95 replies to this topic

[Centurion]

http://www.cumc.colu...7/mid/mid22.pdf

"Active Efflux System: low level of resistance is acquired by the induction of
efflux pumps to remove quinolones from the cell. Present in Gram +/-"

Certain bacteria (both gram neg and pos) use efflux pumps to remove quinolones from cells. This may be of interest. Im not saying im going to seek out the necessary bacteria and then deliberately infect myself, but this may be worth looking into further.

Why would bacterial resistance to quinolones be of interest? The efflux pumps expel the quinolone from the bacteria's cell, not your own cells. Has no implications for humans aside from the fact that your infection won't go away if you attempt to treat a resistant strain with a quinolone.

My head is a monumental mess today. I have no idea what I was thinking at the time! Cheers for the reality check Funk

[Centurion]

I was told by a pharmacist that loratadine 10mg can counteract cipro toxicity. Ive been on loratadine for a few weeks now because its hayfever season, this does not seem to be the case. Any literature I have read also does not support this

[Centurion]

Had my first night of CNS related symptoms last night. Awakening every hour or so, trembles, extreme nervousness. Luckily my melatonin should be arriving by saturday and I should have my melanotan by early July. With those added my regimen for the month of July will stand at (will ensure correct dosages listed this evening)

Magnesium - 500mg daily
Megga Cissus 50% ketosterone - 4 pills before bed
Vitamin B12
Vitamin C
Lutein
Melatonin 3mg sublingual before bed
Glucosamine / MSM / Chondroiton complex
Fish Oil Capsules
Melanotan subcut injections - 0.25mg per day just before bed
Bromelain - taken as needed (vasoconstrictive effects may cause problems with nerves)
Vitamin E - 2400iu along with fish oil
Acidophillus - 250mg daily

I will hold at this for a month and see if there is any reduction in symptoms.

[VespeneGas]

Had my first night of CNS related symptoms last night. Awakening every hour or so, trembles, extreme nervousness. Luckily my melatonin should be arriving by saturday and I should have my melanotan by early July. With those added my regimen for the month of July will stand at (will ensure correct dosages listed this evening)

Magnesium - 500mg daily
Megga Cissus 50% ketosterone - 4 pills before bed
Vitamin B12
Vitamin C
Lutein
Melatonin 3mg sublingual before bed
Glucosamine / MSM / Chondroiton complex
Fish Oil Capsules
Melanotan subcut injections - 0.25mg per day just before bed
Bromelain - taken as needed (vasoconstrictive effects may cause problems with nerves)
Vitamin E - 2400iu along with fish oil
Acidophillus - 250mg daily

I will hold at this for a month and see if there is any reduction in symptoms.

If you've looked into the side effects of melanotan II, you'll notice that it's alerting (it's a 5-HT2C agonist, which is the opposite effect of trazodone [my sleep med] and agomelatine, another sleep-promoting antidepressant). Probably best to dose the melanotan in the morning or afternoon.

hmmm, wikipedia and this say that trazodone antagonize 5-ht2c receptors, while this says that it's a potent agonist. I think the latter is wrong, highly unusual to see flagrantly wrong information in academic abstracts. Disturbing.

Also, that's a crap-ton of vitamin E. I wouldn't ingest that much, but YMMV.

I've just started biosil today on niner's recommendation. Also, several of my tendons seem to have recovered some function. Won't dismiss the possibility that I'm just cycling, but I'll take any indication of improvement with as much hope as I can.

Good luck!
VG

PS - whatever you do, don't turn to GABA(A) agonists (ambien, lunesta, even stuff like ashwagandha or valerian) for sleep, no matter how tempting. Every pill of ambien I ingested noticeably set me back on the road to recovery by tricking my receptors into 'thinking everything is fine', i.e. re-downregulating. If you must, take phenibut (only occasionally) for sleep, it helps, and is more of a ligand for GABA(B) receptors, which are unrelated to cipro toxicity. Trazodone has also helped WRT sleep.

[Centurion]

Good plan. Others have recommended to take an antihistimine 45 mins prior to MTII administration, however I have my suspicions antihistimines are bad news in our case.
The crap-ton of vitamin E is just to "load" or essentially saturate my fat deposits. Ill take that for a month or so and then drop down to 800iu for maintenance.

I need to find a good UK source for biosil, once I do i'll be on it also.

Thanks for the heads up on the GABA(A) agonists, I will avoid them.

How many months in are you now?

