernity, from autoimmune diseases to obesity. Dr. Blaser focuses primarily on h. pylori and its connection with both preventing inflammation and causing ulcers, but he acknowledges that many other microbes play important roles in human health and well-being. I wonder if oxalobacter formigenes and other microbial communities are just as interesting, contradictory, and important as h. pylori. I suspect so, and I also suspect that the basic hypothesis that missing microbes (from antibiotic use, glyphosate, and the Western diet) are causing the many diseases of modernity, is, indeed, true.
Fluoroquinolones obliterate the gut, and kill both helpful and harmful bacteria. In wiping out essential species of bacteria in our gut, are they starting the cycle of inflammation and chronic disease in genetically susceptible individuals? It certainly sounds like a reasonably hypothesis to me.
Can the gut be healed?
Can species of bacteria that have been depleted by fluoroquinolone antibiotics be replenished? Do probiotic supplements help? Can changing one’s diet help? What about fecal transplants?
Those are all million dollar questions that many researchers are working on answering. Unfortunately, I don’t know the answers to them. I am certainly hopeful that the gut can be healed, and I know from personal experience that healing after fluoroquinolone antibiotic toxicity can occur. Organizations like The Human Microbiome Project and Ubiome have many smart and capable scientists who are working to answer those questions, and more.
Until those questions can be more thoroughly answered, here are some helpful resources:
Resources for Healing
Trying Low Oxalates Facebook Group – https://www.facebook.com/groups/TryingLowOxalates/
Information about a low-oxalate diet can be found on Low Oxalate Info: Hope and Healing on the Low Oxalate Diet.
Dr. Rostenberg’s protocol for reducing oxalates can also be found here – http://www.beyondmthfr.com/high-oxalates/. Additional information from Dr. Rostenberg can be found through the Contact page on http://www.beyondmthfr.com/.
Additional information about MTHFR and other gene mutations, and how they affect health, can be found on https://mthfrsupport.com/.
If you would like to get your microbiome sequenced through Ubiome, here is a 10% off link – http://ubiome.refr.cc/VDDLNWP .
Dr. Rostenberg’s videos on oxalates:
Fantastic Post! Very helpful!
I would like to invite those who are interested in finding out the practicalities of how to reduce oxalate to join our Yahoogroup, Trying_Low_Oxalates@yahoogroups.com which has been exploring the use of the low oxalate diet and other ways to reduce oxalate for eleven years and it has 16,000 members.
We also have a facebook group which has 6,000 members by the same name. In these groups, since 2005,we sought to find those who have conditions where the science on oxalate took us.
We confirmed that reducing oxalate has helped dozens of conditions that previously were not understood to be related to elevated oxalate. Readers can listen to an interview where we discussed those conditions with Dr. Neil Nathan at the following link: .http://www.gordonmedical.com/unravelling-complex-chronic-illness/the-importance-of-oxalates-in-health/
Beginning about a dozen years ago, after networking with the major scientists leading the oxalate field at many international conferences, I discovered that these leaders were not acquainted with the basic science work that Dr. Rostenberg has found recently and Dr. Rostenberg is doing a really great job explaining the science to others.
This work on oxalate began really with the Mind of a Child Conference in 2001, with a tailor picked group of scientists there studying the implications of how new findings on sulfate transport would impact health in children, especially those with autism spectrum disorders. Only later did new basic science work discover that oxalate also travels on a whole family of sulfate tranporters all over the body.
Understanding the implications of these new discoveries, our oxalate project formally began in 2005, and until then scientists absolutely did not believe that, outside kidney stone disease, that anyone would be high enough in oxalate to disturb their body chemistry. It has taken our project’s work over the last decade with 22,000 people to learn how many people with dozens of conditions where oxalate was never previously measured, were also elevated in oxalate. With this many people, we learned what conditions improve by reducing oxalate and why.
We learned that it is critical that oxalate is reduced very slowly to prevent adverse reactions that occur because the body may suddenly release oxalate from places in the body where it stores, even if that storage happened over a lifetime. This released oxalate can be far more toxic than it was when it first entered the body, because the quantity can be much larger, a truth we learned from hyperoxaluria literature.
Our project has recently begun exploring the links between oxalate and the autoimmune condition, which began with our article on celiac disease, which was originally published in the Journal of Gluten Sensitivity, and can be read here: http://www.celiac.com/articles/24052/1/What-is-the-Relationship-Between-Oxalate-and-Celiac-Disease/Page1.html.