[Centurion]

Matt, VespeneGas, did either of you guys ever get a strange tingling feeling inside your joints? Or an odd chilled feeling, like theres cold water pouring through them? Odd I know but ive been getting it a lot

[Matt]

Not that I remember. I did get occasional very intense sharp pains in my knees for no obvious reason. Then about 13 months out developed tendon problem on my left knee. Luckily it seems I might have escaped the arthritis, and I also never experienced and clicking or popping of the joints that almost every person who is floxed gets.

I dont remember what you're describing though sorry.

[Centurion]

No probs Matt. I have clicking and popping however, I have always had that even long before cipro. The stiffness in the legs and general knee pain are rather concerning though, given how disruptive loss of knee function would be.

Did you notice a gradual buildup to those tendon problems or was there a sudden onset?

Im not even a month out yet so things could get either better or worse from here onward. Im really hoping the former though

[Centurion]

Incidentally one symptom I am yet to notice (and obviously hope I dont) is impairment of caffeine clearance :-)

[Centurion]

Additional supplement - KRALA - Potassium R-AlphaLipoic Acid. Potent mitochondrial, brain and nerve cell antioxidant. This will replace my usage of regular alpha lipoic acid. Stacked with melatonin and melanotan II I should be getting some serious nerve protection here.

[Centurion]

I appear to have entered my first cycle.
Connective tissue problems have dulled somewhat and given way to CNS symptoms today. Headache, shakeyness, internal tremors, not entirely unlike a hangover, except I didn't even drink last night!

I have been taking many supps to combat connective tissue issues, but very few as yet for CNS / nerve issues. Luckily CNS supps are on the way. Melatonin, Melanotan II, K-RALA ought to fight the tide somewhat.

Matt - whats your take on drinking - absolute no no? My girlfriend drinks and its pretty much the only circumstance under which we spend time together, perhaps I should keep it to the soft drinks for a while?

[Centurion]

My doctor has recommended I come in for a blood test to have IGG and IGE measured. While this is supported as an indicator of quinolone reactions in some literature, I'm uncertain what purpose it will serve?

[VespeneGas]

This may seem obvious, but I thought it was worth posting:

High Dose Vitamin C Supplementation Accelerates the Achilles Tendon Healing in Healthy Rats

Archives of Orthopaedic and Trauma Surgery

Abstract Introduction: This experimental study was performed to assess, whether or not, vitamin C, required during the collagen synthesis, would influence the Achilles tendon healing in a healthy rat model. Materials and methods: The right Achilles tendons of 42 healthy female Wistar Albino rats were completely ruptured. The rats were randomly divided into the vitamin C and control groups and both groups included third, tenth and twenty-first day subgroups. One hundred and fifty milligrams (1.5 cc) of vitamin C and 1.5 cc % 0.9 NaCl were injected once for every 2 days for the vitamin C and control groups, respectively. Qualitative and quantitative microscopic comparisons of the repair tissues of both groups were made on the mentioned days. Results: Angiogenesis was more evident on the third day in the vitamin C group. There was a significant difference between the control and vitamin C groups regarding the type I collagen production on the tenth day. The structure of the repair tissue was almost in the form of regular dense connective tissue at the end of twenty-first day in the vitamin C group. Mean collagen fiber diameter was considerably higher, and the number of active fibroblasts in the repair tissue was slightly elevated in the vitamin C group during the entire healing process. Conclusion: High-dose vitamin C supplementation once for every 2 days has stimulating effects on the Achilles tendon healing because of early angiogenesis and increased collagen synthesis in a healthy rat model. Further studies are needed to make clear the mentioned encouraging effects of the vitamin C on the Achilles tendon healing.
edit: formatting issues.

Edited by VespeneGas, 01 July 2009 - 07:25 PM.

[Centurion]

One Month Update -

Fatigue has improved considerably, as has sleeping - I suspect I never actually had proper insomnia, its been extremely warm here lately and everyones had trouble adjusting, leaving the window open at night seems to help ;-)
I slept last night with 3mg melatonin from 12-6

Joint pains and stiffness have reduced markedly however have not disappeared altogether.

Headaches are pretty much a thing of the past

No caffeine or drug intolerance as yet observed.

I seem to be able to tolerate alcohol reasonably enough, I went out on Friday and Saturday nights - seemed quite reasonable, no major hangover followed on Sunday, however today I do feel slightly rubbery - Ill not be going on a binge any time soon.

One predominant and remaining symptom is an all over itchy skin, which reddens for quite a while when scratched. this is literally all over the body. Have noticed the occasional raised hive-like lump.

Also for a few days (thursday, friday) one of my lymph nodes in the neck was quite swollen - no idea why.

Im hoping the above represents a genuine linear improvement - otherwise I may be cycling.

[Centurion]

One month update cont: body composition

A few weeks pre floxing - my lean mass 136.59 and my fat mass 37.41 (lbs)
As of today - my lean mass 136.61 and my fat mass 30.39

That is a slight gain in muscle mass of <.1lb - which can basically be ignored, its not large enough to be considered significant and could be gone tomorrow. The loss of fat of 7lbs (almost half a stone) however is significant and is probably due to my recent loss of appetite and lack of interest in my previous diet of fat rich meaty foods.

I can only hope I do not experience neuropathy induced muscle loss, so far while it is early, the evidence seems to suggest this is not the case.

[VespeneGas]

heh, I've lost thirteen pounds of lean mass since getting floxed, simply because I can't lift anymore. 6'1", 168 in december, 155 now, still like 10% body fat. I'm a scrawny looking MFer these days :O

Hope your improvement is genuine and not transient! I'm still quite dependent on trazodone to get quality sleep, and I still can't work out. At least I can still drink alcohol

[Centurion]

Bro 155lbs is pretty crazy for your height! Do you have a slim frame? Im 5ft 7 but quite big boned (i.e. wide)

Think of it as a great big cutting phase bro.
You will lift again. I dunno if the body can recreate lost motor nerves linking to your muscle, but the body is a resilient system.

I have a certain amount of nerve damage myself, Im having a few drinks right now and when I hold the bottle (or something of equal weight) my hand shudders from the effort. I dread to think how shit id be at the weights

Edited by Centurion, 11 July 2009 - 05:52 PM.

[VespeneGas]

Some interesting in vitro research on magnesium:

In Vitro Evidence for Effects of Magnesium Supplementation on Quinolone-treated Horse and Dog Chondrocytes
M. Egerbacher, B. Wolfesberger and C. Gabler
Quinolones and magnesium deficiency cause similar lesions in joint cartilage of young animals. Chondrocytes cultivated in the presence of quinolones and in Mg-free medium show severe alterations in cytoskeleton and decreased ability to adhere to the culture dish. We investigated whether Mg²⁺ supplementation can prevent quinolone-mediated effects on chondrocytes in vitro. Chondrocytes cultivated in Dulbecco's modified Eagle's medium/HAM's F-12 medium were treated with ciprofloxacin (80 and 160 µg/ml) and enrofloxacin (100 and 150 µg/ml). Mg²⁺ was added at a concentration of 0.0612 mg/ml (MgCl) and 0.0488 mg/ml (MgSO₄) or a triple dose. In addition, cells were cultivated in Mg-free medium and accordingly treated with Mg²⁺ supplementation. After 5 days in culture, the number of adherent cells per milliliter was determined. The number of chondrocytes in quinolone-treated groups decreased to 12–36% that of the control group within the culture period. With Mg²⁺ supplementation, the number of attached cells increased to 40–70% that of control cells. The threefold dose of Mg²⁺ led to better results than did the single dose. Cell proliferation tested by immunohistochemical staining with Ki67 (clone MIB5) decreased from 70% in control groups to 55%, 48%, and 30% in enrofloxacin-treated groups in a concentration dependent manner (50, 100, and 150 µg/ml). Addition of Mg²⁺ did not increase the rate of cell proliferation. These results suggest that a great part of quinolone-induced damage is due to magnesium complex formation, as Mg²⁺ supplementation is able to reduce the effects in vitro. However, quinolone effects on cell proliferation seem to be an independent process that is not influenced by magnesium supplementation.




The chondrotoxic effect of quinolones, a group of very important antibacterial drugs in human and veterinary medicine, has been traced back to their ability to form chelate complexes with divalent cations, especially magnesium.^18,22 In vivo studies have shown that feeding a Mg-deficient diet to juvenile rats led to lesions in articular cartilage identical to those observed after quinolone treatment.^23,26,26 This finding was confirmed by in vitro studies, in which detachment of chondrocytes of different species and severe alteration of the cytoskeleton were observed after quinolone treatment; these changes were similar to those observed with cultivation of cells in Mg-free medium.^9–11,29 Lack of extracellular Mg²⁺ impairs the function of integrins.^7,20,21 These transmembrane proteins connect the cells to extracellular matrix (ECM) proteins, and their intracellular segment is linked to the cytoskeleton.^1,8,15 Integrins generate a proliferative response when stimulated by binding to ECM proteins such as fibronectin and regulate matrix protein synthesis and matrix-degrading enzyme production.^2,6 Results of in vitro studies of canine and rabbit articular cartilage (explants and monolayer culture) have suggested that quinolones inhibit glycosaminoglycan production, mitochondrial function, and DNA synthesis. It is not clear from these experiments whether observed changes are directly caused by quinolones or are a consequence of transmembrane signalling.^5,14,15,17