More recently, we began conducting a poll of our membership, and have learned of improvements in more than a hundred people that occurred in 19 different autoimmune conditions by listmates who reduced oxalate following our guidelines, We’ve been invited to present these results in a major journal.
Also, working with a group of scientists in Poland, we confirmed the relationship between being high in oxalate and the diagnosis of autism, in a paper published a few years ago in the European Journal of Paediatric Neurology. That paper can be read here:http://usautism.org/content/PDF_files_newsletters/oxalate_and_autism.pdf
This is a very exciting area, but we urge people to link up with our support groups where you will find highly experienced people who have unmatched skill in dealing with the complexities that occur as people reduce oxalate and discover this is a key to returning their health.
Like the fluoroquinolones, I personally took an antibiotic called chloramphenicol in 1967, that also kills oxalobacter formigenes. Four months later, I was diagnosed with idiopathic thrombocytopenia purpura and it worsened into aplastic anemia, and I was soon found to be in bone marrow failure. At the time I was a big spinach eater, but it was only decades later that scientists found that oxalate getting into bone marrow can produce the same changes to bone marrow that almost ended my life. Obviously, this doesn’t happen to everyone elevated in oxalate, so there are other risk factors, and our project has been trying to identify what genetic risks there are that makes oxalate express its toxicity in different ways in different organ systems. We’ve investigated the genetics so far in more than a hundred people, looking at mutations, not polymorphisms. I’ve also personally been working for years at trying to raise awareness of this danger from antibiotics among scientists who may be in a better position to change medical policy. I am sorry if this mechanism proved destructive to others reading here, as it did me! My 92 year old mother was also a victim of Cipro and has been in ICU recently and was given yet another antibiotic that kills oxalobacter! At least, right now, she doesn’t get oxalate from her diet and it wasn’t a fluoroquinolone.
The only reason I don’t cry much is cause of my Family. And last night I was making my lengthy story to tell, and I lost it twice. The first one was long and detailed. Either way, I see now why my gut was wrecked after at least 5× of Levaquin 750s, and why my kidneys/everything related hurts so bad. A few years ago I had pre-cancer tissue cut out of my intestine. Cecil serrated adenoma I believe it is called. I probably was passing stones and didn’t go in about it because I was too busy dieing. I take lemon water, ginger, turmeric and crushed garlic. Also we recently had an email sent about mushroom roots compiled from many types into a form to take for great health benifets. Sorry so long on the message. This was supposed to just be a big Thank You so, Thaaaaaaaank Yall a bunch for Your compilations. I do Love You for what You and the rest do, and also for who You are. Your nature surely is counted up by God. I wish, after a prayer early morning in Boise resulted with a sense of one hundred angels hugging me years ago, could be transfered to You and such as Yourself. Much Spirit to You and power. Too bad it is’not occurring more often to take over the evils of drugs. God has already provided, including You. Good day and appreciation level is high.
The problem doesn’t just lie in the destruction of gut flora by Fluoroquinolones. That is done by any and all antibiotics. The worst part of Fluoroquinolones, is that they destroy tendons and ligaments in the body and can cause lifelong pain, so excruciating that it can and has driven some to suicide. These Fluoroquinolones also cross the blood brain barrier and cause dementia. I for one, came in contact with Fluoroquinolone, twice and both times suffered Pelvic Prolapse (damage to ligaments). Long story short, this crap has caused me to endure pain and suffering and two surgeries, to repair the damage. There is a law suit against Fluoroquinolones at this time. This garbage needs to be taken off the market.
You might want to try this probiotic: http://www.generalbiotics.com/
I’m not sure if it contains oxalobacter, but it just might because it contains 115 strains.
Also their customer support is very responsive, and even though they don’t publish all of their strains (trade secrets) I’m sure they wouldn’t mind confirming if one strain or another was in there.
I personally take it and find it excellent.
I also do not believe that it is impossible to fix the gut once damaged by antibiotics. It might take time though, as you try to introduce missing strains, they have to compete and balance out with the strains you have already.
There is also: http://www.elixa-probiotic.com/. It has fewer strains but is very well encapsulated.
I bookmarked the links here and checked them out. Sounds like a good source. Also mycoultra.Com about mushroom roots is good and also tolweb.org for Legume root nodules regarding good bacteria also. I have been taking roots already and it is helping. Ginger, garlic, and turmeric root. Also lemon water has helped flush out my statement for years. I feel these about saved my life as I was down to a crawl. Going to check out the probiotics. Power to all here.
Reblogged this on Lee's Stuff and commented:
Good article oxalates can prevent healing.