To explore whether or not Mg²⁺ supplementation could prevent quinolone-induced arthropathy, Stahlmann and coworkers found that a Mg²⁺ supplemented diet reduced the number of lesions in rats after quinolone treatment.²⁴ Addition of tocopherol to the diet improved the results significantly. The authors concluded that the lack of magnesium induces O₂ radical formation, which can be prevented by supplementation of vitamin E. Based on our previous studies, we tested the hypothesis that quinolones exert their effects by creating a Mg²⁺ deficiency. The prediction was that there would be a reversal of the negative effects by addition of magnesium to the cultures along with the drug. For that purpose, chondrocytes were cultivated in the presence of ciprofloxacin and enrofloxacin in Mg-free medium. Magnesium was added to test groups in two different concentrations. The number of cells and the cell proliferation rate after 5 days of culture was determined.

<h1 class="title">Integrins mediate the effects of quinolones and magnesium deficiency on cultured rat chondrocytes.</h1>Egerbacher M, Wolfesberger B, Walter I, Seirberl G.

Institute of Histology and Embryology, University of Veterinary Medicine, Vienna/Austria. monika.egerbacher@vu-wien.ac.at

Chondrocyte-matrix interaction is mediated by a series of adhesion molecules. Both alpha and beta integrin subunits are involved and govern crucial functions of cell adhesion and signal transduction. These molecules modulate proliferation and differentiation, thus establishing cartilage integrity. We studied the influence of magnesium deficiency and quinolone antibiotics (which form chelate complexes with divalent cations) on chondrocytes in vitro in order to assess the role of Mg2+ ions in integrin function and to establish cellular changes mediated via integrin signal transduction. Mg2(+)-free medium and quinolone supplementation was found to decrease chondrocyte attachment to collagen type II-coated coverslips. Adhesion and growth of chondrocytes were reduced in the respective medium. Organisation of cytoskeletal fibers (vimentin) was changed and formation of stress fibers (f-actin) was disturbed. Additionally, rates of cell proliferation declined. These results indicate that quinolone-magnesium complex formation is important for chondrotoxicity of these substances. Cell-matrix detachment and morphological alterations described in vitro may explain the lesions observed in articular cartilage after quinolone administration in vivo. The attachment assay described could serve as a simple test to establish the susceptibility of chondrocytes of different species to different quinolones in use or new ones to be introduced.

And in vivo:

Magnesium deficiency induces joint cartilage lesions in juvenile rats which are identical to quinolone-induced arthropathy.R Stahlmann, C Förster, M Shakibaei, J Vormann, T Günther, and H J Merker

Quinolones accumulate in cartilage, and because they form chelate complexes with divalent cations, they possess the potential to induce a deficiency of functionally available magnesium. To test the hypothesis that quinolone-induced arthropathy is caused (or aggravated) by magnesium deficiency in cartilage, we induced magnesium deficiency by feeding juvenile rats a magnesium-deficient diet for 9 days and treated the rats with single oral doses of ofloxacin (0, 100, 300, 600, or 1,200 mg/kg of body weight) during this period. Additional groups of juvenile rats on a normal diet were treated with ofloxacin correspondingly. Typical cartilage lesions (e.g., swollen matrix, cleft formation) were found in knee joints of all magnesium-deficient rats, including those without ofloxacin treatment. Lesions in these groups were not distinguishable from lesions induced by a single dose of 600 mg of ofloxacin per kg of body weight or higher in rats on a normal diet. Ofloxacin levels in plasma after 600 mg/kg of body weight were approximately 10-fold higher than those in humans during therapy with this quinolone. Lesions in rats treated with ofloxacin plus magnesium deficiency were more pronounced than those in rats with normal magnesium concentrations. After intake of a magnesium-deficient diet for 9 days, the magnesium concentration in serum (mean +/- standard deviation) was 0.18 +/- 0.05 mmol/liter (control on normal diet, 0.82 +/- 0.10 mmol/liter). Magnesium concentrations in bone (femur) and cartilage (processus xiphoideus) samples were 64.7 +/- 10.5 and 14.3 +/- 3.9 mmol/kg of dry weight, respectively, which corresponded to approximately 50% of the concentrations measured in controls on a normal diet. It was concluded that quinolone-induced arthropathy is probably caused by a deficit of available magnesium in joint cartilage due to the formation of quinolone-magnesium chelate complexes. If juvenile patients must be treated with quinolones for serious infections, it seems prudent to ensure that these patients do not have a disturbed magnesium balance.

CHANGES IN CARTILAGE OF RATS AFTER TREATMENT
WITH QUINOLONE AND IN MAGNESIUM-DEFICIENT DIET
M. Shakibaei1 and R. Stahlmann 2
1) Institute of Anatomy, Freie Universität Berlin, Berlin, Germany
2) Institute of Clinical Pharmacology and Toxicology, Benjamin Franklin Medical Center, Freie Universität
Berlin, Berlin, Germany

Abstract- Ultrastructural changes in immature articular cartilage were studied after treatment of 5-weeks-old rats with ofloxacin, a fluoroquinolone, and in magnesium deficiency. We concluded that quinolone-induced arthropathy is probably due to chelation of functionally available magnesium in joint cartilage as magnesium deficiency in joint cartilage could impair chondrocyte-matrix- interaction which is mediated by cation dependent integrin-receptors of the β1-subfamily. With immuno- histochemical methods using monoclonal and polyclonal antibodies we showed that B1 integrins were expressed in rat joint cartilage. Joint cartilage lesions were detected in ofloxacin-treated and magnesium-deficient rats. Lesions were more pronounced in the quinolone-treated group. Expression of several integrins was reduced in the vicinity of lesions after oral treatment with 2Ũ600 mg ofloxacin/kg body wt for one day. Gross-structural lesions (e.g. cleft formation, unmasked collagen fibres) in magnesium deficient rats were very similar but changes in integrin expression were less pronounced. Alterations observed on the ultrastructural level showed striking similarities in magnesium-deficient rats and in rats treated with single doses of 600 mg ofloxacin per kg body wt. Typical observations were: bundle shaped, electron- dense aggregates on the surface and in the cytoplasm of chondrocytes, detachement of the cell membrane from the matrix and necrotic chondrocytes, reduced synthesis and/or reduced of extracellular matrix and swelling of cell organelles such as mitochondria. The results of this study confirm our previously reported finding that quinolone-induced arthropathy probably is caused by a reduction of functionally available magnesium (ionized Mg2+) in cartilage. Furthermore, they provide a basis for aimed studies with human cartilage samples from quinolone-treated patients which might be available postmortal or after hip replacement surgery.
which might be available postmortal or after hip replacement surgery.

A LOT of my symptoms are consistent with magnesium deficiency:

1. constant involuntary muscle tension
2. poor stress tolerance, racing heart, irritability, anxiety
3. Hypertension, peripheral vasoconstriction nearly bad enough to induce Raynaud's phenomenon
4. Sleep disturbances, which are severely exacerbated by glycine (a cofactor in NMDA activation, which is normally tempered by Mg+2) and attenuated by gabapentin (among other things, a calcium channel blocker)
5. Connective tissue issues, to say the least
6. Fatigue, brain fog
7. Tinnitus, sensitivity to loud noises, asking people, "What?" more frequently
8. Constipation, anorexia
9. It's highly likely that I've been masking neuropathic pain with the trazodone I take for sleep

Now that I step back and look at myself, I'm kind of a textbook magnesium deficiency patient. I think I hadn't considered it before because I was taking 200 mg Mg citrate qd, but since the bottle ran out, I've been getting headaches (which I never used to get), worsening mood, and lower appetite. Looks like it's time to up my dosage.

In other news, a single 500 mg dose of 50% purity (I know, it was a gift) resveratrol induced pretty serious body-wide tendon pain. Similarities between quinolones and emodin have been discussed on these forums before, so I guess this might be a bit of evidence that the similarity is real WRT tendon issues, given that I'm intolerant of quinolones. YMMV.

How's the recover going, guys? I haven't heard from you in a while.

Edit: citation cleanup.

Edited by VespeneGas, 08 December 2009 - 08:20 PM.

[Matt]

I fully recovered, and by the way, i've had magneisum issues for years, I just HAVE to supplement it even if my diet has plenty. In saying that I was taking magnesium when I took the cipro.

All my tendons have healed, I gained 14 lbs of muscle, took over 2 years to get to this point. I had injuries everywhere over my body, I even injured myself from just taking off my jumper and that neck injury took about 6 months to heal. I forget how many ligament, muscle and tendon problems i had but it was ALL OVER. I can do anything I want now and i train all the time.

check out this new story
http://noquinolones....amp;thread=1666

Edited by Matt, 08 December 2009 - 08:38 PM.

[niner]

Wow, that's very interesting about the Mg deficiency. When I had Legionnaire's disease a couple years ago, I was treated with high dose IV Levaquin for a month. Despite a presumably magnesium-competent diet, my electrolyte readings kept showing Mg deficiency. They kept giving me Mag Oxide and checking my Mg levels. That went on the whole time I was there. It's probably a good thing someone spotted that; I didn't see any obvious flox symptoms, although I was pretty messed up so you never know. Anyway, that is really good to know; if you have to take a quinolone, and I sometimes do because I'm allergic to cephs and pens, then you should supplement Magnesium, probably at a higher than normal level. The remaining question is once the damage from lack of Mg is done, can you undo it by getting your Mg levels back up? I don't know.

[nameless]

Hmm... my doc is considering giving me one of the quinolines, although he is wary and really would prefer not to. If I do have to take it, what dose of magnesium would be recommended to take alongside with it?

Sleep disturbances, which are severely exacerbated by glycine (a cofactor in NMDA activation, which is normally tempered by Mg+2) and attenuated by gabapentin (among other things, a calcium channel blocker)

I've never heard of that before with glycine -- I thought it supposedly helped with sleep? Not that it ever improved my sleep (taken as mag glycinate). If taken near bedtime, it probably even made my sleep worse.

[Matt]

You cannot take magnesium within 2 hours or something before and after the drug. I know quinolones wont do harm for most people, but isn't there something else he can give you? :S

My insomnia (waking up every half hour all night, and usually taking 5 hours to fall to sleep) lasted about 4 months after first 250mg of cipro. Ummm, it never completely resolved until over a year later. Maybe sleep quality took around around 18 months to become completely normal.

We've had a few people that were unsure about taking a quinolone and ended up having a bad reaction. 2 or 3 I think, and also me. Maybe lifestyle has some impact on whether you're gonna react badly. I don't know!

I know that I will never take a quinolone again. They're the ultimate collagen destroying pro aging drug xD haha

Edited by Matt, 08 December 2009 - 09:22 PM.

[nameless]

My doc suspects I have bartonella (heel pain, shin pain and tickly symptoms), and the treatment options are somewhat limited. His first choice was Bactrim, which I had a horrible bad reaction too. Second is Rifampicin, which would be my preferred choice. But it doesn't play well with other medications. When the time comes, I'll check the liver pathways for it and my current medicines, and see if there is any possibility of using it. But Levaquin or Cipro are generally considered the best drugs (I think) for Bart. Just... as you are well aware, there are certain nasty side effects associated with them.

As for mag with a quinolone, I just meant taken daily, not at the same time. A lot of antibiotics can't be taken with minerals.

Edited by nameless, 08 December 2009 - 09:29 PM.

[niner]

My doc suspects I have bartonella (heel pain, shin pain and tickly symptoms), and the treatment options are somewhat limited. His first choice was Bactrim, which I had a horrible bad reaction too. Second is Rifampicin, which would be my preferred choice. But it doesn't play well with other medications. When the time comes, I'll check the liver pathways for it and my current medicines, and see if there is any possibility of using it. But Levaquin or Cipro are generally considered the best drugs (I think) for Bart. Just... as you are well aware, there are certain nasty side effects associated with them.

I'm in the same boat as you due to having a bad reaction to some of the alternative drugs. I would take 4-500 mg/day (elemental) of any mag compound except oxide, and as you already know, take it at least several hours away from the drug. It would be good to bear in mind that the number of doses of quinolones that have been given is measured in the millions, while the number of people who have had side effects is measured in the thousands, though perhaps double digit thousands. The side effects are so potentially bad that even though the odds of having them are frankly quite small, it is reasonable to be concerned. If you do see a bad reaction, stopping quickly would be very wise, and would probably result in damage that you would get over. (This doesn't answer the delayed reaction problem.) Taking oral steroids at the same time as the quinolone is a risk factor in having the reaction, and it may be possible to avoid this. So if you have to take quinolones:

Bear in mind the odds of a bad reaction are very small.
Take magnesium.
Don't take oral corticosteroids.
Stop at the first sign of a flox reaction.

[Matt]

dont go in the sun.

I think that the damage is actually under estimated, especially for tendon related problems. People just don't connect it with antibiotics they took months or a year ago. But I also think that for the majority of people they are safe. Even though they totally wrecked my life for a couple years Im just weird. o.O

Let us know how it goes, will probably be fine!

[VespeneGas]

If you can avoid it, don't take a fluoroquinolone. I know the odds of a reaction are low, but trust me, they're no fun, and quite persistent (it's been approximately 1 year for me, only marginal improvement in mobility, pain, sleep, and tinnitus).

If you must take one, cosupplement with a vitamin E complex and CoQ10, and a ton of magnesium. Avoid corticosteroids and NSAIDs as they may increase the risk of tendon rupture. Constantly, and with great paranoia, monitor yourself for any hearing, vision, sleep, muscular, tendon, joint, or gastrointestinal changes... I've probably missed something, just stop taking those bloody pills if anything bad starts to happen.

I was on the fence, took them, and felt dumb. Hopefully replenishing my (suspected) depleted magnesium stores will improve some symptoms, though I doubt I'll see miracles.

[nameless]

Thanks for the feedback. I'll look into Rifampicin instead, although I really suspect I can't take it due to the fact I take too many other meds (too many interactions). And there really are no alternatives that I'm aware of except a quinolone.

Are any of the quinolones less likely to cause side effects than others? I recall reading some Bart people using Factive + Zithro instead of Levaquin, and getting good results. Factive is a quinolone, but I'm not sure which cause more symptoms than others.

Regardless, I have some time to decide. My doc plans to treat it last, so it may be several months still.

Edited by nameless, 09 December 2009 - 02:29 AM.

[Matt]

I think its Cipro which is less likely to cause the most damage. Maybe what happened to a few of us here really is rare, but its a difficult problem to deal with if you get hit. Didn't know which was worse. CNS damage, PNS damage, connective tissue damage, eye damage, hearing damage... I think most symptoms I had was caused by autonomic nervous system neuropathy though. At times one half of my body would go completely numb! no feeling at all, also my mouth went completely dry for months, my nose, my eyes and my ears bla bla bla. I even developed constant wrinkly finger tips, hands and feet that lasted 18 months! Might be from nerve damage causing dryness. all normal now

Good luck

of course remember, my experience isn't typical.

Edited by Matt, 09 December 2009 - 04:38 AM.

[Matt]

documentary about quinolones on youtube. It gets better from part 2...
Also other videos :-)

Edited by Matt, 09 December 2009 - 04:53 AM.

[ctooraen]

To Whom It May Concern,

 

Currently I am in pretty bad shape. My story is unfortunately similar to many that have taken Cipro, Levaquin, Avelox, and many other Fluoroquinolone antibiotics. All started in June of this year with a kidney stone. Previous to this, I have been an active, healthy individual with virtually no health issues other than a couple bad stomach bugs, over the years. I have not had a flu shot in 20 years. Have not had any major illness ever. I worked 14 hour days in the southern New Mexico oil fields for Halliburton as a Tech. Keep an entire production and stimulation crew running. After that I was managing 40 oil wells for Concho, the largest oil producer in the state. Great job, great friends, had a good life. Little did I know.........

 

From June to September of 2013 I had 4 kidney stone attacks. The 4th one ended with me getting lithotripsy to remove the stone. Levaquin IV was given preoperative and week followup of cipro 500 mg 2x day. All was fine then had the stent removed during outpatient procedure. Single 500 mg cipro dose given then. After this all was good for about a week. Then started having groin pain for about 3 weeks. Dr did another outpatient cytoscopy and said all was fine. Another single 500 mg dose of cipro. Still had pain. So doc did prostate exam and found elevated white blood cells. No culture was done. Script was 500 mg 2x day of cipro for 6 weeks. No help with pain. Dr added sulindac NSAID to help. 12/7 had another surgery performed to make sure no small stones or strictures were present. None found. More preoperative Levaquin given via IV. About a week later started feeling better. I knew of risk factors with cipro and was paying attention to them. On 12/28. Noticed tight muscles in my calves and by next morning the burning in my legs began. Stopped taking cipro that day. Dr said that cipro could cause the muscle issues but did not know of issues with neuropathy. So now 8 months out I have insomnia, peripheral neuropathy, tinnitus, cognitive dysfunction, suicidal thoughts, depression, some anxiety, and mild depersonalization, chronic fatigue, dye eyes and ears, dry mouth, intolerance to heat and cold. Cold hands and feet, improper sweating. Gi motility dysfunction, lost 30 lbs so far. 

 

Cannot work, cannot sleep, cannot walk correctly somedays, cannot care for myself. My spouse now does 90 percent of the work for both of us. I spend most of days in bed. This issue has created a lot of stress and depression not only for me, but for my entire family, which now has to help me with many aspects of my life. The uncertainty of recovery also plays a large role in my overall stress/anxiety level. 

 

Now it's October of 2014. Been to Mayo, University of Washington, The Peripheral Nerve Clinic, and Anderson Specialty Medical Clinic, and Progressive Medical Center in Atlanta so far. Tried IV Therapy, supplements, vitamins, Physical Therapy, Analgesic Nerve Therapy, etc. Had almost every test imaginable. MRI, CT Scans, Blood tests, autonomic tests. Have more tests coming. So far, not much of any improvement. Some better with sleep, but still lots of visual issues, PN, and tinnitus. Anxiety is not bad, tendinopathy is better, and some slow improvements in GI function, but have bad relapses every couple weeks. Have spend 10's of thousands of dollars, not including insurance paid costs, for treatments, supplements, travel, etc.

 

There are reports that many of the symptoms are tied to mitochondrial dysfunction and autonomic system dysfunction. I have added a file outlining the new request to the FDA about the dangers of Mitochondrial toxicity caused by fluoroquinolones. Mito dysfunction causes an entire cascade effect and creates a vicious circle of ROS and cell apoptosis. I could kill you with the technical details regarding NO/OONO cycles, Electron Transport Chain, oxidative phosphorylation, anerobic cell respiration, etc, but I have posted some references at this end of this email.

 

I just want people to know what many practitioners, do not tell you when they give you drugs. There is no INFORMED CONSENT, no consultation, no nothing, they usually just give you a pill and send you home. They leave it up to you to find out what the pill may do to you. For me, I have never had issues with any drugs, especially an antibiotic, so I trusted the Dr to know what he was doing. Now I am screwed up permanently. Please just do your homework and make sound decisions before you trust your health to someone else. 

 

I totally understand that not all doctors are idiots. Actually, I have met quite a few that are very good, and informed, so I don't fault the entire medical profession. I do however blame the "system" we have, that promotes 15 minute DR visits, insurance companies that deny claims based on cost/benefit analysis, regardless of what the best interests of the patient, or if the doctor deems a procedure necessary. There is too much emphasis on costs, not the care of the patient. Both insurance and the medical profession are to blame. Case in point when I had my tests done at Progressive Med Center in Atlanta, the cost to the insurance company was 13K. My costs for the same tests if I was paying for them was 3K...... 

 

I also see that responsibility lies in the realm of the patient, and society to a certain degree. Many people in our time, either are not patient enough to allow an illness to take it's time pass, or just (due to the demands that society puts on us), don't have the time to wait for an illness to pass. So they come in to doctors office and demand a quick fix. "Don't you have a pill for that" is a common phrase that comes to mind. So doctors are trained to make sure a person is not dying, run some labs and based on lab results, prescribe a bill recommended by the companies that make the pill. Look at how many pharmaceutical commercials you see now. 

 

Not that long ago, in many cases, doctors would prescribe things less noxious, and or would recommend diet and lifestyle changes to help with issues we had. Now it's 10 minutes in the office, a few cursory glances, and a script. Some of this is simply dictated by the insurance company and what they will pay for office visits. 

 

Case in point, my urologist did not even culture my EPS, just looked under a scope and said "WBC count high, consistent with infection" and loaded me up with cipro, no consult, no warning, no nothing. I am not a doctor and I know that high WBC can also be due to inflammation, not related to infection. I was in pain, and suffering after the surgery for months, and I attributed it to the surgery, and maybe infection, so I keep taking the crap, not realizing that it was in fact most likely the cause for my symptoms. By the time my legs went out on me, it was too late. So now I am a prisoner in my own house, bound to the recliner. I am lucky as my spouse takes good care of me, but she is very stressed trying to keep it all together. 

 

Don't get me wrong, I do think these kinds of antibiotics are useful, and in some cases are the the only option, but doctors really need to be more informed of the dangers. I cannot tell you how many doctors have no idea of the adverse affects this class of antibiotics can cause. Secondly they need to make sure the patient is fully aware of the possible issues they could have with these drugs and that all other options have been tried before hand. 

 

If I was a practitioner, I would be damn certain a person needed a fluoroquinolone, and I have exhausted all other options before prescribing it. Then if needed, informed consent to the patient would be mandatory, and I would have weekly follow up and labs done to ensure they were responding well to the drugs. Of course the minimum dosage and duration would be paramount. 

 

Here are some links that further describe what has happened to me, and thousands of others.

 

www.ncbi.nlm.nih.gov/pmc/articles/PMC3760005/

www.ncbi.nlm.nih.gov/pmc/articles/PMC2094848/

www.facebook.com/FluoroquinoloneToxicity

en.wikipedia.org/wiki/Adverse_effects_of_fluoroquinolones

well.blogs.nytimes.com/2012/09/10/popular-antibiotics-may-carry-serious-side-effects/?_php=true&_type=blogs&_r=0

fda.gov/Drugs/DrugSafety/ucm365050.htm

survivingcipro.com/

floxiehope.com/

www.facebook.com/pages/The-Fluoroquinolone-Wall-of-Pain/209182505773463

 

All the Best,

Charles Tooraen